Therapeutic effect of acupuncture combining standard swallowing training for post-stroke dysphagia: A prospective cohort study.

PubMed

Mao, Li-Ya; Li, Li-Li; Mao, Zhong-Nan; Han, Yan-Ping; Zhang, Xiao-Ling; Yao, Jun-Xiao; Li, Ming

2016-07-01

To assess the therapeutic effect of acupuncture combining standard swallowing training for patients with dysphagia after stroke. A total of 105 consecutively admitted patients with post-stroke dysphagia in the Affiliated Hospital of Gansu University of Chinese Medicine were included: 50 patients from the Department of Neurology and Rehabilitation received standard swallowing training and acupuncture treatment (acupuncture group); 55 patients from the Department of Neurology received standard swallowing training only (control group). Participants in both groups received 5-day therapy per week for a 4-week period. The primary outcome measures included the scores of Videofluoroscopic Swallow Study (VFSS) and the Standardized Swallowing Assessment (SSA); the secondary outcome measure was the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), all of which were assessed before and after the 4-week treatment. A total of 98 subjects completed the study (45 in the acupuncture group and 53 in the control group). Significant differences were seen in VFSS, SSA and RBHOMS scores in each group after 4-week treatment as compared with before treatment (P<0.01). Comparison between the groups after 4-week treatment showed that the VFSS P=0.007) and SSA scores (P=0.000) were more significantly improved in the acupuncture group than the control group. However, there was no statistical difference (P=0.710) between the acupuncture and the control groups in RBHOMS scores. Acupuncture combined with the standard swallowing training was an effective therapy for post-stroke dysphagia, and acupuncture therapy is worth further investigation in the treatment of post-stroke dysphagia.

A videotape intervention to enhance the informed consent process for medical and psychiatric treatment research.

PubMed

Wirshing, Donna A; Sergi, Mark J; Mintz, Jim

2005-01-01

This study evaluated a brief educational video designed to enhance the informed consent process for people with serious mental and medical illnesses who are considering participating in treatment research. Individuals with schizophrenia who were being recruited for ongoing clinical trials, medical patients without self-reported psychiatric comorbidity, and university undergraduates were randomly assigned to view either a highly structured instructional videotape about the consent process in treatment research or a control videotape that presented only general information about bioethical issues in human research. Knowledge about informed consent was measured before and after viewing. Viewing the experimental videotape resulted in larger gains in knowledge about informed consent. Standardized effect sizes were large in all groups. The videotape was thus an effective teaching tool across diverse populations, ranging from individuals with severe chronic mental illness to university undergraduates.

40 CFR 268.35 - Waste specific prohibitions-petroleum refining wastes.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Prohibitions on Land Disposal § 268.35 Waste... contaminated with these radioactive mixed wastes, are prohibited from land disposal. (b) The requirements of... Universal Treatment Standard levels of § 268.48, the waste is prohibited from land disposal, and all...

40 CFR 268.35 - Waste specific prohibitions-petroleum refining wastes.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Prohibitions on Land Disposal § 268.35 Waste... contaminated with these radioactive mixed wastes, are prohibited from land disposal. (b) The requirements of... Universal Treatment Standard levels of § 268.48, the waste is prohibited from land disposal, and all...

40 CFR 268.35 - Waste specific prohibitions-petroleum refining wastes.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Prohibitions on Land Disposal § 268.35 Waste... contaminated with these radioactive mixed wastes, are prohibited from land disposal. (b) The requirements of... Universal Treatment Standard levels of § 268.48, the waste is prohibited from land disposal, and all...

40 CFR 268.35 - Waste specific prohibitions-petroleum refining wastes.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Prohibitions on Land Disposal § 268.35 Waste... contaminated with these radioactive mixed wastes, are prohibited from land disposal. (b) The requirements of... Universal Treatment Standard levels of § 268.48, the waste is prohibited from land disposal, and all...

40 CFR 268.35 - Waste specific prohibitions-petroleum refining wastes.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Prohibitions on Land Disposal § 268.35 Waste... contaminated with these radioactive mixed wastes, are prohibited from land disposal. (b) The requirements of... Universal Treatment Standard levels of § 268.48, the waste is prohibited from land disposal, and all...

40 CFR 268.48 - Universal treatment standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Endosulfan sulfate 1031-07-8 0.029 0.13 Endrin 72-20-8 0.0028 0.13 Endrin aldehyde 7421-93-4 0.025 0.13 Ethyl... Methyl ethyl ketone 78-93-3 0.28 36 Methyl isobutyl ketone 108-10-1 0.14 33 Methyl methacrylate 80-62-6 0...

40 CFR 268.48 - Universal treatment standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Endosulfan sulfate 1031-07-8 0.029 0.13 Endrin 72-20-8 0.0028 0.13 Endrin aldehyde 7421-93-4 0.025 0.13 Ethyl... Methyl ethyl ketone 78-93-3 0.28 36 Methyl isobutyl ketone 108-10-1 0.14 33 Methyl methacrylate 80-62-6 0...

40 CFR 268.48 - Universal treatment standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Endosulfan sulfate 1031-07-8 0.029 0.13 Endrin 72-20-8 0.0028 0.13 Endrin aldehyde 7421-93-4 0.025 0.13 Ethyl... Methyl ethyl ketone 78-93-3 0.28 36 Methyl isobutyl ketone 108-10-1 0.14 33 Methyl methacrylate 80-62-6 0...

Extravasation injuries: current medical and surgical treatment.

PubMed

Doornaert, M; Monstrey, S; Roche, N

2013-01-01

Extravasation is a devastating complication of intravenous therapy that develops when a drug infiltrates the interstitial tissue surrounding the vein. Due to the uncertain and possibly dramatic outcome, early recognition and adequate treatment with the aid of a standardized protocol are needed. A pubmed literature search was conducted and all relevant articles were reviewed for the development of an extravasation treatment protocol. An overview of current treatment guidelines and clinical experience is provided. The extravasation treatment protocol was implied during 1 year in this university hospital with satisfactory outcome. Treatment starts with prevention. In case of an established extravasation injury, early recognition, assessment of severity, and treatment with medical and/or surgical therapies are recommended.

Intravenous immunoglobulin treatment of the complex regional pain syndrome: a randomized trial.

PubMed

Goebel, Andreas; Baranowski, Andrew; Maurer, Konrad; Ghiai, Artemis; McCabe, Candy; Ambler, Gareth

2010-02-02

Treatment of long-standing complex regional pain syndrome (CRPS) is empirical and often of limited efficacy. Preliminary data suggest that the immune system is involved in sustaining this condition and that treatment with low-dose intravenous immunoglobulin (IVIG) may substantially reduce pain in some patients. To evaluate the efficacy of IVIG in patients with longstanding CRPS under randomized, controlled conditions. A randomized, double-blind, placebo-controlled crossover trial. (National Research Registry number: N0263177713; International Standard Randomised Controlled Trial Number Registry: 63918259) University College London Hospitals Pain Management Centre. Persons who had pain intensity greater than 4 on an 11-point (0 to 10) numerical rating scale and had CRPS for 6 to 30 months that was refractory to standard treatment. IVIG, 0.5 g/kg, and normal saline in separate treatments, divided by a washout period of at least 28 days. The primary outcome was pain intensity 6 to 19 days after the initial treatment and the crossover treatment. 13 eligible participants were randomly assigned between November 2005 and May 2008; 12 completed the trial. The average pain intensity was 1.55 units lower after IVIG treatment than after saline (95% CI, 1.29 to 1.82; P < 0.001). In 3 patients, pain intensity after IVIG was less than after saline by 50% or more. No serious adverse reactions were reported. The trial was small, and recruitment bias and chance variation could have influenced results and their interpretation. IVIG, 0.5 g/kg, can reduce pain in refractory CRPS. Studies are required to determine the best immunoglobulin dose, the duration of effect, and when repeated treatments are needed. Association of Anaesthetists of Great Britain and Ireland, University College London Hospitals Charity, and CSL-Behring.

[An investigation for standardized diagnosis and treatment of idiopathic normal-pressure hydrocephalus].

PubMed

Jiang, H J; Zhang, J M; Fu, W M; Zheng, Z; Luo, W; Zheng, Y X; Zhu, J M

2016-06-07

To investigate some important issues for diagnosis and treatment of idiopathic normal-pressure hydrocephalus (iNPH), such as standardized pre-operative assessment, initial pressure value of diverter pump, and pressure regulation during follow-up. Twenty six iNPH patients (21 males) who treated in Department of Neurosurgery of 2nd Affiliated Hospital of Zhejiang University School of Medicine from 2011 to 2015 were analyzed retrospectively. The average age was 60.5 year. The analysis focused on the treatment process of iNPH, initial pressure value of diverter pump, choice of diverter pump, and pressure regulation during follow-up. As a result, 24 cases (92.3%) had a good prognosis based on their imaging and clinical manifestations. Based on the literature and their clinical experiences, this department established a diagnosis and treatment procedure of iNPH and a pressure regulation procedure for the follow-up of iNPH. Moreover, it is proposed that choosing an anti-gravity diverter pump and making an initial pressure value 20 mmH2O less than pre-surgical cerebrospinal pressure may be beneficial for the prognosis. This standardized diagnosis and treatment procedure for iNPH is practical and effective.

Creation of a bovine herpes virus 1 (BoHV-1) quantitative particle standard by transmission electron microscopy and comparison with established standards for use in real-time PCR.

PubMed

Hoferer, Marc; Braun, Anne; Sting, Reinhard

2017-07-01

Standards are pivotal for pathogen quantification by real-time PCR (qPCR); however, the creation of a complete and universally applicable virus particle standard is challenging. In the present study a procedure based on purification of bovine herpes virus type 1 (BoHV-1) and subsequent quantification by transmission electron microscopy (TEM) is described. Accompanying quantitative quality controls of the TEM preparation procedure using qPCR yielded recovery rates of more than 95% of the BoHV-1 virus particles on the grid used for virus counting, which was attributed to pre-treatment of the grid with 5% bovine albumin. To compare the value of the new virus particle standard for use in qPCR, virus counter based quantification and established pure DNA standards represented by a plasmid and an oligonucleotide were included. It could be shown that the numbers of virus particles, plasmid and oligonucleotide equivalents were within one log10 range determined on the basis of standard curves indicating that different approaches provide comparable quantitative values. However, only virus particles represent a complete, universally applicable quantitative virus standard that meets the high requirements of an RNA and DNA virus gold standard. In contrast, standards based on pure DNA have to be considered as sub-standard due to limited applications. Copyright © 2017 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR TREATMENT OF CENSORED DATA (IIT-A-4.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to treat censored data which are below detection limits. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by the University of Arizona NHEXAS and Battelle Laboratorie...

From Expert Protocols to Standardized Management of Infectious Diseases.

PubMed

Lagier, Jean-Christophe; Aubry, Camille; Delord, Marion; Michelet, Pierre; Tissot-Dupont, Hervé; Million, Matthieu; Brouqui, Philippe; Raoult, Didier; Parola, Philippe

2017-08-15

We report here 4 examples of management of infectious diseases (IDs) at the University Hospital Institute Méditerranée Infection in Marseille, France, to illustrate the value of expert protocols feeding standardized management of IDs. First, we describe our experience on Q fever and Tropheryma whipplei infection management based on in vitro data and clinical outcome. Second, we describe our management-based approach for the treatment of infective endocarditis, leading to a strong reduction of mortality rate. Third, we report our use of fecal microbiota transplantation to face severe Clostridium difficile infections and to perform decolonization of patients colonized by emerging highly resistant bacteria. Finally, we present the standardized management of the main acute infections in patients admitted in the emergency department, promoting antibiotics by oral route, checking compliance with the protocol, and avoiding the unnecessary use of intravenous and urinary tract catheters. Overall, the standardization of the management is the keystone to reduce both mortality and morbidity related to IDs. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Periodontal Management by Risk Assessment: A Pragmatic Approach.

PubMed

Mullins, Joanna M; Even, Joshua B; White, Joel M

2016-06-01

An evidence-based periodontal disease risk assessment and diagnosis system has been developed and combined with a clinical decision support and management program to improve treatment and measure patient outcomes. There is little agreement on a universally accepted periodontal risk assessment, periodontal diagnosis, and treatment management tool and their incorporation into dental practice to improve patient care. This article highlights the development and use of a practical periodontal management and risk assessment program that can be implemented in dental settings. The approach taken by Willamette Dental Group to develop a periodontal disease risk assessment, periodontal diagnosis, and treatment management tool is described using evidence-based best practices. With goals of standardized treatment interventions while maintaining personalized care and improved communication, this process is described to facilitate its incorporation into other dental settings. Current electronic health records can be leveraged to enhance patient-centered care through the use of risk assessments and standardized guidelines to more effectively assess, diagnose, and treat patients to improve outcomes. Dental hygienists, and other committed providers, with their emphasis on prevention of periodontal disease can be principal drivers in creation and implementation of periodontal risk assessments and personalized treatment planning. Willamette Dental Group believes that such evidence-based tools can advance dentistry to new diagnostic and treatment standards. Copyright © 2016 Elsevier Inc. All rights reserved.

Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

PubMed

Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

2018-02-09

Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P < 0.01). Chart design did support neither clinical authorization of individual insulin prescription (10%), nor insulin administration confirmed by nurses' signature (25%), nor treatment of hypoglycemia (0%), which resulted in a reduced documentation and treatment quality in clinical practice 7%, 30%, 25%, respectively. A multitude of charts with variable design characteristics and structural deficits were in use across the inpatient wards. More than half of the inpatients had a chart displaying a medication error. Lack of structure quality features of the charts had an impact on documentation and treatment quality. Based on identified deficits and international standards, a new insulin chart was developed to overcome these quality hurdles.

Wastewater Treatment Costs and Outlays in Organic Petrochemicals: Standards Versus Taxes With Methodology Suggestions for Marginal Cost Pricing and Analysis

NASA Astrophysics Data System (ADS)

Thompson, Russell G.; Singleton, F. D., Jr.

1986-04-01

With the methodology recommended by Baumol and Oates, comparable estimates of wastewater treatment costs and industry outlays are developed for effluent standard and effluent tax instruments for pollution abatement in five hypothetical organic petrochemicals (olefins) plants. The computational method uses a nonlinear simulation model for wastewater treatment to estimate the system state inputs for linear programming cost estimation, following a practice developed in a National Science Foundation (Research Applied to National Needs) study at the University of Houston and used to estimate Houston Ship Channel pollution abatement costs for the National Commission on Water Quality. Focusing on best practical and best available technology standards, with effluent taxes adjusted to give nearly equal pollution discharges, shows that average daily treatment costs (and the confidence intervals for treatment cost) would always be less for the effluent tax than for the effluent standard approach. However, industry's total outlay for these treatment costs, plus effluent taxes, would always be greater for the effluent tax approach than the total treatment costs would be for the effluent standard approach. Thus the practical necessity of showing smaller outlays as a prerequisite for a policy change toward efficiency dictates the need to link the economics at the microlevel with that at the macrolevel. Aggregation of the plants into a programming modeling basis for individual sectors and for the economy would provide a sound basis for effective policy reform, because the opportunity costs of the salient regulatory policies would be captured. Then, the government's policymakers would have the informational insights necessary to legislate more efficient environmental policies in light of the wealth distribution effects.

Autologous platelet-rich gel for treatment of diabetic chronic refractory cutaneous ulcers: A prospective, randomized clinical trial.

PubMed

Li, Lan; Chen, Dawei; Wang, Chun; Yuan, Nanbing; Wang, Yan; He, Liping; Yang, Yanzhi; Chen, Lihong; Liu, Guanjian; Li, Xiujun; Ran, Xingwu

2015-01-01

The purpose of the study is to examine the safety and effectiveness of topical autologous platelet-rich gel (APG) application on facilitating the healing of diabetic chronic refractory cutaneous ulcers. The study was designed as a prospective, randomized controlled trial between January 1, 2007 and December 31, 2011. Eligible inpatients at the Diabetic Foot Care Center of West China Hospital, Sichuan University (China) were randomly prescribed with a 12-week standard treatment of ulcers (the control group) or standard treatment plus topical application APG (the APG group). The wound healing grades (primary endpoint), time to complete healing, and healing velocity within 12 weeks were monitored as short-term effectiveness measurements, while side effects were documented safety endpoints. The rates of survival and recurrence within the follow up were recorded as long-term effectiveness endpoints. Analysis on total diabetic ulcers (DUs) (n = 117) and subgroup analysis on diabetic foot ulcers (DFUs) (n = 103) were both conducted. Standard treatment plus APG treatment was statistically more effective than standard treatment (p < 0.05 in both total DUs and subgroup of DFUs). The subjects defined as healing grade 1 were 50/59 (84.8%) in total DUs and 41/48 (85.4%) in DFUs in the APG group compared with 40/58 (69.0%) and 37/55 (67.3%) in the control group from intent to treat population. The Kaplan-Meier time-to-healing were significantly different between the two groups (p < 0.05 in both total DUs and subgroup of DFUs). No side effects were identified after topical APG application. The long-term survival and recurrence rates were comparative between groups (p > 0.05). This study shows that topical APG application plus standard treatment is safe and quite effective on diabetic chronic refractory cutaneous ulcers, compared with standard treatment. © 2015 by the Wound Healing Society.

77 FR 60373 - Advisory Committee on Universal Cotton Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... on Universal Cotton Standards AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of Re-establishment of the U.S. Department of Agriculture (USDA) Advisory Committee on Universal Cotton Standards and...- establish the Advisory Committee on Universal Cotton Standards (Committee). The Committee is necessary and...

The Development of a Dental Diagnostic Terminology

PubMed Central

Kalenderian, Elsbeth; Ramoni, Rachel L.; White, Joel M.; Schoonheim-Klein, Meta E.; Stark, Paul C.; Kimmes, Nicole S.; Zeller, Gregory G.; Willis, George P.; Walji, Muhammad F.

2011-01-01

There is no commonly accepted standardized terminology for oral diagnoses. The purpose of this article is to report the development of a standardized dental diagnostic terminology by a work group of dental faculty members. The work group developed guiding principles for decision making and adhered to principles of terminology development. The members used an iterative process to develop a terminology incorporating concepts represented in the Toronto/University of California, San Francisco/Creighton University and International Classification of Diseases (ICD)-9/10 codes and periodontal and endodontic diagnoses. Domain experts were consulted to develop a final list of diagnostic terms. A structure was developed, consisting of thirteen categories, seventy-eight subcategories, and 1,158 diagnostic terms, hierarchically organized and mappable to other terminologies and ontologies. Use of this standardized diagnostic terminology will reinforce the diagnosis-treatment link and will facilitate clinical research, quality assurance, and patient communication. Future work will focus on implementation and approaches to enhance the validity and reliability of diagnostic term utilization. PMID:21205730

78 FR 29111 - Notice of Meeting of Advisory Committee on Universal Cotton Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... of Advisory Committee on Universal Cotton Standards AGENCY: Agricultural Marketing Service, USDA... the Advisory Committee on Universal Cotton Standards (Committee). The Committee is being convened to recommend to the Secretary of Agriculture any changes considered necessary to the Universal Cotton Standards...

Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

PubMed

Liu, Shan; Cipriano, Lauren E; Holodniy, Mark; Goldhaber-Fiebert, Jeremy D

2013-01-01

No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments. A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening) and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B) triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy). Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars) and quality adjusted life-years (QALYs). Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY. The cost-effectiveness of one-time birth-cohort hepatitis C screening for 40-64 year olds is comparable to other screening programs, provided that the healthcare system has sufficient capacity to deliver prompt treatment and appropriate follow-on care to many newly screen-detected individuals.

7 CFR 28.106 - Universal cotton standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Universal cotton standards. 28.106 Section 28.106... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.106 Universal cotton standards. Whenever any of the official cotton...

7 CFR 28.106 - Universal cotton standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Universal cotton standards. 28.106 Section 28.106... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.106 Universal cotton standards. Whenever any of the official cotton...

7 CFR 28.106 - Universal cotton standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Universal cotton standards. 28.106 Section 28.106... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.106 Universal cotton standards. Whenever any of the official cotton...

7 CFR 28.106 - Universal cotton standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Universal cotton standards. 28.106 Section 28.106... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.106 Universal cotton standards. Whenever any of the official cotton...

7 CFR 28.106 - Universal cotton standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Universal cotton standards. 28.106 Section 28.106... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.106 Universal cotton standards. Whenever any of the official cotton...

The Impact of Participation in Freshman Learning Communities on Student Academic Achievement and Retention at One College

ERIC Educational Resources Information Center

Roark, Deborah Jo

2013-01-01

This research study was specifically designed to examine the relationship of a learning communities program, as a standard treatment effect, on the academic performance and retention of college freshmen during the Fall 2008 through Fall 2011 academic semesters, and specifically for a university comprised of higher levels of underrepresented…

Turbidimetric Analysis of Water and Wastewater Samples Using a Spectrofluorimeter

NASA Astrophysics Data System (ADS)

Evans, Jason J.

2000-12-01

As student interest in environmental science grows, many colleges and universities are developing new courses in environmental chemistry. Environmental analysis in the "real world" has become increasingly instrumental, and it is important to introduce students to the instruments and procedures that are commonly used in environmental laboratories. Turbidimetric analysis of water and wastewater is ordinarily performed in environmental laboratories using a nephelometer. This experiment illustrates that a spectrofluorimeter can be successfully employed for these types of analysis. Samples from various stages of the water and wastewater treatment processes were collected from the Carlisle Water and Wastewater Treatment Plants. The students in our Environmental Chemistry laboratory used the spectrofluorimeter to measure the scattering intensity from the samples and from a series of formazine standards. The standard curve produced from their data gave a correlation coefficient of .999, and the detection limit was 0.03 Standard Turbidity Units, which is sufficient to obtain meaningful data on most water samples. This experiment was an excellent supplement to lecture material covering water and wastewater treatment because the students were able to monitor the level of suspended particulates in the water as it makes its way through the treatment plants.

[The International Standards for Tuberculosis Care (ISTC): what is the importance for Japan?].

PubMed

Fujiwara, Paula I

2008-07-01

In 2005, the World Health Assembly resolved that all Member States should ensure that all persons with tuberculosis (TB) "have access to the universal standard of care based on proper diagnosis, treatment and reporting consistent with the DOTS strategy..." The purpose of the International Standards for Tuberculosis Care (ISTC) is to define the widely accepted level of care of persons either suspected of, or diagnosed with, TB by all health practitioners, especially those in the private sector, who often lack guidance and systematic evaluation of outcomes provided by government programs. Since their publication in 2006 on World TB Day, the standards have been endorsed by the major international health organizations as well as many country-level professional societies. The intention is to complement local and national control polices consistent with those of the World Health Organization: they are not intended to replace local guidelines, but are written to accommodate local differences in practice. The ISTC comprise seventeen evidence-based standards on tuberculosis diagnosis and treatment, as well as the responsibility of the public health sector. These are based on the basic principles of TB care: prompt and accurate diagnosis, standardized treatment regimens of proven efficacy, appropriate treatment support and supervision, monitoring of response to treatment and the carrying out of essential public health responsibilities. The relevance of the ISTC to the Japanese context is highlighted, in terms of when persons should be suspected of TB; the appropriate diagnostic modalities, including the use of chest radiographs; the advantages of fixed dose combinations; the importance of follow-up laboratory tests to document response to treatment, the importance of recordkeeping and reporting to public health authorities, the value of HIV testing of TB patients and the use of anti-retrovirals for those dually infected; and the assessment of drug resistance and the appropriate treatment of multidrug-resistant tuberculosis. Finally, some proposals were made on the way forward for Japan.

Assessing the clinical effectiveness of an algorithmic approach for mucosal lichen planus (MLP): A retrospective review.

PubMed

Ashack, Kurt A; Haley, Laura L; Luther, Chelsea A; Riemer, Christie A; Ashack, Richard J

2016-06-01

Mucosal lichen planus (MLP) is a therapeutic challenge in need of a new treatment approach because of its debilitating effect on patient's quality of life. We sought to evaluate a standardized treatment plan for patients with MLP. A second objective was to describe the effect of mycophenolate mofetil in this patient population. The study retrospectively analyzed 53 patients with MLP treated using a standardized algorithm. The number of MLP lesions, disease activity, and pain at the last visit were compared with baseline scores determined at the initial visit. Results were analyzed using the paired samples t test and confirmed with the Wilcoxon matched pairs signed rank test. The average number of lesions was reduced from 3.77 to 1.67 (P < .001). The average disease activity was reduced from 2.73 to 0.90 (P < .001). Average pain reported decreased from 2.03 to 1.03 (P < .001). This study was a retrospective analysis of a small patient population. There was no universal symptom severity scale used at the time of treatment for some patients. The standardized treatment plan reduced symptoms for patients with MLP. Mycophenolate mofetil appears to be a reasonable treatment option for these patients. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Clinical efficacy of telemedicine in emergency radiotherapy for malignant spinal cord compression.

PubMed

Hashimoto, S; Shirato, H; Kaneko, K; Ooshio, W; Nishioka, T; Miyasaka, K

2001-09-01

The authors developed a Telecommunication-HElped Radiotherapy Planning and Information SysTem (THERAPIST), then estimated its clinical benefit in radiotherapy in district hospitals where consultation with the university hospital was required. The system consists of a personal computer with an image scanner and a digital camera, set up in district hospitals and directly connected via ISDN to an image server, and a treatment planning device set up in a university hospital. Image data and consultative reports are sent to the server. Radiation oncologists at the university hospital determine a treatment schedule and verify actual treatment fields. From 1998 to 1999, 12 patients with malignant spinal cord compression (MSCC) were treated by emergency radiotherapy with the help of this system. Image quality, transmission time, and cost benefit also were satisfactory for clinical use. The mean time between the onset of symptoms and the start of radiotherapy was reduced significantly from 7.1 days to 0.8 days (P < .05) by the introduction of the system. Five of 6 nonambulant patients became ambulant after the introduction of THERAPIST compared with 2 of 8 before the introduction of THERAPIST. The treatment outcome was significantly better after the introduction of the system (P < .05), and suggested to be beyond the international standard. The telecommunication-helped radiotherapy and information system was useful in emergency radiotherapy in district hospitals for patients with MSCC for whom consultation with experienced radiation oncologists at a university hospital was required.

Considerations for clinics and practitioners treating foreign patients with assisted reproductive technology: lessons from experiences at Ghent University Hospital, Belgium.

PubMed

De Sutter, Petra

2011-11-01

Cross-border reproductive care (CBRC) is not a new concept, having been around since the beginning of assisted reproductive technology. Countries having taken the lead in developing new technologies have seen an influx of patients from other countries, because of legal limitations or the unavailability of good-quality care in their home country. This paper describes the experience of the Ghent University Hospital fertility centre with Dutch and French patients and tries to set out standards of care for CBRC patients. Dutch patients usually have longer histories, more complex pathology and are better informed, more outspoken and more financially secure. Thus, the care for these patients is challenging. The standards of care should be the same for local patients and CBRC patients; however, the nature of the complexity of the problems they come with will necessitate more time investment. Experience shows that many patients who have no access to treatment in their own country obtain reasonably good results. Some of them, however, are beyond possible help and these patients need a high standard of psychological care. All should be done to avoid that cross-border patients compromise the local care system. Special arrangements should be taken to manage possible complications following treatment. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Greenery in the university environment: Students’ preferences and perceived restoration likelihood

PubMed Central

2018-01-01

A large body of evidence shows that interaction with greenery can be beneficial for human stress reduction, emotional states, and improved cognitive function. It can, therefore, be expected that university students might benefit from greenery in the university environment. Before investing in real-life interventions in a university environment, it is necessary to first explore students’ perceptions of greenery in the university environment. This study examined (1) preference for university indoor and outdoor spaces with and without greenery (2) perceived restoration likelihood of university outdoor spaces with and without greenery and (3) if preference and perceived restoration likelihood ratings were modified by demographic characteristics or connectedness to nature in Dutch university students (N = 722). Digital photographic stimuli represented four university spaces (lecture hall, classroom, study area, university outdoor space). For each of the three indoor spaces there were four or five stimuli conditions: (1) the standard design (2) the standard design with a colorful poster (3) the standard design with a nature poster (4) the standard design with a green wall (5) the standard design with a green wall plus interior plants. The university outdoor space included: (1) the standard design (2) the standard design with seating (3) the standard design with colorful artifacts (4) the standard design with green elements (5) the standard design with extensive greenery. Multi-level analyses showed that students gave higher preference ratings to the indoor spaces with a nature poster, a green wall, or a green wall plus interior plants than to the standard designs and the designs with the colorful posters. Students also rated preference and perceived restoration likelihood of the outdoor spaces that included greenery higher than those without. Preference and perceived restoration likelihood were not modified by demographic characteristics, but students with strong connectedness to nature rated preference and perceived restoration likelihood overall higher than students with weak connectedness to nature. The findings suggest that students would appreciate the integration of greenery in the university environment. PMID:29447184

Greenery in the university environment: Students' preferences and perceived restoration likelihood.

PubMed

van den Bogerd, Nicole; Dijkstra, S Coosje; Seidell, Jacob C; Maas, Jolanda

2018-01-01

A large body of evidence shows that interaction with greenery can be beneficial for human stress reduction, emotional states, and improved cognitive function. It can, therefore, be expected that university students might benefit from greenery in the university environment. Before investing in real-life interventions in a university environment, it is necessary to first explore students' perceptions of greenery in the university environment. This study examined (1) preference for university indoor and outdoor spaces with and without greenery (2) perceived restoration likelihood of university outdoor spaces with and without greenery and (3) if preference and perceived restoration likelihood ratings were modified by demographic characteristics or connectedness to nature in Dutch university students (N = 722). Digital photographic stimuli represented four university spaces (lecture hall, classroom, study area, university outdoor space). For each of the three indoor spaces there were four or five stimuli conditions: (1) the standard design (2) the standard design with a colorful poster (3) the standard design with a nature poster (4) the standard design with a green wall (5) the standard design with a green wall plus interior plants. The university outdoor space included: (1) the standard design (2) the standard design with seating (3) the standard design with colorful artifacts (4) the standard design with green elements (5) the standard design with extensive greenery. Multi-level analyses showed that students gave higher preference ratings to the indoor spaces with a nature poster, a green wall, or a green wall plus interior plants than to the standard designs and the designs with the colorful posters. Students also rated preference and perceived restoration likelihood of the outdoor spaces that included greenery higher than those without. Preference and perceived restoration likelihood were not modified by demographic characteristics, but students with strong connectedness to nature rated preference and perceived restoration likelihood overall higher than students with weak connectedness to nature. The findings suggest that students would appreciate the integration of greenery in the university environment.

Inter-comparison of boron concentration measurements at INFN-University of Pavia (Italy) and CNEA (Argentina).

PubMed

Portu, Agustina; Postuma, Ian; Gadan, Mario Alberto; Saint Martin, Gisela; Olivera, María Silvina; Altieri, Saverio; Protti, Nicoletta; Bortolussi, Silva

2015-11-01

An inter-comparison of three boron determination techniques was carried out between laboratories from INFN-University of Pavia (Italy) and CNEA (Argentina): alpha spectrometry (alpha-spect), neutron capture radiography (NCR) and quantitative autoradiography (QTA). Samples of different nature were analysed: liquid standards, liver homogenates and tissue samples from different treatment protocols. The techniques showed a good agreement in a concentration range of interest in BNCT (1-100ppm), thus demonstrating their applicability as precise methods to quantify boron and determine its distribution in tissues. Copyright © 2015 Elsevier Ltd. All rights reserved.

Renormalization group evolution of the universal theories EFT

DOE PAGES

Wells, James D.; Zhang, Zhengkang

2016-06-21

The conventional oblique parameters analyses of precision electroweak data can be consistently cast in the modern framework of the Standard Model effective field theory (SMEFT) when restrictions are imposed on the SMEFT parameter space so that it describes universal theories. However, the usefulness of such analyses is challenged by the fact that universal theories at the scale of new physics, where they are matched onto the SMEFT, can flow to nonuniversal theories with renormalization group (RG) evolution down to the electroweak scale, where precision observables are measured. The departure from universal theories at the electroweak scale is not arbitrary, butmore » dictated by the universal parameters at the matching scale. But to define oblique parameters, and more generally universal parameters at the electroweak scale that directly map onto observables, additional prescriptions are needed for the treatment of RG-induced nonuniversal effects. Finally, we perform a RG analysis of the SMEFT description of universal theories, and discuss the impact of RG on simplified, universal-theories-motivated approaches to fitting precision electroweak and Higgs data.« less

Renormalization group evolution of the universal theories EFT

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

Wells, James D.; Zhang, Zhengkang

The conventional oblique parameters analyses of precision electroweak data can be consistently cast in the modern framework of the Standard Model effective field theory (SMEFT) when restrictions are imposed on the SMEFT parameter space so that it describes universal theories. However, the usefulness of such analyses is challenged by the fact that universal theories at the scale of new physics, where they are matched onto the SMEFT, can flow to nonuniversal theories with renormalization group (RG) evolution down to the electroweak scale, where precision observables are measured. The departure from universal theories at the electroweak scale is not arbitrary, butmore » dictated by the universal parameters at the matching scale. But to define oblique parameters, and more generally universal parameters at the electroweak scale that directly map onto observables, additional prescriptions are needed for the treatment of RG-induced nonuniversal effects. Finally, we perform a RG analysis of the SMEFT description of universal theories, and discuss the impact of RG on simplified, universal-theories-motivated approaches to fitting precision electroweak and Higgs data.« less

Clinical Components of Telemedicine Programs for Diabetic Retinopathy.

PubMed

Horton, Mark B; Silva, Paolo S; Cavallerano, Jerry D; Aiello, Lloyd Paul

2016-12-01

Diabetic retinopathy is a leading cause of new-onset vision loss worldwide. Treatments supported by large clinical trials are effective in preserving vision, but many persons do not receive timely diagnosis and treatment of diabetic retinopathy, which is typically asymptomatic when most treatable. Telemedicine evaluation to identify diabetic retinopathy has the potential to improve access to care, but there are no universal standards regarding camera choice or protocol for ocular telemedicine. We review the literature regarding the impact of imaging device, number and size of retinal images, pupil dilation, type of image grader, and diagnostic accuracy on telemedicine assessment for diabetic retinopathy. Telemedicine assessment of diabetic retinopathy has the potential to preserve vision, but further development of telemedicine specific technology and standardization of operations are needed to better realize its potential.

Insight: An Annual Collection of Articles on Teaching and Learning by Faculty of the Community Colleges of the State University of New York.

ERIC Educational Resources Information Center

Burns, Charles A., Ed.

This collection of 15 articles on teaching and learning by community college faculty explores the following topics: (1) using modern treatments of standard literary themes and texts to enhance "relevance"; (2) coordination of a course based on Jacob Bronowski's "The Ascent of Man"; (3) planning a "Library Awareness…

Audit of compliance with the British Committee for Standards in Haematology (BCSH) revised guidelines for the diagnosis and assessment of treatment response of hairy cell leukemia in University Hospital Galway.

PubMed

Velazquez-Kennedy, K; Crowe, C; Craven, B; Walsh, J; Prendergast, C; Krawczyk, J

2017-05-01

Hairy cell leukemia (HCL) is an uncommon B cell lymphoproliferative disorder. The object of the present audit was to assess whether the investigation and management of HCL in University College Hospital Galway (UCHG) complies with the British Committee for Standards in Haematology (BCSH) guidelines. Following a review of the records in our Haematology Department, 18 cases of HCL were identified between January 2006 and October 2014. Blood film examination had been performed in all cases. Flow cytometry of liquid material had been undertaken in 89 % (n = 16) of cases, of which only 31 % (n = 5) included all four hairy cell panel markers (CD11c, CD25, CD103, CD123). Although all initial trephine biopsies included CD20, none analyzed DBA44. Only 65 % (n = 11) of treated patients had a post-treatment bone marrow biopsy preformed. This audit highlights areas of improvement in the diagnosis and management of HCL in UCHG, which do not currently adhere to the BCSH recommendations.

Programmatic assessment of a university-based implant training program using patient-reported outcomes.

PubMed

Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

2014-11-01

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

40 CFR 262.107 - Under what circumstances will a university's participation in this environmental management...

Code of Federal Regulations, 2010 CFR

2010-07-01

... university's participation in this environmental management standard pilot be terminated? 262.107 Section 262...) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project-Laboratory Environmental Management Standard § 262.107 Under what circumstances will a university's participation in this...

Preservice laboratory education strengthening enhances sustainable laboratory workforce in Ethiopia

PubMed Central

2013-01-01

Background There is a severe healthcare workforce shortage in sub Saharan Africa, which threatens achieving the Millennium Development Goals and attaining an AIDS-free generation. The strength of a healthcare system depends on the skills, competencies, values and availability of its workforce. A well-trained and competent laboratory technologist ensures accurate and reliable results for use in prevention, diagnosis, care and treatment of diseases. Methods An assessment of existing preservice education of five medical laboratory schools, followed by remedial intervention and monitoring was conducted. The remedial interventions included 1) standardizing curriculum and implementation; 2) training faculty staff on pedagogical methods and quality management systems; 3) providing teaching materials; and 4) procuring equipment for teaching laboratories to provide practical skills to complement didactic education. Results A total of 2,230 undergraduate students from the five universities benefitted from the standardized curriculum. University of Gondar accounted for 252 of 2,230 (11.3%) of the students, Addis Ababa University for 663 (29.7%), Jimma University for 649 (29.1%), Haramaya University for 429 (19.2%) and Hawassa University for 237 (10.6%) of the students. Together the universities graduated 388 and 312 laboratory technologists in 2010/2011 and 2011/2012 academic year, respectively. Practical hands-on training and experience with well-equipped laboratories enhanced and ensured skilled, confident and competent laboratory technologists upon graduation. Conclusions Strengthening preservice laboratory education is feasible in resource-limited settings, and emphasizing its merits (ample local capacity, country ownership and sustainability) provides a valuable source of competent laboratory technologists to relieve an overstretched healthcare system. PMID:24164781

Simplified Method for Groundwater Treatment Using Dilution and Ceramic Filter

NASA Astrophysics Data System (ADS)

Musa, S.; Ariff, N. A.; Kadir, M. N. Abdul; Denan, F.

2016-07-01

Groundwater is one of the natural resources that is not susceptible to pollutants. However, increasing activities of municipal, industrial, agricultural or extreme land use activities have resulted in groundwater contamination as occured at the Research Centre for Soft Soil Malaysia (RECESS), Universiti Tun Hussein Onn Malaysia (UTHM). Thus, aims of this study is to treat groundwater by using rainwater and simple ceramic filter as a treatment agent. The treatment uses rain water dilution, ceramic filters and combined method of dilute and filtering as an alternate treatment which are simple and more practical compared to modern or chemical methods. The water went through dilution treatment processes able to get rid of 57% reduction compared to initial condition. Meanwhile, the water that passes through the filtering process successfully get rid of as much as 86% groundwater parameters where only chloride does not pass the standard. Favorable results for the combination methods of dilution and filtration methods that can succesfully eliminate 100% parameters that donot pass the standards of the Ministry of Health and the Interim National Drinking Water Quality Standard such as those found in groundwater in RECESS, UTHM especially sulfate and chloride. As a result, it allows the raw water that will use clean drinking water and safe. It also proves that the method used in this study is very effective in improving the quality of groundwater.

First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium.

PubMed

Musselwhite, Laura W; Maciag, Karolina; Lankowski, Alex; Gretes, Michael C; Wellems, Thomas E; Tavera, Gloria; Goulding, Rebecca E; Guillen, Ethan

2012-01-01

Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughput screening and medicinal chemistry research programs to identify lead compounds for small molecule drugs and novel drug targets. Furthermore, product development partnerships are emerging between academic institutions, non-profit entities, and biotechnology and pharmaceutical companies to create diagnostics, therapies, and vaccines for diseases of the poor. With not for profit mission statements, open access publishing standards, open source platforms for data sharing and collaboration, and a shift in focus to more translational research, universities and other public research institutions are well-placed to accelerate development of medical technologies, particularly for neglected tropical diseases.

Abstracts of the International Conference (INFOS 83) on Insulating Films on Semiconductors Held at the University of Technology. Eindhoven (The Netherlands) on 11-13 April 1983.

DTIC Science & Technology

1983-04-13

progressed at the same pace. Initially the analogy with conventional well-known ion sensors, such as the glass membrane electrode, led to the...chemical and physical treatments. The standard etching processing using bromine in methanol can deplete cations and produce a surface layer of TeO2 .(l

40 CFR 273.19 - Tracking universal waste shipments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tracking universal waste shipments... WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.19 Tracking universal waste shipments. A small quantity handler of universal waste is...

Consensus on Recording Deep Endometriosis Surgery: the CORDES statement.

PubMed

Vanhie, A; Meuleman, C; Tomassetti, C; Timmerman, D; D'Hoore, A; Wolthuis, A; Van Cleynenbreugel, B; Dancet, E; Van den Broeck, U; Tsaltas, J; Renner, S P; Ebert, A D; Carmona, F; Abbott, J; Stepniewska, A; Taylor, H; Saridogan, E; Mueller, M; Keckstein, J; Pluchino, N; Janik, G; Zupi, E; Minelli, L; Cooper, M; Dunselman, G; Koh, C; Abrao, M S; Chapron, C; D'Hooghe, T

2016-06-01

Which essential items should be recorded before, during and after endometriosis surgery and in clinical outcome based surgical trials in patients with deep endometriosis (DE)? A DE surgical sheet (DESS) was developed for standardized reporting of the surgical treatment of DE and an international expert consensus proposal on relevant items that should be recorded in surgical outcome trials in women with DE. Surgery is an important treatment for symptomatic DE. So far, data have been reported in such a way that comparison of different surgical techniques is impossible. Therefore, we present an international expert proposal for standardized reporting of surgical treatment and surgical outcome trials in women with DE. International expert consensus based on a systematic review of literature. Taking into account recommendations from Consolidated Standards of Reporting Trials (CONSORT), the Innovation Development Exploration Assessment and Long-term Study (IDEAL), the Initiative on Methods, Measurement and Pain Assessment in Clinical trials (IMMPACT) and the World Endometriosis Research Foundation Phenome and Biobanking Harmonisation Project (WERF EPHect), a systematic literature review on surgical treatment of DE was performed and resulted in a proposal for standardized reporting, adapted by contributions from eight members of the multidisciplinary Leuven University Hospitals Endometriosis Care Program, from 18 international experts and from audience feedback during three international meetings. We have developed the DESS to record in detail the surgical procedures for DE, and an international consensus on pre-, intra- and post-operative data that should be recorded in surgical outcome trials on DE. The recommendations in this paper represent a consensus among international experts based on a systematic review of the literature. For several items and recommendations, high-quality RCTs were not available. Further research is needed to validate and evaluate the recommendations presented here. This international expert consensus for standardized reporting of surgical treatment in women with DE, based on a systematic literature review and international consensus, can be used as a guideline to record and report surgical management of patients with DE and as a guideline to design, execute, interpret and compare clinical trials in this patient population. None of the authors received funding for the development of this paper. M.A. reports personal fees and non-financial support from Bayer Pharma outside the submitted work; H.T. reports a grant from Pfizer and personal fees for being on the advisory board of Perrigo, Abbvie, Allergan and SPD. N/A. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Surgery or Rehabilitation: A Randomized Clinical Trial Comparing the Treatment of Vocal Fold Polyps via Phonosurgery and Traditional Voice Therapy with "Voice Therapy Expulsion" Training.

PubMed

Barillari, Maria Rosaria; Volpe, Umberto; Mirra, Giuseppina; Giugliano, Francesco; Barillari, Umberto

2017-05-01

Phonomicrosurgery is generally considered to be the treatment of choice for removing vocal fold polyps. However, specific techniques of voice therapy may represent, in selected cases and under certain conditions, a noninvasive therapeutic option for the treatment of such laryngeal lesions. The aim of the present study is to longitudinally assess, in terms of clinical outcomes and quality of life, two groups of patients with cordal polyps, treated either with standard surgery plus standard voice therapy or with a specific training of voice therapy alone, which we have called "Voice Therapy Expulsion." This study is a randomized controlled trial. A total of 150 patients with vocal fold polyps were randomly assigned to either standard surgery or "voice therapy expulsion" protocol. The trial was carried out at the Division of Phoniatrics and Audiology of the Second University of Naples and at the Division of Communication Disorders of Local Health Unit (3 Naples South) from January 2010 to December 2013. A thorough phoniatric evaluation, including laryngostroboscopy, acoustic voice analysis, global grade of dysphonia, instability, roughness, breathiness, asthenia, and strain scale, Voice Handicap Index, and Voice-Related Quality of Life, was performed by using standardized tools, at baseline, at the end of the treatment, and up to 1 year after treatment. We found no significant differences between the two experimental groups in terms of clinical outcomes and personal satisfaction. However, "Voice Therapy Expulsion" was associated with higher scores for quality of life at endpoint evaluation. Besides phonosurgery, this specific "Voice Therapy Expulsion" technique should be considered as a valid, noninvasive, and well-tolerated therapeutic option for the treatment of selected patients with vocal fold polyps. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effects of manual therapy on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly: a randomised controlled pilot study.

PubMed

Cabrera-Martos, I; Valenza, M C; Valenza-Demet, G; Benítez-Feliponi, A; Robles-Vizcaíno, C; Ruiz-Extremera, A

2016-11-01

Despite growing evidence regarding nonsynostotic plagiocephaly and their repercussions on motor development, there is little evidence to support the use of manual therapy as an adjuvant option. The aim of this study was to evaluate the effects of a therapeutic approach based on manual therapy as an adjuvant option on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly. This is a randomised controlled pilot study. The study was conducted at a university hospital. Forty-six infants with severe nonsynostotic plagiocephaly (types 4-5 of the Argenta scale) referred to the Early Care and Monitoring Unit were randomly allocated to a control group receiving standard treatment (repositioning and an orthotic helmet) or to an experimental group treated with manual therapy added to standard treatment. Infants were discharged when the correction of the asymmetry was optimal taken into account the previous clinical characteristics. The outcome measures were treatment duration and motor development assessed with the Alberta Infant Motor Scale (AIMS) at baseline and at discharge. Asymmetry after the treatment was minimal (type 0 or 1 according to the Argenta scale) in both groups. A comparative analysis showed that treatment duration was significantly shorter (p < 0.001) in the experimental group (109.84 ± 14.45 days) compared to the control group (148.65 ± 11.53 days). The motor behaviour was normal (scores above the 16th percentile of the AIMS) in all the infants after the treatment. Manual therapy added to standard treatment reduces the treatment duration in infants with severe nonsynostotic plagiocephaly.

Combined Hydrophobic/Oleophobic Membrane Separation and Extraction for Fuel Treatment (Briefing Charts)

DTIC Science & Technology

2015-03-24

Institute, Dayton, OH 45469 4 California State University, Long Beach, CA 90840 5 University of Michigan, Ann Arbor, MI 48109 2 Acknowledgements Ms. Yvonne...ppm) C2 Thiophenes 0.3 C3-C4 Thiophenes 1.4 C5 Thiophenes 3.7 C6 Thiophenes 3.5 C7 Thiophenes 4.1 C8 -C9 Thiophenes 2.9 C10 Thiophenes 0.6 C11...Thiophenes 6.3 C6 Thiophenes 6.1 C7 Thiophenes 5.8 C8 -C9 Thiophenes 4.9 C10 Thiophenes 1.3 C11 Thiophenes 0.9 C12+ Thiophenes 2.0 Standard Grade RP-1 (Errors

Brain imaging predictors and the international study to predict optimized treatment for depression: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Approximately 50% of patients with major depressive disorder (MDD) do not respond optimally to antidepressant treatments. Given this is a large proportion of the patient population, pretreatment tests that predict which patients will respond to which types of treatment could save time, money and patient burden. Brain imaging offers a means to identify treatment predictors that are grounded in the neurobiology of the treatment and the pathophysiology of MDD. Methods/Design The international Study to Predict Optimized Treatment in Depression is a multi-center, parallel model, randomized clinical trial with an embedded imaging sub-study to identify such predictors. We focus on brain circuits implicated in major depressive disorder and its treatment. In the full trial, depressed participants are randomized to receive escitalopram, sertraline or venlafaxine-XR (open-label). They are assessed using standardized multiple clinical, cognitive-emotional behavioral, electroencephalographic and genetic measures at baseline and at eight weeks post-treatment. Overall, 2,016 depressed participants (18 to 65 years old) will enter the study, of whom a target of 10% will be recruited into the brain imaging sub-study (approximately 67 participants in each treatment arm) and 67 controls. The imaging sub-study is conducted at the University of Sydney and at Stanford University. Structural studies include high-resolution three-dimensional T1-weighted, diffusion tensor and T2/Proton Density scans. Functional studies include standardized functional magnetic resonance imaging (MRI) with three cognitive tasks (auditory oddball, a continuous performance task, and Go-NoGo) and two emotion tasks (unmasked conscious and masked non-conscious emotion processing tasks). After eight weeks of treatment, the functional MRI is repeated with the above tasks. We will establish the methods in the first 30 patients. Then we will identify predictors in the first half (n = 102), test the findings in the second half, and then extend the analyses to the total sample. Trial registration International Study to Predict Optimized Treatment - in Depression (iSPOT-D). ClinicalTrials.gov, NCT00693849. PMID:23866851

Brain imaging predictors and the international study to predict optimized treatment for depression: study protocol for a randomized controlled trial.

PubMed

Grieve, Stuart M; Korgaonkar, Mayuresh S; Etkin, Amit; Harris, Anthony; Koslow, Stephen H; Wisniewski, Stephen; Schatzberg, Alan F; Nemeroff, Charles B; Gordon, Evian; Williams, Leanne M

2013-07-18

Approximately 50% of patients with major depressive disorder (MDD) do not respond optimally to antidepressant treatments. Given this is a large proportion of the patient population, pretreatment tests that predict which patients will respond to which types of treatment could save time, money and patient burden. Brain imaging offers a means to identify treatment predictors that are grounded in the neurobiology of the treatment and the pathophysiology of MDD. The international Study to Predict Optimized Treatment in Depression is a multi-center, parallel model, randomized clinical trial with an embedded imaging sub-study to identify such predictors. We focus on brain circuits implicated in major depressive disorder and its treatment. In the full trial, depressed participants are randomized to receive escitalopram, sertraline or venlafaxine-XR (open-label). They are assessed using standardized multiple clinical, cognitive-emotional behavioral, electroencephalographic and genetic measures at baseline and at eight weeks post-treatment. Overall, 2,016 depressed participants (18 to 65 years old) will enter the study, of whom a target of 10% will be recruited into the brain imaging sub-study (approximately 67 participants in each treatment arm) and 67 controls. The imaging sub-study is conducted at the University of Sydney and at Stanford University. Structural studies include high-resolution three-dimensional T1-weighted, diffusion tensor and T2/Proton Density scans. Functional studies include standardized functional magnetic resonance imaging (MRI) with three cognitive tasks (auditory oddball, a continuous performance task, and Go-NoGo) and two emotion tasks (unmasked conscious and masked non-conscious emotion processing tasks). After eight weeks of treatment, the functional MRI is repeated with the above tasks. We will establish the methods in the first 30 patients. Then we will identify predictors in the first half (n=102), test the findings in the second half, and then extend the analyses to the total sample. International Study to Predict Optimized Treatment--in Depression (iSPOT-D). ClinicalTrials.gov, NCT00693849.

Randomised controlled clinical trial of increased dose and frequency of albendazole and ivermectin on Wuchereria bancrofti microfilarial clearance in northern Malawi.

PubMed

Tafatatha, Terence T; Ngwira, Bagrey M; Taegtmeyer, Miriam; Phiri, Amos J; Wilson, Trevor P; Banda, Louis G; Piston, Wilson N; Koole, Olivier; Horton, John; French, Neil

2015-06-01

In Africa, albendazole and ivermectin are currently used in combination for annual mass drug administration (MDA) for lymphatic filariasis (LF) elimination. Rapid and sustained clearance is desirable for public health impact and elimination of LF. Increasing the dose and/or frequency of albendazole and ivermectin treatment may be more effective in clearing microfilariae than standard MDA. We conducted a randomised controlled open label trial in northern Malawi comparing three modified treatment groups to standard dosage of ivermectin and albendazole in adults with confirmed circulating LF antigen and microfilaria. Participants were followed-up every 6 months for 2 years for repeat microfilarial counts and safety assessments. A total of 1851 adults were screened and 70 with microfilarial counts >80 microfilariae/ml were randomised. All treatment groups achieved a significant reduction of microfilariae levels by 12- and 24-months of follow-up. Doubling the standard dose and administering it twice yearly showed a non-significant tendency towards faster and more complete clearance. There were no serious adverse reactions. In this small study, all regimens effectively cleared microfilaria. Standard treatment may be adequate in settings like Malawi but not in all endemic settings and larger studies are required to demonstrate benefit of higher dosages. [ClinicalTrials.gov identifier: NCT01213576]. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effect of laser parameters and mode on pulp surgery outcome

NASA Astrophysics Data System (ADS)

Wilder-Smith, Petra B. B.; Arrastia-Jitosho, Anna-Marie A.; Peavy, George M.; Kurosaki, Tom

1997-05-01

The objective of this study was to determine the effectiveness of localized laser pulp surgery in the canine model. Effects of laser parameters on treatment outcome were also investigated. Pulpal exposure 3 mm in diameter were prepared in healthy teeth and left open to infection from the oral cavity for 72 hours. Pulpal tissue was then removed using high speed handpiece with sterile irrigation, or a CO2 laser. Teeth were monitored clinically, radiographically for 3 months. Results for each criterion were evaluated on a scale of 0-(-2). After sacrifice, histological assessment was made soft and hard tissue response. Results for each category were evaluated on a standard scale of 0-(-2). All evaluations were performed by 1 blinded, pre-standardized clinician. Statistical assessment using the chi-square test and Fisher's Exact Test associated laser treatment with a significantly better clinical, radiographic and histological treatment outcome. NIH RRO1192, seed grant funding form Loma Linda University, the Edna P. Jacobsen Charitable Trust for Animals, Inc.

Consensus Statement on Research Definitions for Drug-Resistant Tuberculosis in Children.

PubMed

Seddon, James A; Perez-Velez, Carlos M; Schaaf, H Simon; Furin, Jennifer J; Marais, Ben J; Tebruegge, Marc; Detjen, Anne; Hesseling, Anneke C; Shah, Sarita; Adams, Lisa V; Starke, Jeffrey R; Swaminathan, Soumya; Becerra, Mercedes C

2013-06-01

Few children with drug-resistant (DR) tuberculosis (TB) are identified, diagnosed, and given an appropriate treatment. The few studies that have described this vulnerable population have used inconsistent definitions. The World Health Organization (WHO) definitions used for adults with DR-TB and for children with drug-susceptible TB are not always appropriate for children with DR-TB. The Sentinel Project on Pediatric Drug-Resistant Tuberculosis was formed in 2011 as a network of experts and stakeholders in childhood DR-TB. An early priority was to establish standardized definitions for key parameters in order to facilitate study comparisons and the development of an evidence base to guide future clinical management. This consensus statement proposes standardized definitions to be used in research. In particular, it suggests consistent terminology, as well as definitions for measures of exposure, drug resistance testing, previous episodes and treatment, certainty of diagnosis, site and severity of disease, adverse events, and treatment outcome. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society.

Understanding University Success. A Report from Standards for Success.

ERIC Educational Resources Information Center

Conley, David T.

This booklet outlines what students must know and be able to do to succeed in entry-level university courses. The standards presented in the booklet were designed to create a new way to view college preparation. The standards--known as the knowledge and skills for university success (KSUS) standards--were developed from a 2-year study in which…

Kinematics, influence functions and field quantities for disturbance propagation from moving disturbance sources

NASA Technical Reports Server (NTRS)

Das, A.

1984-01-01

A unified method is presented for deriving the influence functions of moving singularities which determine the field quantities in aerodynamics and aeroacoustics. The moving singularities comprise volume and surface distributions having arbitrary orientations in space and to the trajectory. Hence one generally valid formula for the influence functions which reveal some universal relationships and remarkable properties in the disturbance fields. The derivations used are completely consistent with the physical processes in the propagation field, such that treatment renders new descriptions for some standard concepts. The treatment is uniformly valid for subsonic and supersonic Mach numbers.

[Cytostatic hyperthermic isolated limb perfusion (HILP) in VFN (General Faculty Hospital in Prague)].

PubMed

Spacek, M; Mitás, P; Lacina, L; Krajsová, I; Hodková, G; Salmay, M; Spunda, R; Brlicová, L; Lindner, J

2011-01-01

Hyperthermic isolated limb perfusion (HILP) is a standardized method of treatment in selected patients with in-transient locoregional recurrence/methastasis of melanoma or, some other soft tissue tumors (incl. sarcoma etc.) Authors present history and current status of this treatment modality in General University Hospital in Prague. During one year period (7/2009-6/2010) 10 patients were indicated for this procedure. We performed 13 procedures (3x redo), 11 in lower extremity and 2 in upper extremity. There was no serious complication in this cohort of patiens. Multidisciplinar approach is indicated in melanoma patients care.

The Nitrogen Footprint Tool for Institutions: Comparing Results for a Diverse Group of Institutions

NASA Astrophysics Data System (ADS)

Castner, E.; Leach, A. M.; Galloway, J. N.; Hastings, M. G.; Lantz-Trissel, J.; Leary, N.; Kimiecik, J.; de la Reguera, E.

2015-12-01

Anthropogenic production of reactive nitrogen (Nr) has drastically altered the nitrogen cycle over the past few decades by causing it to accumulate in the environment. A nitrogen footprint (NF) estimates the amount of Nr released to the environment as a result of an entity's activities. The Nitrogen Footprint Tool (NFT) for universities and institutions provides a standardized method for quantifying the NF for the activities and operations of these entities. The NFT translates data on energy use, food purchasing, sewage treatment, and fertilizer use to the amount of Nr lost to the environment using NOx and N2O emission factors, virtual nitrogen factors (VNFs) for food production, N reduction rates from wastewater treatment, and nitrogen uptake factors for fertilizer. As part of the Nitrogen Footprint Project supported by the EPA, seven institutions (colleges, universities, and research institutions) have completed NFT assessments: University of Virginia, University of New Hampshire, Brown University, Dickinson College, Colorado State University, Eastern Mennonite University, and the Marine Biological Laboratory. The results of these assessments reveal the magnitude of impacts on the global nitrogen cycle by different activities and sectors, and will allow these institutions to set NF reduction goals along with management decisions based on scenarios and projections in the NFT. The trends revealed in early analysis of the results include geographic differences based on regional energy sources and local sewage treatment, as well as operational differences that stem from institution type and management. As an example of the impact of management, the amount and type of food served directly impacts the food production NF, which is a large percentage of the total NF for all institutions (35-75%). Comparison of these first NF results will shed light on the primary activities of institutions that add Nr to the environment and examine the differences between them.

Influence of growth hormone therapy on selected dental and skeletal system parameters.

PubMed

Partyka, Małgorzata; Chałas, Renata; Dunin-Wilczyńska, Izabella; Drohomyretska, Myroslava; Klatka, Maria

2018-03-14

Growth hormone deficiency (GHD) is one of the main indications for growth hormone therapy. One characteristic of this disease is bone age delay in relation to the chronological age. Pituitary dysfunction negatively affects the growth and development of the jaws and teeth of the child. The secretion of endocrine glands regulates growth, development, and gender differentiation. It also controls the growth of bones and teeth, regulates metabolism of calcium and phosphate, proteins, lipids and carbohydrates. The primary role in the endocrine system is played by the pituitary gland which is responsible for the production of somatotropin [1]. Dysfunction of the pituitary gland has a negative effect on the growth and development of long bones in the body, and may have an adverse effect on the development of maxilla, mandible and dentition of a child. There is some information in the literature that dental age is delayed in short stature children; the replacement of deciduous teeth by permanent teeth is also delayed, and newly erupted permanent teeth often require orthodontic treatment. Applying hormonal therapy positively affects the process of replacement of dentition [2, 3, 4, 5, 6]. The aim of the study was to assess bone and dental age, as well as analyze the state of dentition in children diagnosed with GH deficiency treated with growth hormone, depending on the duration of treatment. The study material consisted of 110 children (27 males, 83 females), hospitalized for somatotropin hypopituitarism in the Department of Paediatric Endocrinology and Diabetology at the Medical University of Lublin, Poland. The mean birth age was 13 years (156 months) with a standard deviation of 2 years and 6 months (30 months). 47 children (43%) started treatment with the growth hormone (group starting treatment) and 63 children (57%) whose treatment was started 2-3 years previously (group in the course of treatment). The control group consisted of 41 generally healthy children (15males, 25 females) with ENT problems, such as hypoacusis and a condition after nasal injury, hospitalized in the Department of Paediatric Otolaryngology at the Medical University of Lublin, Poland. The mean age was 11 years and 5 months (137 months) with standard deviation of 2 years and 5 months (29 months). Informed consent was obtained from the parents. The study was approved by the Bioethical Committee at the Medical University of Lublin (Resolution No. KE-0254 /216 /2012).

Bronchoscopic cryotherapy treatment of isolated endoluminal typical carcinoid tumor.

PubMed

Bertoletti, Laurent; Elleuch, Rami; Kaczmarek, David; Jean-François, Rita; Vergnon, Jean Michel

2006-11-01

Bronchial typical carcinoid tumors are rare. The "gold standard" treatment is surgery, but there is literature to support bronchoscopic therapy with curative intent. Based on the efficacy of cryotherapy for in situ lung cancer, we studied the safety and efficacy of rigid bronchoscopic treatment with cryotherapy on isolated endoluminal typical carcinoid tumors. All the patients from the Department of Pulmonary Diseases and Thoracic Oncology of St. Etienne University Hospital (France), and of Hôpital Notre Dame, University Hospital of Montreal referred with typical carcinoid were screened. Inclusion criteria included the following: proven typical carcinoid, strictly endoluminal disease amenable to bronchoscopic therapy, and no evidence of lymph node invasion. All patients had a complete removal of the tumor, and all patients received cryotherapy to the implantation base. Twenty-nine patients were screened, and 18 were included. Mean age was 47 years, and study population included 11 women. Median follow-up was 55 months. There was a single recurrence 7 years after the initial bronchoscopic treatment. Cryotherapy is a safe and effective adjunct to endobronchial mechanical resection of typical carcinoids. Unlike other adjuncts that have been proposed, cryotherapy is not associated with long-term complications including bronchial stenosis.

NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (G01)

EPA Science Inventory

The purpose of this SOP is to develop a consistent method and style for all Emory University/Harvard University/Johns Hopkins University standard operating procedures. SOPs are necessary to document all procedures, methods, and techniques used in the NHEXAS investigations. Deve...

Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study.

PubMed

Carda, Stefano; Biasiucci, Andrea; Maesani, Andrea; Ionta, Silvio; Moncharmont, Julien; Clarke, Stephanie; Murray, Micah M; Millán, José Del R

2017-08-01

To evaluate the effects of electrically assisted movement therapy (EAMT) in which patients use functional electrical stimulation, modulated by a custom device controlled through the patient's unaffected hand, to produce or assist task-specific upper limb movements, which enables them to engage in intensive goal-oriented training. Randomized, crossover, assessor-blinded, 5-week trial with follow-up at 18 weeks. Rehabilitation university hospital. Patients with chronic, severe stroke (N=11; mean age, 47.9y) more than 6 months poststroke (mean time since event, 46.3mo). Both EAMT and the control intervention (dose-matched, goal-oriented standard care) consisted of 10 sessions of 90 minutes per day, 5 sessions per week, for 2 weeks. After the first 10 sessions, group allocation was crossed over, and patients received a 1-week therapy break before receiving the new treatment. Fugl-Meyer Motor Assessment for the Upper Extremity, Wolf Motor Function Test, spasticity, and 28-item Motor Activity Log. Forty-four individuals were recruited, of whom 11 were eligible and participated. Five patients received the experimental treatment before standard care, and 6 received standard care before the experimental treatment. EAMT produced higher improvements in the Fugl-Meyer scale than standard care (P<.05). Median improvements were 6.5 Fugl-Meyer points and 1 Fugl-Meyer point after the experimental treatment and standard care, respectively. The improvement was also significant in subjective reports of quality of movement and amount of use of the affected limb during activities of daily living (P<.05). EAMT produces a clinically important impairment reduction in stroke patients with chronic, severe upper limb paresis. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Paving the way for a gold standard of care for infertility treatment: improving outcomes through standardization of laboratory procedures.

PubMed

Schoolcraft, William; Meseguer, Marcos

2017-10-01

Infertility affects over 70 million couples globally. Access to, and interest in, assisted reproductive technologies is growing worldwide, with more couples seeking medical intervention to conceive, in particular by IVF. Despite numerous advances in IVF techniques since its first success in 1978, almost half of the patients treated remain childless. The multifactorial nature of IVF treatment means that success is dependent on many variables. Therefore, it is important to examine how each variable can be optimized to achieve the best possible outcomes for patients. The current approach to IVF is fragmented, with various protocols in use. A systematic approach to establishing optimum best practices may improve IVF success and live birth rates. Our vision of the future is that technological advancements in the laboratory setting are standardized and universally adopted to enable a gold standard of care. Implementation of best practices for laboratory procedures will enable clinicians to generate high-quality gametes, and to produce and identify gametes and embryos of maximum viability and implantation potential, which should contribute to improving take-home healthy baby rates. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

40 CFR 273.54 - Response to releases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 273.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.54 Response to... other residues from universal wastes. (b) A universal waste transporter must determine whether any...

Screening, testing, and reporting for drug and alcohol use on labor and delivery: a survey of Maryland birthing hospitals.

PubMed

Miller, Catherine; Lanham, Amy; Welsh, Christopher; Ramanadhan, Shaalini; Terplan, Mishka

2014-01-01

Recent amendments to the Child Abuse Prevention and Treatment Act tie the receipt of federal block grants to mandatory reporting of substance-exposed newborns. To determine rates of screening, testing, and reporting of drug and alcohol use at the time of delivery, we administered a telephone survey of nursing managers and perinatal social workers at Maryland birthing hospitals. Of the 34 hospitals, 31 responded (response rate 91%). Although 97% of hospitals reported universal screening, only 6% used a validated instrument. Testing was reported by 94% with 45% reporting universal maternal testing and 7% universal newborn testing. Only 32% reported obtaining maternal consent prior to testing. There is significant heterogeneity in screening and testing for substance use in birthing hospitals. Given federal reporting mandates, state-level practices need to be standardized.

Fluctuations in the inflationary universe

NASA Astrophysics Data System (ADS)

Hawking, S. W.; Moss, I. G.

1983-08-01

In the usual treatment of the inflationary universe, it is assumed that the expectation value of some component of the Higgs field develops a non-zero symmetry breaking value Φ0. However, in the models normally considered, the expectation value of Φ will be zero at all times because Φ and -Φ are equally probable. To overcome this difficulty, we calculate the effective action as a function of <Φ2> rather than <Φ>. This also solves the infra-red problem associated with a Coleman-Weinberg condition in de Sitter space. The expectation value of Φ2 grows linearly with time at first and then as (t2 - t-1). The irregularities in the resulting universe are smaller than those predicted by previous authors, though in the case of the standard SU(5) GUT they are still bigger than the limit set by the microwave background.

Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial.

PubMed

Bearss, Karen; Johnson, Cynthia; Smith, Tristram; Lecavalier, Luc; Swiezy, Naomi; Aman, Michael; McAdam, David B; Butter, Eric; Stillitano, Charmaine; Minshawi, Noha; Sukhodolsky, Denis G; Mruzek, Daniel W; Turner, Kylan; Neal, Tiffany; Hallett, Victoria; Mulick, James A; Green, Bryson; Handen, Benjamin; Deng, Yanhong; Dziura, James; Scahill, Lawrence

2015-04-21

Disruptive behavior is common in children with autism spectrum disorder. Behavioral interventions are used to treat disruptive behavior but have not been evaluated in large-scale randomized trials. To evaluate the efficacy of parent training for children with autism spectrum disorder and disruptive behavior. This 24-week randomized trial compared parent training (n = 89) to parent education (n = 91) at 6 centers (Emory University, Indiana University, Ohio State University, University of Pittsburgh, University of Rochester, Yale University). We screened 267 children; 180 children (aged 3-7 years) with autism spectrum disorder and disruptive behaviors were randomly assigned (86% white, 88% male) between September 2010 and February 2014. Parent training (11 core, 2 optional sessions; 2 telephone boosters; 2 home visits) provided specific strategies to manage disruptive behavior. Parent education (12 core sessions, 1 home visit) provided information about autism but no behavior management strategies. Parents rated disruptive behavior and noncompliance on co-primary outcomes: the Aberrant Behavior Checklist-Irritability subscale (range, 0-45) and the Home Situations Questionnaire-Autism Spectrum Disorder (range, 0-9). On both measures, higher scores indicate greater severity and a 25% reduction indicates clinical improvement. A clinician blind to treatment assignment rated the Improvement scale of the Clinical Global Impression (range, 1-7), a secondary outcome, with a positive response less than 3. At week 24, the Aberrant Behavior Checklist-Irritability subscale declined 47.7% in parent training (from 23.7 to 12.4) compared with 31.8% for parent education (23.9 to 16.3) (treatment effect, -3.9; 95% CI, -6.2 to -1.7; P < .001, standardized effect size = 0.62). The Home Situations Questionnaire-Autism Spectrum Disorder declined 55% (from 4.0 to 1.8) compared with 34.2% in parent education (3.8 to 2.5) (treatment effect, -0.7; 95% CI, -1.1 to -0.3; P < .001, standardized effect size = 0.45). Neither measure met the prespecified minimal clinically important difference. The proportions with a positive response on the Clinical Global Impression-Improvement scale were 68.5% for parent training vs 39.6% for parent education (P < .001). For children with autism spectrum disorder, a 24-week parent training program was superior to parent education for reducing disruptive behavior on parent-reported outcomes, although the clinical significance of the improvement is unclear. The rate of positive response judged by a blinded clinician was greater for parent training vs parent education. clinicaltrials.gov Identifier: NCT01233414.

Effects of contact with treatment users on mental illness stigma: evidence from university roommate assignments.

PubMed

Eisenberg, Daniel; Downs, Marilyn F; Golberstein, Ezra

2012-09-01

Mental illness stigma refers to negative stereotypes and prejudices about people with mental illness, and is a widespread phenomenon with damaging social, psychological, and economic consequences. Despite considerable policy attention, mental illness stigma does not appear to have declined significantly in recent years. Interpersonal contact with persons with mental illness has been identified as a promising approach to reducing mental illness stigma. This study investigates the effect of contact with mental health treatment users on stigma using an observational research design that is free of self-selection bias. The research design is based on the quasi-experiment in which university students are assigned to live together as roommates. Survey data were collected from first-year undergraduates at two large universities in the United States (N = 1605). Multivariable regressions were used to estimate the effect of assignment to a roommate with a history of mental health treatment on a brief measure of stigmatizing attitudes. Contact with a treatment user caused a modest increase in stigma (standardized effect size = 0.15, p = 0.03). This effect was present among students without a prior treatment history of their own, but not among those with a prior history. The findings indicate that naturalistic contact alone does not necessarily yield a reduction in mental illness stigma. This may help explain why stigma has not declined in societies such as the United States even as treatment use has risen substantially. The findings also highlight the importance of isolating the specific components, beyond contact per se, that are necessary to reduce stigma in contact-based interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

40 CFR 273.17 - Response to releases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 273.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.17... of universal wastes and other residues from universal wastes. (b) A small quantity handler of...

40 CFR 273.37 - Response to releases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 273.37 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.37... of universal wastes and other residues from universal wastes. (b) A large quantity handler of...

Ideas, properties, and standards of fracture repositioning with osteopathy in traditional Mongolian medicine in China.

PubMed

Wang, Mei; Wang, Hongxia; Zhao, Namula

2015-02-01

To explore the unique ideas, properties, and standards of fracture repositioning with osteopathy in traditional Mongolian medicine in China. Based on the natural life concept of "integration of universe and man", osteopathy in traditional Mongolian medicine in China uses the modern principles and methods of physiology, psychology, and biomechanics. Against this background, we explored the unique ideas, properties, and stan- dards of fracture repositioning in traditional Mongolian medicine. Fracture treatment with osteopathy in traditional Mongolian medicine in China is based on (a) the ideas of natural, sealed, self and dynamic repositioning of fractures; (b) the properties of structural continuity and functional completeness; (c) the standards of "integration of movement and stillness" and "force to force". The unique ideas, properties, and standards of fracture repositioning with osteopathy in traditional Mongolian medicine in China have resulted in the widespread use of such techniques and represents the future direction of the development of fracture repositioning.

The ethics of HIV research in developing nations.

PubMed

Resnik, David B

1998-10-01

This paper discusses a dispute concerning the ethics of research on preventing the perinatal transmission of HIV in developing nations. Critics of this research argue that it is unethical because it denies a proven treatment to placebo-control groups. Since studies conducted in developed nations would not deny this treatment to subjects, the critics maintain that these experiments manifest a double standard for ethical research and that a single standard of ethics should apply to all research on human subjects. Proponents of the research, however, argue that these charges fail to understand the ethical complexities of research in developing nations, and that study designs can vary according to the social, economic, and scientific conditions of research. This essay explores some of the ethical issues raised by this controversial case in order to shed some light on the deeper, meta-ethical questions. The paper argues that standards of ethical research on human subjects are universal but not absolute: there are some general ethical principles that apply to all cases of human subjects research but the application of these principles must take into account factors inherent in particular situations.

40 CFR 273.33 - Waste management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Waste management. 273.33 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.33 Waste management. (a) Universal waste batteries. A large quantity handler of universal waste must manage...

40 CFR 273.13 - Waste management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Waste management. 273.13 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.13 Waste management. (a) Universal waste batteries. A small quantity handler of universal waste must manage...

40 CFR 273.62 - Tracking universal waste shipments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of each type of universal waste received (e.g., batteries, pesticides, thermostats); (3) The date of... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Tracking universal waste shipments... WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Destination Facilities § 273.62...

40 CFR 273.62 - Tracking universal waste shipments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of each type of universal waste received (e.g., batteries, pesticides, thermostats); (3) The date of... 40 Protection of Environment 27 2011-07-01 2011-07-01 false Tracking universal waste shipments... WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Destination Facilities § 273.62...

40 CFR 273.62 - Tracking universal waste shipments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of each type of universal waste received (e.g., batteries, pesticides, thermostats); (3) The date of... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tracking universal waste shipments... WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Destination Facilities § 273.62...

40 CFR 273.62 - Tracking universal waste shipments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of each type of universal waste received (e.g., batteries, pesticides, thermostats); (3) The date of... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Tracking universal waste shipments... WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Destination Facilities § 273.62...

40 CFR 273.62 - Tracking universal waste shipments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of each type of universal waste received (e.g., batteries, pesticides, thermostats); (3) The date of... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Tracking universal waste shipments... WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Destination Facilities § 273.62...

Quality assessment of dental health services provided at the Faculty of Dentistry, King Abdulaziz University.

PubMed

Hassan, Ali H; Amer, Hala A; Maghrabi, Abdulhamaid A

2005-01-01

The objectives of this research were to assess the quality of dental services delivered in King Abdulaziz University and highlight the necessary recommendations that would improve it. The methods used were live photographs illustrating the structure of dental services of the faculty presented in the clinic buildings, waiting places, equipments, instruments and supplies, as well as the comfort and privacy. Review of official records of the faculty for the number, qualifications and training of the dental staff and auxiliary personnel, as well as the process of care (starting from patient registration until completion of treatment). Records also demonstrated the access and utilization of services delivered in the various departments, the quality of these services and of infection control measures and procedures. The results revealed the high quality of services delivered through evaluating the structure and process of care in the university dental clinics. Dental services of King Abdulaziz University conform to high quality standards, with implementation of some changes for improvement and development.

First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium

PubMed Central

Musselwhite, Laura W.; Maciag, Karolina; Lankowski, Alex; Gretes, Michael C.; Wellems, Thomas E.; Tavera, Gloria; Goulding, Rebecca E.; Guillen, Ethan

2012-01-01

Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughput screening and medicinal chemistry research programs to identify lead compounds for small molecule drugs and novel drug targets. Furthermore, product development partnerships are emerging between academic institutions, non-profit entities, and biotechnology and pharmaceutical companies to create diagnostics, therapies, and vaccines for diseases of the poor. With not for profit mission statements, open access publishing standards, open source platforms for data sharing and collaboration, and a shift in focus to more translational research, universities and other public research institutions are well-placed to accelerate development of medical technologies, particularly for neglected tropical diseases. PMID:22232453

Expectations and satisfaction of denture patients in a university clinic.

PubMed

Davis, E L; Albino, J E; Tedesco, L A; Portenoy, B S; Ortman, L F

1986-01-01

These results indicate that patients' expectations of dentures before treatment were unrealistically high and that informational videotapes did not significantly affect these expectations. Satisfaction with current dentures was surprisingly high before treatment and increased significantly from pretreatment to postreatment for both groups in the study. While it is likely that this increase in satisfaction reflects a change from poor to excellent denture status, this finding may also be attributed to cognitive dissonance theory; that is, high satisfaction may represent the means by which patients justify the expenses of their denture treatment. Although the videotape presentations did not alter the expectations of patients and their satisfaction with dentures, the tapes represent a potential source of accurate, standardized information for both patient and student dentist.

Consistency of physicians' legal standard and personal judgments of competency in patients with Alzheimer's disease.

PubMed

Marson, D C; Earnst, K S; Jamil, F; Bartolucci, A; Harrell, L E

2000-08-01

To investigate the consistency of physician judgments of treatment consent capacity (competency) for patients with Alzheimer's disease (AD) when specific legal standards (LS) for competency are used, and to identify the LS most clinically relevant to experienced physicians. Control and AD patient participants were videotaped being administered a measure of capacity to consent to medical treatment. Study physicians viewed videotapes of these assessments individually and made competency judgments for each participant under different LS followed by their own personal judgment of competency. A university medical center. Participants were 10 older controls and 21 patients with AD (10 with mild and 11 with moderate AD). Five physicians with experience assessing the competency of AD patients were recruited from the geriatric psychiatry, geriatric medicine, and neurology services of a university medical center. The 31 participants were videotaped performing on a measure of treatment consent capacity (Capacity to Consent to Treatment Instrument) (CCTI). The CCTI consists of two clinical vignettes (A-neoplasm and B-cardiac) that test competency under five LS. Vignette A and B assessments were videotaped separately for each participant (total videotapes for sample = 62). Each study physician viewed each videotaped vignette individually, made judgments under each of the LS (competent or incompetent), and then made his/her own personal competency judgment. Physicians were blinded to participant diagnosis. Within participant group, consistency of physician judgments was evaluated across LS and personal judgments using percentage agreement and kappa. Agreement between personal and LS judgments for the AD group was evaluated for each physician using logistic regression. As expected, physicians as a group generally demonstrated very high percentage agreement in their LS and personal competency judgments for the control group. For the AD group, mean percentage judgment agreement among physicians ranged from a high of 84% (LS1) (evidencing a treatment choice) to a low of 67% (LS3) (appreciating consequences of treatment choice). Mean percentage agreement for personal competency judgments was 76%. For the AD sample, kappa analyses for physicians as a group demonstrated significant agreement not attributable to chance for LS5 (understanding treatment situation/choices) (k = 0.57, P = .001), LS4 (providing rational reasons for treatment choice) (k = 0.39, P = .04), and also for personal judgments (k = 0.48, P = .009). Analysis of LS judgment agreement within physician indicated that physicians applied the LS as discrete standards. Within-physician and for the AD sample, personal competency judgments were associated significantly with judgments on LS5 (P = .001), LS4 (P = .004), and LS3 (P < .04). Experienced physicians demonstrated significant agreement assessing competency in AD patients when judgments were based upon specific legal standards. Personal competency judgments of physicians showed a substantially higher level of agreement than found in a previous study, where specific LS were not used. These results suggest that consistency of physician competency judgments can be enhanced if they are guided by knowledge of specific LS. Physicians' personal competency judgments were most closely associated with comprehension and reasoning LS, the most conservative and clinically appropriate standards for deciding competency.

Implant dentistry curriculum in undergraduate education: part 1-a literature review.

PubMed

Kroeplin, Birgit S; Strub, Joerg R

2011-01-01

The aim of this literature review was to evaluate to what extent oral implant dentistry was integrated into undergraduate educational programs worldwide. An online search of PubMed (MEDLINE and additional life science journals) was performed for articles published from 1966 to January 2010 using combinations of select medical subject headings. Additionally, the ISI Web of Knowledge database (MEDLINE: 1950 to present, Web of Science: 1945 to present) was searched using "education" and "implant" as search terms. The online search was supplemented with a manual search of dental journals in the fields of education, prosthodontics, and implant dentistry and of the reference lists of selected full-text articles. Surveys comparing different undergraduate dental implant curricula and articles describing the undergraduate dental implant curriculum of a single university were identified. Postgraduate or continuing education programs for dental practitioners or master and specialist programs were excluded. Twenty-five articles met the inclusion criteria of this review. The percentage of universities that included implant dentistry in undergraduate education increased from 51% in 1974 to 97% in 2006 for universities in the United States and to 100% for surveyed European universities. All curricula included lectures (mostly 1 to 20 hours) and 30% to 42% included laboratory courses, but the level of clinical experience differed greatly between surveyed universities. Because oral implant dentistry has become a standard treatment alternative, the undergraduate dental curricula should include its application in treatment planning, observation of placing and restoring implants, and treating patients with implant-retained or -supported restorations.

Pain treatment facilities: do we need quantity or quality?

PubMed

de Meij, Nelleke; Köke, Albère; van der Weijden, Trudy; van Kleef, Maarten; Patijn, Jacob

2014-10-01

Chronic pain patients referred to a pain treatment facility have no guarantee that they will receive a proper diagnostic procedure or treatment. To obtain information about organizational aspects of pain treatment facilities and the content of their daily pain practice, we performed a questionnaire survey. The aim of the study was to evaluate the amount of pain treatment facilities, the content of organized specialized pain care and adherence to the criteria of the internationally accepted guidelines for pain treatment services. The University Pain Centre Maastricht in the Department of Anaesthesiology and Pain Management at Maastricht University Medical Centre developed a questionnaire survey based on the Recommendations for Pain Treatment Services of the International Association for the Study of Pain (IASP). The questionnaire was sent to the medical boards of all hospitals in the Netherlands (n=94). The response rate was 86% (n=81). Of all hospitals, 88.9% (n=72) reported the provision of organized specialized pain care, which was provided by a pain management team in 86.1% (n=62) and by an individual specialist in 13.9% (n=10). Insight was obtained from pain treatment facilities in five different domains: the organizational structure of pain management, composition of the pain team, pain team practice, patient characteristics, and research and education facilities. Although 88.9% of all hospitals stated that organized specialized pain care was provided, only a few hospitals could adhere to the criteria for pain treatment services of the IASP. The outcome of the questionnaire survey may help to define quality improvement standards for pain treatment facilities. © 2014 John Wiley & Sons, Ltd.

Dramatic response to alectinib in inflammatory myofibroblastic tumor with anaplastic lymphoma kinase fusion gene.

PubMed

Saiki, Masafumi; Ohyanagi, Fumiyoshi; Ariyasu, Ryo; Koyama, Junji; Sonoda, Tomoaki; Nishikawa, Shingo; Kitazono, Satoru; Yanagitani, Noriko; Horiike, Atsushi; Ninomiya, Hironori; Ishikawa, Yuichi; Nishio, Makoto

2017-12-01

Inflammatory myofibroblastic tumor (IMT) is a neoplasm characterized by the proliferaton of myofibroblasts with the infiltration of inflammatory cells. There is no standard treatment for patients with recurrent or metastatic IMT. We describe here a patient with hyper-progressive IMT with an anaplastic lymphoma kinase (ALK) fusion gene that dramatically responded to alectinib without adverse events. His dramatic and enduring response supports the observation that alectinib may be considered a good treatment option for rare aggressive ALK-positive tumors. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Treatment Algorithms Based on Tumor Molecular Profiling: The Essence of Precision Medicine Trials.

PubMed

Le Tourneau, Christophe; Kamal, Maud; Tsimberidou, Apostolia-Maria; Bedard, Philippe; Pierron, Gaëlle; Callens, Céline; Rouleau, Etienne; Vincent-Salomon, Anne; Servant, Nicolas; Alt, Marie; Rouzier, Roman; Paoletti, Xavier; Delattre, Olivier; Bièche, Ivan

2016-04-01

With the advent of high-throughput molecular technologies, several precision medicine (PM) studies are currently ongoing that include molecular screening programs and PM clinical trials. Molecular profiling programs establish the molecular profile of patients' tumors with the aim to guide therapy based on identified molecular alterations. The aim of prospective PM clinical trials is to assess the clinical utility of tumor molecular profiling and to determine whether treatment selection based on molecular alterations produces superior outcomes compared with unselected treatment. These trials use treatment algorithms to assign patients to specific targeted therapies based on tumor molecular alterations. These algorithms should be governed by fixed rules to ensure standardization and reproducibility. Here, we summarize key molecular, biological, and technical criteria that, in our view, should be addressed when establishing treatment algorithms based on tumor molecular profiling for PM trials. © The Author 2015. Published by Oxford University Press.

How to avoid a swift kick in the chameleons

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

Padilla, Antonio; Stefanyszyn, David; Wilson, Toby

2016-03-01

Recently, it was argued that the conformal coupling of the chameleon to matter fields created an issue for early universe cosmology. As standard model degrees of freedom become non-relativistic in the early universe, the chameleon is attracted towards a ''surfing'' solution, so that it arrives at the potential minimum with too large a velocity. This leads to rapid variations in the chameleon's mass and excitation of high energy modes, casting doubts on the classical treatment at Big Bang Nucleosynthesis. Here we present the DBI chameleon, a consistent high energy modification of the chameleon theory that dynamically renders it weakly coupledmore » to matter during the early universe thereby eliminating the adverse effects of the 'kicks'. This is done without any fine tuning of the coupling between the chameleon and matter fields, and retains its screening ability in the solar system. We demonstrate this explicitly with a combination of analytic and numerical results.« less

Universal access to HIV treatment versus universal 'test and treat': transmission, drug resistance & treatment costs.

PubMed

Wagner, Bradley G; Blower, Sally

2012-01-01

In South Africa (SA) universal access to treatment for HIV-infected individuals in need has yet to be achieved. Currently ~1 million receive treatment, but an additional 1.6 million are in need. It is being debated whether to use a universal 'test and treat' (T&T) strategy to try to eliminate HIV in SA; treatment reduces infectivity and hence transmission. Under a T&T strategy all HIV-infected individuals would receive treatment whether in need or not. This would require treating 5 million individuals almost immediately and providing treatment for several decades. We use a validated mathematical model to predict impact and costs of: (i) a universal T&T strategy and (ii) achieving universal access to treatment. Using modeling the WHO has predicted a universal T&T strategy in SA would eliminate HIV within a decade, and (after 40 years) cost ~$10 billion less than achieving universal access. In contrast, we predict a universal T&T strategy in SA could eliminate HIV, but take 40 years and cost ~$12 billion more than achieving universal access. We determine the difference in predictions is because the WHO has under-estimated survival time on treatment and ignored the risk of resistance. We predict, after 20 years, ~2 million individuals would need second-line regimens if a universal T&T strategy is implemented versus ~1.5 million if universal access is achieved. Costs need to be realistically estimated and multiple evaluation criteria used to compare 'treatment as prevention' with other prevention strategies. Before implementing a universal T&T strategy, which may not be sustainable, we recommend striving to achieve universal access to treatment as quickly as possible. We predict achieving universal access to treatment would be a very effective 'treatment as prevention' approach and bring the HIV epidemic in SA close to elimination, preventing ~4 million infections after 20 years and ~11 million after 40 years.

Development and Standardization of Inventory for Measuring Students' Integration into University Academic Culture

ERIC Educational Resources Information Center

Esomonu, Nkechi Patricia-Mary; Okeaba, James Uzoma

2016-01-01

The study developed and standardized an Inventory for measuring Students' Integration into University Academic Culture named Inventory for Students' Integration into University Academic Culture (ISIUAC). The increase in dropout rates, substance use, cultism and other deviant behaviours in Nigerian universities makes it necessary for one to ask the…

HIV-related stigma and universal testing and treatment for HIV prevention and care: design of an implementation science evaluation nested in the HPTN 071 (PopART) cluster-randomized trial in Zambia and South Africa.

PubMed

Hargreaves, James R; Stangl, Anne; Bond, Virginia; Hoddinott, Graeme; Krishnaratne, Shari; Mathema, Hlengani; Moyo, Maureen; Viljoen, Lario; Brady, Laura; Sievwright, Kirsty; Horn, Lyn; Sabapathy, Kalpana; Ayles, Helen; Beyers, Nulda; Bock, Peter; Fidler, Sarah; Griffith, Sam; Seeley, Janet; Hayes, Richard

2016-12-01

Stigma and discrimination related to HIV and key populations at high risk of HIV have the potential to impede the implementation of effective HIV prevention and treatment programmes at scale. Studies measuring the impact of stigma on these programmes are rare. We are conducting an implementation science study of HIV-related stigma in communities and health settings within a large, pragmatic cluster-randomized trial of a universal testing and treatment intervention for HIV prevention in Zambia and South Africa and will assess how stigma affects, and is affected by, implementation of this intervention. A mixed-method evaluation will be nested within HIV prevention trials network (HPTN) 071/PopART (Clinical Trials registration number NCT01900977), a three-arm trial comparing universal door-to-door delivery of HIV testing and referral to prevention and treatment services, accompanied by either an immediate offer of anti-retroviral treatment to people living with HIV regardless of clinical status, or an offer of treatment in-line with national guidelines, with a standard-of-care control arm. The primary outcome of HPTN 071/PopART is HIV incidence measured among a cohort of 52 500 individuals in 21 study clusters. Our evaluation will include integrated quantitative and qualitative data collection and analysis in all trial sites. We will collect quantitative data on indicators of HIV-related stigma over 3 years from large probability samples of community members, health workers and people living with HIV. We will collect qualitative data, including in-depth interviews and observations from members of these same groups sampled purposively. In analysis, we will: (1) compare HIV-related stigma measures between study arms, (2) link data on stigma to measures of the success of implementation of the PopART intervention and (3) explore changes in the dominant drivers and manifestations of stigma in study communities and the health system. HIV-related stigma may impede the successful implementation of HIV prevention and treatment programmes. Using a novel study-design nested within a large, community randomized trial we will evaluate the extent to which HIV-related stigma affects and is affected by the implementation of a comprehensive combination HIV prevention intervention including a universal test and treatment approach. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

40 CFR 273.55 - Off-site shipments.

Code of Federal Regulations, 2010 CFR

2010-07-01

....55 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.55 Off-site... universal waste being shipped off-site meets the Department of Transportation's definition of hazardous...

40 CFR 268.48 - Universal treatment standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... aldehyde 7421-93-4 0.025 0.13 EPTC 6 759-94-4 0.042 1.4 Ethyl acetate 141-78-6 0.34 33 Ethyl benzene 100-41...-chloroaniline) 101-14-4 0.50 30 Methylene chloride 75-09-2 0.089 30 Methyl ethyl ketone 78-93-3 0.28 36 Methyl isobutyl ketone 108-10-1 0.14 33 Methyl methacrylate 80-62-6 0.14 160 Methyl methanesulfonate 66-27-3 0.018...

40 CFR 268.48 - Universal treatment standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... aldehyde 7421-93-4 0.025 0.13 EPTC 6 759-94-4 0.042 1.4 Ethyl acetate 141-78-6 0.34 33 Ethyl benzene 100-41...-chloroaniline) 101-14-4 0.50 30 Methylene chloride 75-09-2 0.089 30 Methyl ethyl ketone 78-93-3 0.28 36 Methyl isobutyl ketone 108-10-1 0.14 33 Methyl methacrylate 80-62-6 0.14 160 Methyl methanesulfonate 66-27-3 0.018...

Education for specialization in prosthodontics in Switzerland and the role of EPA.

PubMed

Mericske-Stern, Regina

2014-07-01

Advertisement for any dental treatment was rare in Switzerland. Then the use of digital media became popular, particularly in the field of implant- and esthetic-dentistry. In parallel to the dental schools of public universities, private universities and companies built up centers for continuing education that issue specialists diplomas and M.Sc. degrees. Prosthodontics itself is characterized by many sub-disciplines that incorporated their own associations. These also offer graduate training curricula which diminish the significance of specialization in prosthodontics. Specialized prosthodontists do not have a financial benefit in Switzerland where dentistry is not supported by any insurance. In other European countries funding of prosthodontic treatment depends on their healthcare systems. There are four specialties in Dentistry recognized by the European Union (EU). Specialization in prosthodontics was introduced in Sweden already in 1982 and today it is declared in about 20 European countries, while for others no recognized program exists. Thus there are great variations with more recognized specialists in former east European countries. In Switzerland the prosthodontic specialization curriculum was developed and guided by the Swiss Society for Reconstructive Dentistry, and only in 2001 it became fully acknowledged by the Federal Department of Health. The four Swiss Universities offer the 3-year program under the supervision of the society, while the government remains the executive body. In 2003 EPA tried to set up guidelines and quality standards for an EPA recognized specialization. In spite of these attempts and the Bologna Reform in Europe, it appears that the quality standards and the level of education still may differ significantly among European countries. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

A conversation with Drs. Kaplan and Moser about conflicting data, confusing results, and some recent treatment recommendations for the management of hypertension.

PubMed

Post, Wendy; Moser, Marvin; Kaplan, Norman

2005-10-01

Following a hypertension symposium in Baltimore, MD, on June 1, 2005, Dr. Wendy Post from the Johns Hopkins University School of Medicine, Baltimore, MD, had the opportunity to interview two of the outstanding hypertension experts in the United States on several controversial issues in hypertension management. Dr. Norman Kaplan is Clinical Professor of Medicine at the Southwestern Health Science Center in Dallas, TX, and Dr. Marvin Moser is Clinical Professor of Medicine at the Yale University School of Medicine, New Haven, CT. Both have been leaders in the field of hypertension treatment and education for more than 40 years. Dr. Kaplan's book Clinical Hypertension has been a standard textbook since 1973 and is now in its ninth edition. Dr. Marvin Moser was the Senior Medical Consultant to the National High Blood Pressure Education Program from 1974 to 2002 and was Chairman of the first Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure and a member of the six subsequent committees. His book Clinical Management of Hypertension is in its seventh edition. Drs. Moser and Kaplan were corecipients of the 2004 International Society of Hypertension Award for Outstanding Contributions to Hypertension Treatment and Education and have lectured extensively throughout the United States and overseas.

78 FR 18668 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-27

.... Frequency of Submission: On occasion. Respondent Universe: 728 railroads. Total Estimated Responses: 25,000... compliance with the performance standard. Respondent Universe: 728 railroads. Frequency of Submission: On... noise standards for new locomotives. Respondent Universe: 2 Locomotive Manufacturers. Frequency of...

Kinome expression profiling of human neuroblastoma tumors identifies potential drug targets for ultra high-risk patients.

PubMed

Russo, Roberta; Cimmino, Flora; Pezone, Lucia; Manna, Francesco; Avitabile, Marianna; Langella, Concetta; Koster, Jan; Casale, Fiorina; Raia, Maddalena; Viola, Giampietro; Fischer, Matthias; Iolascon, Achille; Capasso, Mario

2017-10-01

Neuroblastoma (NBL) accounts for >7% of malignancies in patients younger than 15 years. Low- and intermediate-risk patients exhibit excellent or good prognosis after treatment, whereas for high-risk (HR) patients, the estimated 5-year survival rates is still <40%. The ability to stratify HR patients that will not respond to standard treatment strategies is critical for informed treatment decisions. In this study, we have generated a specific kinome gene signature, named Kinome-27, which is able to identify a subset of HR-NBL tumors, named ultra-HR NBL, with highly aggressive clinical behavior that not adequately respond to standard treatments. We have demonstrated that NBL cell lines expressing the same kinome signature of ultra-HR tumors (ultra-HR-like cell lines) may be selectively targeted by the use of two drugs [suberoylanilide hydroxamic acid (SAHA) and Radicicol], and that the synergic combination of these drugs is able to block the ultra-HR-like cells in G2/M phase of cell cycle. The use of our signature in clinical practice will allow identifying patients with negative outcome, which would benefit from new and more personalized treatments. Preclinical in vivo studies are needed to consolidate the SAHA and Radicicol treatment in ultra-HR NBL patients. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model.

PubMed

Ostojić, DraŽenka; Čulo, Ilaria; Silić, Ante; Kos, Suzana; Savić, Aleksandar

2018-06-01

First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models.

Impact of adherence to standard operating procedures for pneumonia on outcome of intensive care unit patients.

PubMed

Nachtigall, Irit; Tamarkin, Andrey; Tafelski, Sascha; Deja, Maria; Halle, Elke; Gastmeier, Petra; Wernecke, Klaus D; Bauer, Torsten; Kastrup, Marc; Spies, Claudia

2009-01-01

Pneumonia accounts for almost half of intensive care unit (ICU) infections and nearly 60% of deaths from nosocomial infections. It increases hospital stay by 7-9 days, crude mortality by 70% and attributable mortality by 30%. Our purpose was to assess the impact of standard operating procedures adapted to the local resistance rates in the initial empirical treatment for pneumonia on duration of first pneumonia episode, duration of mechanical ventilation, and length of ICU stay. Prospective observational cohort study with retrospective expert audit. Five anesthesiologically managed ICUs at University hospital (one cardio-surgical, one neurosurgical, two interdisciplinary, and one intermediate care). Of 524 consecutive patients with > or = 36 hr ICU treatment 131 patients with pneumonia on ICU were identified. Their first pneumonia episode was evaluated daily for adherence to standard operating procedures. Pneumonia was diagnosed according to the American Thoracic Society guidelines. Patients with > 70% compliance were assigned to high adherence group (HAG), patients with < or = 70% to low adherence group (LAG). HAG consisted of 45 (49 first episode) patients, LAG of 86 (82 first episode) patients, respectively. Mean duration of treatment of the first pneumonia episode was 10.11 +/- 7.95 days in the LAG and 6.22 +/- 3.27 days in the HAG (p = 0.001). Duration of mechanical ventilation was 317.59 +/- 336.18 hrs in the LAG and 178.07 +/- 191.33 hrs in the HAG (p = 0.017). Length of ICU stay was 20.24 +/- 16.59 days in the LAG and 12.04 +/- 10.42 days in the HAG (p = 0.001). Barriers in compliance need further evaluation. Adherence to standard operating procedure is associated with a shorter duration of treatment of first pneumonia episode, a shorter duration of mechanical ventilation, and a shorter ICU stay.

40 CFR 273.56 - Exports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Exports. 273.56 Section 273.56 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.56 Exports. A universal waste...

40 CFR 273.18 - Off-site shipments.

Code of Federal Regulations, 2011 CFR

2011-07-01

....18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.18 Off-site shipments. (a) A small quantity handler of universal waste is prohibited from sending or...

40 CFR 273.38 - Off-site shipments.

Code of Federal Regulations, 2012 CFR

2012-07-01

....38 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.38 Off-site shipments. (a) A large quantity handler of universal waste is prohibited from sending or...

40 CFR 273.38 - Off-site shipments.

Code of Federal Regulations, 2011 CFR

2011-07-01

....38 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.38 Off-site shipments. (a) A large quantity handler of universal waste is prohibited from sending or...

40 CFR 273.18 - Off-site shipments.

Code of Federal Regulations, 2012 CFR

2012-07-01

....18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.18 Off-site shipments. (a) A small quantity handler of universal waste is prohibited from sending or...

40 CFR 273.35 - Accumulation time limits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... container became a waste or was received; (2) Marking or labeling the individual item of universal waste (e... Section 273.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste...

40 CFR 273.18 - Off-site shipments.

Code of Federal Regulations, 2010 CFR

2010-07-01

....18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.18 Off-site shipments. (a) A small quantity handler of universal waste is prohibited from sending or...

40 CFR 273.38 - Off-site shipments.

Code of Federal Regulations, 2010 CFR

2010-07-01

....38 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.38 Off-site shipments. (a) A large quantity handler of universal waste is prohibited from sending or...

40 CFR 273.35 - Accumulation time limits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... container became a waste or was received; (2) Marking or labeling the individual item of universal waste (e... Section 273.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste...

40 CFR 273.38 - Off-site shipments.

Code of Federal Regulations, 2014 CFR

2014-07-01

....38 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.38 Off-site shipments. (a) A large quantity handler of universal waste is prohibited from sending or...

40 CFR 273.18 - Off-site shipments.

Code of Federal Regulations, 2014 CFR

2014-07-01

....18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.18 Off-site shipments. (a) A small quantity handler of universal waste is prohibited from sending or...

40 CFR 273.38 - Off-site shipments.

Code of Federal Regulations, 2013 CFR

2013-07-01

....38 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.38 Off-site shipments. (a) A large quantity handler of universal waste is prohibited from sending or...

40 CFR 273.35 - Accumulation time limits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... container became a waste or was received; (2) Marking or labeling the individual item of universal waste (e... Section 273.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste...

40 CFR 273.18 - Off-site shipments.

Code of Federal Regulations, 2013 CFR

2013-07-01

....18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.18 Off-site shipments. (a) A small quantity handler of universal waste is prohibited from sending or...

40 CFR 273.35 - Accumulation time limits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... container became a waste or was received; (2) Marking or labeling the individual item of universal waste (e... Section 273.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste...

40 CFR 273.35 - Accumulation time limits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... container became a waste or was received; (2) Marking or labeling the individual item of universal waste (e... Section 273.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste...

Standard methods for sampling freshwater fishes: Opportunities for international collaboration

USGS Publications Warehouse

Bonar, Scott A.; Mercado-Silva, Norman; Hubert, Wayne A.; Beard, Douglas; Dave, Göran; Kubečka, Jan; Graeb, Brian D. S.; Lester, Nigel P.; Porath, Mark T.; Winfield, Ian J.

2017-01-01

With publication of Standard Methods for Sampling North American Freshwater Fishes in 2009, the American Fisheries Society (AFS) recommended standard procedures for North America. To explore interest in standardizing at intercontinental scales, a symposium attended by international specialists in freshwater fish sampling was convened at the 145th Annual AFS Meeting in Portland, Oregon, in August 2015. Participants represented all continents except Australia and Antarctica and were employed by state and federal agencies, universities, nongovernmental organizations, and consulting businesses. Currently, standardization is practiced mostly in North America and Europe. Participants described how standardization has been important for management of long-term data sets, promoting fundamental scientific understanding, and assessing efficacy of large spatial scale management strategies. Academics indicated that standardization has been useful in fisheries education because time previously used to teach how sampling methods are developed is now more devoted to diagnosis and treatment of problem fish communities. Researchers reported that standardization allowed increased sample size for method validation and calibration. Group consensus was to retain continental standards where they currently exist but to further explore international and intercontinental standardization, specifically identifying where synergies and bridges exist, and identify means to collaborate with scientists where standardization is limited but interest and need occur.

40 CFR 273.52 - Waste management.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Waste management. 273.52 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.52 Waste management. (a) A universal waste transporter must comply with all applicable U.S. Department of...

40 CFR 273.52 - Waste management.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Waste management. 273.52 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.52 Waste management. (a) A universal waste transporter must comply with all applicable U.S. Department of...

40 CFR 273.52 - Waste management.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 27 2011-07-01 2011-07-01 false Waste management. 273.52 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.52 Waste management. (a) A universal waste transporter must comply with all applicable U.S. Department of...

40 CFR 273.52 - Waste management.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Waste management. 273.52 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.52 Waste management. (a) A universal waste transporter must comply with all applicable U.S. Department of...

40 CFR 273.52 - Waste management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Waste management. 273.52 Section 273...) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.52 Waste management. (a) A universal waste transporter must comply with all applicable U.S. Department of...

40 CFR 273.15 - Accumulation time limits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... individual item of universal waste (e.g., each battery or thermostat) with the date it became a waste or was... Section 273.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste...

40 CFR 273.15 - Accumulation time limits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... individual item of universal waste (e.g., each battery or thermostat) with the date it became a waste or was... Section 273.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste...

40 CFR 273.15 - Accumulation time limits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... individual item of universal waste (e.g., each battery or thermostat) with the date it became a waste or was... Section 273.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste...

40 CFR 273.15 - Accumulation time limits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... individual item of universal waste (e.g., each battery or thermostat) with the date it became a waste or was... Section 273.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste...

40 CFR 273.15 - Accumulation time limits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... individual item of universal waste (e.g., each battery or thermostat) with the date it became a waste or was... Section 273.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste...

Cost Effectiveness of Colorectal Cancer Screening Interventions with Their Effects on Health Disparity Being Considered.

PubMed

Lee, Kwang-Sig; Park, Eun-Cheol

2016-07-01

The purpose of this study was to evaluate the cost effectiveness of colorectal cancer screening interventions with their effects on health disparity being considered. Markov cohort simulation was conducted with the cycle/duration of 1/40 year(s). Data came from the results of randomized trials and others. Participants were hypothetical cohorts aged 50 years as of year 2013 in 16 Korean provinces. The interventions until the age of 80 were annual organized fecal occult blood test (FOBT) (standard screening), annual FOBT with basic reminders for provinces with higher mortalities than the national average (targeted reminder) and annual FOBT with basic/enhanced reminders for all provinces (universal reminder 1 and 2). The comparison was non-screening, the outcome was quality-adjusted life years, and only medical costs for screening and treatment were considered from a societal perspective. The Atkinson incremental cost effectiveness ratio (Atkinson ICER), the incremental cost effectiveness ratio adjusted by the Atkinson Inequality Index, was used to evaluate the cost effectiveness of the four interventions with their impacts on regional health disparity being considered. Health disparity was smallest (or greatest) in non-screening (or the standard screening). The targeted reminder had smaller health disparity, and smaller Atkinson ICER with respect to standard screening, than did the universal reminder 1 and 2. The targeted reminder might be more cost effective than the universal reminders with their effects on health disparity being considered. This study helps to develop promotional effort for colorectal cancer screening with both the greatest cost effectiveness and the smallest health disparity.

[Research and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before World War II in the context of psychiatry in Europe].

PubMed

Rutkowski, Krzysztof; Dembińska, Edyta

2014-01-01

The aim of this article is to offer an overview of the research into diagnosis and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before the outbreak of World War II. It also includes a profile of the work of Prof. Jan Piltz, the then director of the Clinic, and his major scientific achievements. The publications cited in the article date in the main from the period of World War I, and comprise clinical analyses of the consequences of stress suffered at the front as well as a description of the ways in which they were treated. These are presented alongside other major findings related to war neuroses being made in Europe at the time. The article draws attention to the very modern thinking on treatment of war neuroses, far ahead of the average standards of the day, evinced by Prof. Piltz and his team. The most important innovative elements of their treatment of these conditions were the fact that they perceived the cause of the neurosis to lie in previous personality disorders in the patients, their recommendation of psychotherapy as the main method of treatment, and their emphasis on the need for further rehabilitation following the completion of the course of hospital treatment. They also paid significant attention to the importance of drawing up individual therapy plans for each patient.

High-dose versus standard-dose radiotherapy with concurrent chemotherapy in stages II-III esophageal cancer.

PubMed

Suh, Yang-Gun; Lee, Ik Jae; Koom, Wong Sub; Cha, Jihye; Lee, Jong Young; Kim, Soo Kon; Lee, Chang Geol

2014-06-01

In this study, we investigated the effects of radiotherapy ≥60 Gy in the setting of concurrent chemo-radiotherapy for treating patients with Stages II-III esophageal cancer. A total of 126 patients treated with 5-fluorouracilbased concurrent chemo-radiotherapy between January 1998 and February 2008 were retrospectively reviewed. Among these patients, 49 received a total radiation dose of <60 Gy (standard-dose group), while 77 received a total radiation dose of ≥60 Gy (high-dose group). The median doses in the standard- and high-dose groups were 54 Gy (range, 45-59.4 Gy) and 63 Gy (range, 60-81 Gy), respectively. The high-dose group showed significantly improved locoregional control (2-year locoregional control rate, 69 versus 32%, P < 0.01) and progression-free survival (2-year progression-free survival, 47 versus 20%, P = 0.01) than the standard-dose group. Median overall survival in the high- and the standard-dose groups was 28 and 18 months, respectively (P = 0.26). In multivariate analysis, 60 Gy or higher radiotherapy was a significant prognostic factor for improved locoregional control, progression-free survival and overall survival. No significant differences were found in frequencies of late radiation pneumonitis, post-treatment esophageal stricture or treatment-related mortality between the two groups. High-dose radiotherapy of 60 Gy or higher with concurrent chemotherapy improved locoregional control and progression-free survival without a significant increase of in treatment-related toxicity in patients with Stages II-III esophageal cancer. Our study could provide the basis for future randomized clinical trials. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comprehensive Quality of Life (QoL) in Neurofibromatosis Type II (NF2): Development, Refinement and Standardization of a Multi-Dimensional Metric

DTIC Science & Technology

2012-12-01

or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington...University. 9 Additionally, incorporation of NF2 specific QoL metrics is progressing in all aspects of NF care at NYU. The baseline QoL data will...utilization of mental health providers to provide both counseling, and when necessary, treatment of this currently under-recognized aspect of NF2

Research priorities in cancer cachexia: The University of Rochester Cancer Center NCI Community Oncology Research Program Research Base Symposium on Cancer Cachexia and Sarcopenia.

PubMed

Dunne, Richard F; Mustian, Karen M; Garcia, Jose M; Dale, William; Hayward, Reid; Roussel, Breton; Buschmann, Mary M; Caan, Bette J; Cole, Calvin L; Fleming, Fergal J; Chakkalakal, Joe V; Linehan, David C; Hezel, Aram F; Mohile, Supriya G

2017-12-01

Cancer cachexia remains understudied and there are no standard treatments available despite the publication of an international consensus definition and the completion of several large phase III intervention trials in the past 6 years. In September 2015, The University of Rochester Cancer Center NCORP Research Base led a Symposium on Cancer Cachexia and Sarcopenia with goals of reviewing the state of the science, identifying knowledge gaps, and formulating research priorities in cancer cachexia through active discussion and consensus. Research priorities that emerged from the discussion included the implementation of morphometrics into clinical decision making, establishing specific diagnostic criteria for the stages of cachexia, expanding patient selection in intervention trials, identifying clinically meaningful trial endpoints, and the investigation of exercise as an intervention for cancer cachexia. Standardizing how we define and measure cancer cachexia, targeting its complex biologic mechanisms, enrolling patients early in their disease course, and evaluating exercise, either alone or in combination, were proposed as initiatives that may ultimately result in the improved design of cancer cachexia therapeutic trials.

Defining and managing biohazardous waste in U.S. research-oriented universities: a survey of environmental health and safety professionals.

PubMed

Mecklem, Robin Lyn; Neumann, Catherine M

2003-01-01

A survey was conducted of environmental health and safety professionals responsible for biohazardous waste management at 122 institutions. The overall response rate was 82.6 percent (100 out of 122). Results indicate that university policies for biohazardous waste are heavily influenced by state environmental regulations, the Occupational Safety and Health Administration Bloodborne Pathogens Standard, and the biosafety guidelines of the Centers for Disease Control and Prevention and the National Institutes of Health. With respect to definition of waste, 84 percent of the universities treat non-infectious human-cell-culture waste as biohazardous. Sharp items, including hypodermic needles, syringes with needles, and scalpel blades, are commonly treated (by 85 percent of universities) as biohazardous sharps regardless of contamination status. Importantly, while 90 percent of universities use autoclave sterilization for waste treatment, only 52 percent use a biological indicator to validate the process. On-site incineration is currently used by 42 percent of universities. Twenty-two of 42 incinerators are hospital/medical/infectious-waste incinerators, and 10 of these will continue to operate under the U.S. Environmental Protection Agency's revised incinerator regulations. Eighty-seven percent of the respondents indicated that some portion of their university's biohazardous waste is treated and disposed of through a licensed medical waste hauler (MWH). To ensure compliance with institutional policy, most universities segregate and package waste, train waste generators, and conduct inspections.

Effects of Self-Knee Massage With Ginger Oil in Patients With Osteoarthritis: An Experimental Study.

PubMed

Tosun, Betul; Unal, Nursemin; Yigit, Deniz; Can, Nuray; Aslan, Ozlem; Tunay, Servet

2017-11-01

The purpose of our study was to assess the effects of self-knee massage with ginger oil on pain and daily living activities in patients with knee osteoarthritis. Participants (N = 68) were asked about their sociodemographic characteristics, pain level in the last week using the Visual Analog Scale (VAS), and functionality in activities of daily living with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Standard treatment prescribed by a physician was given to the patients with osteoarthritis. In addition to the standard treatment, self-knee massage with ginger oil twice a week was recommended to the intervention group (n = 34). At the end of the first and fifth week, participants in both groups were assessed regarding pain and functional state. The mean VAS Pain scores of the intervention group were significantly lower at the end of the first and fifth weeks (p< .05). The mean total scores and mean Function subscale scores of the WOMAC were significantly lower in massage group in the first- and fifth-week assessments (p < .05). Self-massage of the knee with ginger oil may be used as a complementary method to standard medical treatment. Nurses can easily train patients and their caregivers on knee massage, and the intervention can be implemented by patients at home without any restrictions on location.

Recent Advances in Targeted Therapy for Glioma.

PubMed

Lin, Lin; Cai, Jinquan; Jiang, Chuanlu

2017-01-01

Gliomas are the most common primary malignant brain tumors, which have a universally fatal outcome. Current standard treatment for glioma patients is surgical removal followed by radiotherapy and adjuvant chemotherapy. Due to therapeutic resistance and tumor recurrence, efforts are ongoing to identify the molecules that are fundamental to regulate the tumor progression and provide additional methods for individual treatment of glioma patients. By studying the initiation and maintenance of glioma, studies focused on the targets of tyrosine kinase receptors including EGFR, PDGFR and other crucial signal pathways such as PI3K/AKT and RAS/RAF/MAPK pathway. Furthermore, recent advances in targeting immunotherapy and stem cell therapy also brought numerous strategies to glioma treatment. This article reviewed the researches focused on the advanced strategies of various target therapies for improving the glioma treatment efficacy, and discussed the challenges and future directions for glioma therapy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare.

PubMed

Mannion, Russell; Exworthy, Mark

2017-03-28

Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by 'standardization' and 'customization' in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics - the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Common Bibliographic Standards for Baylor University Libraries. Revised.

ERIC Educational Resources Information Center

Scott, Sharon; And Others

Developed by a Baylor University (Texas) Task Force, the revised policies of bibliographic standards for the university libraries provide formats for: (1) archives and manuscript control; (2) audiovisual media; (3) books; (4) machine-readable data files; (5) maps; (6) music scores; (7) serials; and (8) sound recordings. The task force assumptions…

The affordability for patients of a new universal MDR-TB coverage model in China.

PubMed

Ruan, Y-Z; Li, R-Z; Wang, X-X; Wang, L-X; Sun, Q; Chen, C; Xu, C-H; Su, W; Zhao, J; Pang, Y; Cheng, J; Wang, Q; Fu, Y-T; Huan, S-T; Chen, M-T; Scano, F; Floyd, K; Chin, D P; Fitzpatrick, C

2016-05-01

China has piloted a new model of universal coverage for multidrug-resistant tuberculosis (MDR-TB), designed to rationalize hospital use of drugs and tests and move away from fee-for-service payment towards a standard package with financial protection against catastrophic health costs. To evaluate the affordability to patients of this new model. This was an observational study of 243 MDR-TB cases eligible for enrolment on treatment under the project. We assessed the affordability of the project from the perspective of households, with a focus on catastrophic costs. Of the 243 eligible cases, 172 (71%) were enrolled on treatment; of the 71 cases not enrolled, 26 (37%) cited economic reasons. The 73 surveyed cases paid an average of RMB 5977 (US$920) out-of-pocket in search costs incurred outside the pilot model. Within the pilot, they paid another RMB 2094 (US$322) in medical fees and RMB 5230 (US$805) in direct non-medical costs. Despite 90% reimbursement of medical fees, 78% of households experienced catastrophic costs, including indirect costs. The objectives of the pilot model are aligned with health reform in China and universal health coverage globally. Enrollment would almost certainly be higher with 100% reimbursement of medical fees, but patient enablers will be required to truly eliminate catastrophic costs.

Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid.

PubMed

Estades-Rubio, Francisco J; Reyes-Martín, Alvaro; Morales-Marcos, Victor; García-Piriz, Mercedes; García-Vera, Juan J; Perán, Macarena; Marchal, Juan A; Montañez-Heredia, Elvira

2017-03-17

Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane ® ) and Group II with HA (Go-ON ® ). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

Sticking with it: Psychotherapy outcomes for adults with autism spectrum disorder in a university counseling center setting.

PubMed

Anderberg, Emily; Cox, Jonathan C; Neeley Tass, E Shannon; Erekson, David M; Gabrielsen, Terisa P; Warren, Jared S; Cline, Jared; Petersen, Devin; South, Mikle

2017-12-01

Young adults with autism spectrum disorders (ASD) experience high rates of comorbid mental health concerns in addition to distress arising from the core symptoms of autism. Many adults with ASD seek psychological treatment in outpatient facilities in their communities that are not specifically geared toward individuals with ASD. However, few studies have looked at the effectiveness of standard psychotherapeutic care in adults with ASD. This study aimed to discover how individuals with ASD fare in psychotherapy within a college counseling setting, compared to their neurotypical peers. Clients with ASD (n = 76) or possible ASD (n = 91) were retrospectively identified from counseling center case notes. Data from the Outcome Questionnaire-45 (OQ) were retrieved for each therapy session as a measure of client distress. Clients with ASD showed no difference in level of distress at intake compared to their neurotypical peers (n = 21,546), and improved about the same amount from pre- to post-treatment. However, students with ASD stayed in treatment for significantly more sessions than neurotypical clients, and took significantly longer to achieve maximum improvement on OQ reports. Results are discussed with implications for university and other community based treatment settings. Autism Res 2017, 10: 2048-2055. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. This study aimed to discover how individuals with autism spectrum disorders (ASD) fare in psychotherapy within a university counseling setting, compared to their neurotypical peers. Clients with ASD showed no difference in level of distress at intake compared to their neurotypical peers, and improved about the same amount from pre- to post-treatment. However, students with ASD stayed in treatment for significantly more sessions than neurotypical clients, and took significantly longer to achieve maximum improvement on Outcome Questionnaire-45 reports. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

HIV Vaccine Trial participation in South Africa - an ethical assessment.

PubMed

Moodley, Keymanthri

2002-04-01

Trial participation in the proposed HIV Vaccine Trials in South Africa is discussed in the context of the ethical tension that exists between international ethical research standards and local standards of care and cultural norms in the Third World. The important concepts of informed consent, risk-benefit ratio and fair treatment of trial participants are interpreted differently in traditional, rural African communities, where a moderate form of communitarianism referred to as "Ubuntu" or "communalism" is still prevalent. Research is an altruistic endeavor that benefits communities and societies as a result of risks taken by individuals. Universal ethical guidelines that are highly individualistic and fail to emphasize communalism may represent serious problems for the sort of research needed in Africa today.

Universal HPLC Detector for Hydrophilic Organic Compounds by Means of Total Organic Carbon Detection.

PubMed

Ohira, Shin-Ichi; Kaneda, Kyosuke; Matsuzaki, Toru; Mori, Shuta; Mori, Masanobu; Toda, Kei

2018-06-05

Most quantifications are achieved by comparison of the signals obtained with the sample to those from a standard. Thus, the purity and stability of the standard are key in chemical analysis. Furthermore, if an analyte standard cannot be obtained, quantification cannot be achieved, even if the chemical structures are identified by a qualification method (e.g., high-resolution mass spectrometry). Herein, we describe a universal and analyte standard-free detector for aqueous-eluent-based high-performance liquid chromatography. This universal carbon detector (UCD) was developed based on total organic carbon detection. Separated analytes were oxidized in-line and converted to carbon dioxide (CO 2 ). Generated CO 2 was transferred into the gas phase and collected into ultrapure water, which was followed by conductivity detection. The system can be applied as a HPLC detector that does not use an organic solvent as an eluent. The system can be calibrated with a primary standard of sodium bicarbonate for organic compounds. The universality and quantification were evaluated with organic compounds, including organic acids, sugars, and amino acids. Furthermore, the system was successfully applied to evaluation of the purity of formaldehyde in formalin solution, and determination of sugars in juices. The results show the universal carbon detector has good universality and can quantify many kinds of organic compounds with a single standard such as sodium bicarbonate.

Affirmative Action, the Academy and Compromised Standards: Does Affirmative Action Lower Standards in University Hiring, Tenure and Promotion?

ERIC Educational Resources Information Center

Hanks, Lawrence J.; Sullivan, Jas; Spencer, Sara B.; Rogers, Elgin

2008-01-01

The literature opposed to affirmative action in hiring, granting tenure and promotion in the university claims that it lowers standards. However, anecdotal evidence suggests that in the decades prior to the institutionalization of affirmative action in the Academy, hiring, tenure and promotion standards were quite lax--resembling an "old boys…

Anthranilic Diamide Insecticides Delivered via Multiple Approaches to Control Vegetable Pests: A Case Study in Snap Bean.

PubMed

Schmidt-Jeffris, Rebecca A; Nault, Brian A

2016-12-01

Many vegetable insect pests are managed using neonicotinoid and pyrethroid insecticides. Unfortunately, these insecticides are toxic to many bees and natural enemies and no longer control some pests that have developed resistance. Anthranilic diamide insecticides provide systemic control of many herbivorous arthropod pests, but exhibit low toxicity to beneficial arthropods and mammals, and may be a promising alternative to neonicotinoids and pyrethroids. Anthranilic diamides may be delivered to vegetable crops via seed, in-furrow, or foliar treatments; therefore, it would be desirable to identify which application method provides high levels of pest control while minimizing the amount of active ingredient. As a case study, chlorantraniliprole and cyantraniliprole applied via the methods listed above were evaluated for managing seedcorn maggot, Delia platura (Meigen) (Diptera: Anthomyiidae), and European corn borer, Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae), in snap bean. Chlorantraniliprole and cyantraniliprole delivered as seed and in-furrow treatments reduced D. platura damage to the same level as the standard neonicotinoid seed treatment. Both diamides applied via all three methods significantly reduced O. nubilalis damage, but only the foliar application provided similar control as the standard pyrethroid spray. Results from laboratory bioassays revealed that both diamides applied as seed and in-furrow treatments caused high O. nubilalis neonate mortality up to 44 d after application. While the diamides provided equivalent control of these pests as the neonicotinoid and pyrethroid standards when applied in the same manner, chlorantraniliprole delivered as a seed treatment showed the most promise for managing both pests. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial.

PubMed

Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia; Skerris, Anja; Skou, Christina; Christoffersen, Jane; Seest, Line Skou; Poulsen, Mai Bang; Rønholt, Finn; Overgaard, Karsten

2016-03-01

To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. Interventional, randomised, safety/efficacy open-label trial. University hospital stroke unit in collaboration with three municipalities. Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from P<0.00001 to P=0.01). Economical estimations of intervention costs were lower than total costs of standard treatment. Early home-based rehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective. © The Author(s) 2015.

Managed competition: an analysis of consumer concerns. The Working Group on Managed Competition.

PubMed

1994-01-01

Advocates for health care reform (representing a broad range of constituencies) raise serious concerns about the ability of managed competition to meet the health care needs of the American people. Similarities in managed competition proposals include establishment of a collective purchasing authority, creation of health plans, standardization of rules and requirements, and limitation on tax subsidies. Managed competition proposals vary as to whether they call for true universality, meaningful cost containment, and fair financing. The article raises questions about managed competition, including the technical feasibility; the link to employment; the role for insurance companies; severing the link between insurance and income, age, or health status; comprehensive benefits; cost containment; the role for managed care; universality of coverage; and the role for insurance companies to make treatment decisions.

Grading Standards and Student Performance in Community College and University Courses

ERIC Educational Resources Information Center

Friedl, John; Pittenger, David J.; Sherman, Michael

2012-01-01

Research was undertaken to determine whether comparable grading standards are used in evaluating student performance at two-year community colleges and four-year universities. Examination of academic records of 417 students who took college level math at the University of Tennessee at Chattanooga in fall 2009 compared the performance of those who…

Effect of different surface treatments on shear bond strength of zirconia to three resin cements

NASA Astrophysics Data System (ADS)

Dadjoo, Nisa

Statement of problem: There are no standard guidelines for material selection to obtain acceptable bonding to high-strength zirconium oxide ceramic. Studies suggest resin cements in combination with MDP-containing primer is a reasonable choice, however, the other cements cannot be rejected and need further investigation. Objective: The purpose of this in vitro study was the evaluation of the shear bond strength of three composite resin cements to zirconia ceramic after using different surface conditioning methods. Materials and methods: One hundred and twenty sintered Y-TZP ceramic (IPS e.max ZirCAD) squares (8 x 8 x 4 mm) were embedded in acrylic molds, then divided into three groups (n=40) based on the type of cement used. Within each group, the specimens were divided into four subgroups (n=10) and treated as follows: (1) Air abrasion with 50microm aluminum oxide (Al2O 3) particles (ALO); (2) Air abrasion + Scotchbond Universal adhesive (SBU); (3) Air abrasion + Monobond Plus (MBP); (4) Air abrasion + Z-Prime Plus (ZPP). Composite cylinders were used as carriers to bond to conditioned ceramic using (1) RelyX Ultimate adhesive resin cement (RX); (2) Panavia SA self-adhesive resin cement (PSA); (3) Calibra esthetic cement (CAL). The bonded specimens were submerged in distilled water and subjected to 24-hour incubation period at 37°C. All specimens were stressed in shear at a constant crosshead speed of 0.5 mm/min until failure. Statistical analysis was performed by ANOVA. The bond strength values (MPa), means and standard deviations were calculated and data were analyzed using analysis of variance with Fisher's PLSD multiple comparison test at the 0.05 level of significance. The nature of failure was recorded. Results: The two-way ANOVA showed Panavia SA to have the highest strength at 44.3 +/- 16.9 MPa (p<0.05). The combination of Scotchbond Universal surface treatment with Panavia SA cement showed statistically higher bond strength (p=0.0054). The highest bond strengths for all three cements were observed with Scotchbond Universal surface treatment (p=0.0041). Calibra in combination with aluminum oxide air abrasion resulted in statistically lowest bond strength at 12.0 +/- 3.9 MPa. The predominant mode of failure was cohesive with cement remaining principally on the zirconium oxide samples in 57.5% of the specimens, followed by cement found on both the zirconium oxide samples and composite rods (mixed) in 32.5% of the samples. Only 10% of the specimens were found with cement on the composite rods (adhesive failure). Conclusions: Within the limitations of this in vitro study, the MDP-containing resin cement, Panavia SA, yielded the strongest bond to Y-TZP ceramic when compared to adhesive (RelyX Ultimate) or esthetic (Calibra) resin cements. Air abrasion particle + Scotchbond Universal surface treatment demonstrated the highest bond strength regardless of the cement. Significance: The variation of surface conditioning methods yielded different results in accordance with the cement types. Overall, Scotchbond Universal adhesive + air abrasion yielded the highest bond strengths among all three surface treatments. The phosphate monomer-containing luting system, Panavia SA, is acceptable for bonding to zirconia ceramics.

[The role of the cervical spine and the craniomandibular system in the pathogenesis of tinnitus. Somatosensory tinnitus].

PubMed

Biesinger, E; Reisshauer, A; Mazurek, B

2008-07-01

The causes of tinnitus, vertigo, and hearing disturbances may be pathological processes in the cervical spine and temporomaxillary joint. In these cases, tinnitus is called somatosensory tinnitus (SST). For afferences of the cervical spine, projections of neuronal connections in the cochlear nucleus were found. A reflex-like impact of the cervical spine on the cochlear nucleus can be assumed. The tinnitus treatment concept of the Charité University Hospital in Berlin involves the cooperation of ENT specialists with many other disciplines in an outpatient clinic. A standardized examination protocol has been established, and physical therapy has been integrated into the interdisciplinary tinnitus treatment. For tinnitus-modulating therapy of muscular trigger points, local anesthetics as well as self-massage or treatment by a physiotherapist or osteopath are useful.

A decade of experience promoting the clinical treatment of tobacco dependence in Wisconsin.

PubMed

Redmond, Lezli A; Adsit, Robert; Kobinsky, Kathleen H; Theobald, Wendy; Fiore, Michael C

2010-04-01

The University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) is the designated lead agency at the University of Wisconsin-Madison charged with the responsibility of reducing the harms from tobacco use in Wisconsin and beyond. In 2000, the UW-CTRI, with funding from the state of Wisconsin, launched a population-wide effort--the Wisconsin Cessation Outreach Program (Program)--to increase the availability and use of evidence-based clinical treatments for tobacco dependence. This paper describes the Program's strategies, outcomes, and impact on the clinical treatment of tobacco dependence in Wisconsin. The Program was designed to change the standard of health care in Wisconsin, so that primary care professionals, and the health systems in which they work, universally identified and intervened with tobacco users. Five primary strategies were used to accomplish its goal: (1) deliver clinic-based and Web-based training and technical assistance for clinicians, including free continuing medical education (CME); (2) provide technical assistance to accomplish health systems' change to support the routine provision of tobacco-dependence treatment; (3) include evidence-based cessation treatment as a covered insurance benefit and reduce other barriers to cessation treatment such as co-pays; (4) provide telephonic tobacco cessation quit line services to all state residents and integrate it with routine medical services; and (5) reduce tobacco-related disparities by increasing access to and use of evidence-based treatment by priority populations. In the 10 years since the Program was initiated, progress has been achieved in a number of tobacco use parameters in Wisconsin, including higher rates of Wisconsin smokers making a quit attempt; increased insurance coverage for cessation counseling and medications; higher rates of discussion of cessation treatment options by clinicians; and integration of the Wisconsin Tobacco Quit Line (WTQL) into routine primary care, with almost 100,000 Wisconsin smokers using the WTQL. Nearly half of all WTQL callers were uninsured or Medicaid enrollees. Additionally, smoking rates in Wisconsin have fallen by almost 20% during this period, from about 24% of all adults in 2000 to <20% today.

[Effectiveness of a micronized purified flavonoid fraction (MPFF) in the healing process of lower limb ulcers. An open multicentre study, controlled and randomized].

PubMed

Glinski, W; Chodynicka, B; Roszkiewicz, J; Bogdanowski, T; Lecewicz-Torun, B; Kaszuba, A; Bowszyc, J; Nowak, A; Wnorowski, J; Wasik, F; Glinska-Ferenz, M; Blaszczyk, M; Strzyga, P; Pachocki, R

2001-04-01

To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care. A randomised, open, controlled, multicentre study. Departments of Dermatology and University Outpatients Clinics. One hundred and forty patients with chronic venous insufficiency and venous ulcers. PATIENTS received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks. Healing of ulcers and their reduction in size after 24 weeks of treatment. The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05. OR=2.3, 95% CI 1.1-4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients (p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) (p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was 1026.2 compared with 1871.8 in the control group. These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

The use of immunosuppressive agents in the management of recalcitrant lower limb ulcers.

PubMed

Millen, A; Coulston, J; Brennan, J; Kennedy, T

2014-08-01

Lower limb ulcers that are resistant to standard forms of treatment place a significant burden on both patients and health services. There is no widely agreed definition of a recalcitrant ulcer but failure to heal following 6-12 months of focused treatment would identify a small group of patients with highly resistant ulceration. We describe a series of patients with recalcitrant ulceration for which immunosuppressive agents have been used. This is a case series of 13 patients who underwent immunomodulation therapy for lower limb ulcers at a tertiary referral university hospital. Regimens of immunomodulation used mainly ciclosporin and/or cyclophosphamide, with concurrent antibiotic therapy. Case notes and computer systems were analysed by two reviewers. A patient was deemed to have a success if their ulcer fully healed while on immunomodulation therapy. Over a period of eight years, from 2004-2012, 13 patients underwent immunomodulation therapy. Among these patients there were 18 ulcerated limbs. Ulcer healing occurred in 10 limbs out of 18 (55.6%) and full healing occurred in six patients (46.2%). Ulcers were present for a median of five years (range 2-40 years), with a median diameter of 7.5 cm (range 4-18 cm) before treatment. Treatment of truly recalcitrant ulceration can be very frustrating for both the patient and physician, with poor success from more standard forms of treatment. We report experience with immunomodulation therapy that suggests there may be benefit from using this treatment in a subset of patients with this debilitating disease.

Transvenous Endovascular Treatment for Scalp Arteriovenous Fistulas: Results with Combined Use of Onyx and Coils.

PubMed

Ni, Wei; Tian, Yanlong; Gu, Yuxiang; Mao, Ying

2017-11-01

Scalp arteriovenous fistulas (AVFs) are rare lesions that may occur spontaneously or secondary to head trauma. A standard treatment strategy for these lesions has not been established to date. We present 3 cases of successful treatment of scalp AVFs using a combination of Onyx-18 and coils via a transvenous approach. The patient database at Huashan Hospital, Fudan University, Shanghai, China was reviewed, and patients with scalp AVFs treated with Onyx-18 and coils via a transvenous approach were identified for analysis. Between 2014 and 2016, 3 consecutive patients with scalp AVFs were treated transvenously with Onyx embolization in combination with coil placement at our hospital. No procedure-related complications were noted. Postembolization angiography demonstrated successful and complete occlusion of the AVFs immediately after treatment. Clinical follow-up showed resolution of symptoms. The technique of transvenous "armored concrete" embolization using a combination of coils and Onyx is an effective treatment modality for scalp AVFs, particularly in type C cases. Copyright © 2017 Elsevier Inc. All rights reserved.

[Treatment regulations and treatment limits: factors influencing clinical decision-making].

PubMed

Baberg, H T; Kielstein, R; de Zeeuw, J; Sass, H-M

2002-08-02

Providing or withholding of treatment is based on a variety of factors. We sought for criteria in clinical decision making and reviewed attitudes towards clinical intuition and the patient's will. 503 physicians (25.6 % females; mean age 36.3) in 49 departments at nine hospitals of the universities Bochum and Magdeburg filled in a validated questionnaire. The most important factors in the decision to carry out a therapy were "international standards" and "own experience". The decision to omit a therapy was mainly influenced by the "patient's wish". Physicians with a higher status judged their own experience higher than young physicians, who considered the experience of colleagues more important. "Severe accompanying illnesses" and "multimorbidity" were the most frequently named reasons to withdraw a therapy. Intuitive decision-making was rare, especially in young physicians, although these decisions were seldom risky and often successful. A patient's will plays a prominent role in clinical decision making, especially in decisions to withdraw or to withhold treatment. Cost containment and research interest have been called less important, a remarkable response from research-based university hospitals. Also remarkable is the recognition and importance of clinical intuition in situations of complex or missing information. This important aspect is rarely discussed in the literature or in medical education. The widely voiced concern that priorities in clinical care are guided by scientific interest, financial or technical possibilities could not be confirmed.

Napropamide residues in runoff and infiltration water from pepper production.

PubMed

Antonious, George F; Patterson, Matthew A

2005-01-01

A field study was conducted on a Lowell silty loam soil of 2.7% organic matter at the Kentucky State University Research Farm, Franklin County, Kentucky. Eighteen universal soil loss equation (USLE) standard plots (22 x 3.7 m each) were established on a 10% slope. Three soil management practices were used: (i) class-A biosolids (sewage sludge), (ii) yard waste compost, each mixed with native soil at a rate of 50 ton acre(-1) on a dry-weight basis, and (iii) a no-mulch (NM) treatment (rototilled bare soil), used for comparison purposes. Devrinol 50-DF "napropamide" [N,N-diethyl-2-(1-naphthyloxy) propionamide] was applied as a preemergent herbicide, incorporated into the soil surface, and the plots were planted with 60-day-old sweet bell pepper seedlings. Napropamide residues one hour following spraying averaged 0.8, 0.4, and 0.3 microg g(-1) dry soil in sewage sludge, yard waste compost, and no-mulch treatments, respectively. Surface runoff water, runoff sediment, and napropamide residues in runoff were significantly reduced by the compost and biosolid treatments. Yard waste compost treatments increased water infiltration and napropamide residues in the vadose zone compared to sewage sludge and NM treatments. Total pepper yields from yard waste compost amended soils (9187 lbs acre(-1)) was significantly higher (P < 0.05) than yield from either the soil amended with class-A biosolids (6984 lbs acre(-1)) or the no-mulch soil (7162 lbs acre(-1)).

The effect of proportional v. value pricing on fountain drink purchases: results from a field experiment.

PubMed

Gollust, Sarah E; Tang, Xuyang; Runge, Carlisle Ford; French, Simone A; Rothman, Alexander J

2018-05-15

Reducing sugar-sweetened beverage consumption is a public health priority, yet finding an effective and acceptable policy intervention is challenging. One strategy is to use proportional pricing (a consistent price per fluid ounce) instead of the typical value-priced approach where large beverages offer better value. The purpose of the present study was to evaluate whether proportional pricing affects the purchasing of fountain beverages at a university cinema concession stand. Four price strategies for beverages were evaluated over ten weekends of film screenings. We manipulated two factors: the price structure (value pricing v. proportional pricing) and the provision of information about the price per fluid ounce (labels v. no labels). The key outcomes were the number and size of beverages purchased. We analysed data using regression analyses, with standard errors clustered by film and controlling for the day and time of purchase. A university cinema concession stand in Minnesota, USA, in spring 2015. University students. Over the study period (360 beverages purchased) there were no significant effects of the proportional pricing treatment. Pairing a label with the standard value pricing increased the likelihood of purchasing large drinks but the label did not affect purchasing when paired with proportional pricing. Proportional prices did not significantly affect the size of beverages purchased by students at a university cinema, but adding a price-per-ounce label increased large drink purchases when drinks were value-priced. More work is needed to address whether pricing and labelling strategies might promote healthier beverage purchases.

46 CFR 160.010-1 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Bureau of Standards (NBS) “The Universal Color Language” and “The Color Names Dictionary” in Color: Universal Language and Dictionary of Names, National Bureau of Standards Special Publication 440. Military...

Improved survival with an innovative approach to the treatment of severely burned patients: development of a burn treatment manual.

PubMed

Morisada, S; Nosaka, N; Tsukahara, K; Ugawa, T; Sato, K; Ujike, Y

2015-09-30

The management of severely burned patients remains a major issue worldwide as indicated by the high incidence of permanent debilitating complications and poor survival rates. In April 2012, the Advanced Emergency & Critical Care Medical Center of the Okayama University Hospital began implementing guidelines for severely burned patients, distributed as a standard burn treatment manual. The protocol, developed in-house, was validated by comparing the outcomes of patients with severe extensive burns (SEB) treated before and after implementation of these new guidelines at this institution. The patients included in this study had a burn index (BI) ≥30 or a prognostic burn index (PBI = BI + patient's age) ≥100. The survival rate of the patients with BI ≥30 was 65.2% with the traditional treatment and 100% with the new guidelines. Likewise, the survival rate of the patients with PBI ≥100 was 61.1% with the traditional treatment compared to 100% with the new guidelines. Together, these data demonstrate that the new treatment guidelines dramatically improved the treatment outcome and survival of SEB patients.

A universal standard for the validation of blood pressure measuring devices: Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Collaboration Statement.

PubMed

Stergiou, George S; Alpert, Bruce; Mieke, Stephan; Asmar, Roland; Atkins, Neil; Eckert, Siegfried; Frick, Gerhard; Friedman, Bruce; Graßl, Thomas; Ichikawa, Tsutomu; Ioannidis, John P; Lacy, Peter; McManus, Richard; Murray, Alan; Myers, Martin; Palatini, Paolo; Parati, Gianfranco; Quinn, David; Sarkis, Josh; Shennan, Andrew; Usuda, Takashi; Wang, Jiguang; Wu, Colin O; O'Brien, Eoin

2018-03-01

: In the last 30 years, several organizations, such as the US Association for the Advancement of Medical Instrumentation (AAMI), the British Hypertension Society, the European Society of Hypertension (ESH) Working Group on Blood Pressure (BP) Monitoring and the International Organization for Standardization (ISO) have developed protocols for clinical validation of BP measuring devices. However, it is recognized that science, as well as patients, consumers and manufacturers would be best served if all BP measuring devices were assessed for accuracy according to an agreed single validation protocol that had global acceptance. Therefore, an international initiative was taken by AAMI, ESH and ISO experts who agreed to develop a universal standard for device validation. This statement presents the key aspects of a validation procedure, which were agreed by the AAMI, ESH and ISO representatives as the basis for a single universal validation protocol. As soon as the AAMI/ESH/ISO standard is fully developed, this will be regarded as the single universal standard and will replace all other previous standards/protocols.

A Universal Standard for the Validation of Blood Pressure Measuring Devices: Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Collaboration Statement.

PubMed

Stergiou, George S; Alpert, Bruce; Mieke, Stephan; Asmar, Roland; Atkins, Neil; Eckert, Siegfried; Frick, Gerhard; Friedman, Bruce; Graßl, Thomas; Ichikawa, Tsutomu; Ioannidis, John P; Lacy, Peter; McManus, Richard; Murray, Alan; Myers, Martin; Palatini, Paolo; Parati, Gianfranco; Quinn, David; Sarkis, Josh; Shennan, Andrew; Usuda, Takashi; Wang, Jiguang; Wu, Colin O; O'Brien, Eoin

2018-03-01

In the past 30 years, several organizations, such as the US Association for the Advancement of Medical Instrumentation (AAMI), the British Hypertension Society, the European Society of Hypertension (ESH) Working Group on Blood Pressure (BP) Monitoring, and the International Organization for Standardization (ISO), have developed protocols for clinical validation of BP measuring devices. However, it is recognized that science, as well as patients, consumers, and manufacturers, would be best served if all BP measuring devices were assessed for accuracy according to an agreed single validation protocol that had global acceptance. Therefore, an international initiative was taken by the AAMI, ESH, and ISO experts who agreed to develop a universal standard for device validation. This statement presents the key aspects of a validation procedure, which were agreed by the AAMI, ESH, and ISO representatives as the basis for a single universal validation protocol. As soon as the AAMI/ESH/ISO standard is fully developed, this will be regarded as the single universal standard and will replace all other previous standards/protocols. © 2018 American Heart Association, Inc., and Wolters Kluwer Health, Inc.

A Step Towards Electric Propulsion Testing Standards: Pressure Measurements and Effective Pumping Speeds

NASA Technical Reports Server (NTRS)

Dankanich, John W.; Swiatek, Michael W.; Yim, John T.

2012-01-01

The electric propulsion community has been implored to establish and implement a set of universally applicable test standards during the research, development, and qualification of electric propulsion systems. Existing practices are fallible and result in testing variations which leads to suspicious results, large margins in application, or aversion to mission infusion. Performance measurements and life testing under appropriate conditions can be costly and lengthy. Measurement practices must be consistent, accurate, and repeatable. Additionally, the measurements must be universally transportable across facilities throughout the development, qualification, spacecraft integration and on-orbit performance. A preliminary step to progress towards universally applicable testing standards is outlined for facility pressure measurements and effective pumping speed calculations. The standard has been applied to multiple facilities at the NASA Glenn Research Center. Test results and analyses of universality of measurements are presented herein.

Astroparticle physics and cosmology.

PubMed

Mitton, Simon

2006-05-20

Astroparticle physics is an interdisciplinary field that explores the connections between the physics of elementary particles and the large-scale properties of the universe. Particle physicists have developed a standard model to describe the properties of matter in the quantum world. This model explains the bewildering array of particles in terms of constructs made from two or three quarks. Quarks, leptons, and three of the fundamental forces of physics are the main components of this standard model. Cosmologists have also developed a standard model to describe the bulk properties of the universe. In this new framework, ordinary matter, such as stars and galaxies, makes up only around 4% of the material universe. The bulk of the universe is dark matter (roughly 23%) and dark energy (about 73%). This dark energy drives an acceleration that means that the expanding universe will grow ever larger. String theory, in which the universe has several invisible dimensions, might offer an opportunity to unite the quantum description of the particle world with the gravitational properties of the large-scale universe.

Z-Score Demystified: A Critical Analysis of the Sri Lankan University Admission Policy

ERIC Educational Resources Information Center

Warnapala, Yajni; Silva, Karishma

2011-01-01

In the year 2001, the University Grants Commission of Sri Lanka successfully appealed to change the method of determining the cut-off scores for university admissions from raw scores to standardized z-scores. This standardization allegedly eliminated the discrepancy caused due to the assumption of equal difficulty levels across all subjects. This…

Answering a Call to Action: Engaging University Faculty on the Common Core State Standards

ERIC Educational Resources Information Center

Alvarado-Santos, Angelita; Case, Jennifer M.; Thompson, Ashleigh; Chertoff, Natalie

2017-01-01

Using various strategies, the City University of New York--a large, public, urban university system--engaged hundreds of faculty across 15 colleges in integrating the Common Core state standards (CCSS) in college coursework. Against the backdrop of a dynamic political climate, this CCSS initiative is described along with findings from a…

Toward a neurologic model of competency: Cognitive predictors of capacity to consent in Alzheimer's disease using three different legal standards.

PubMed

Marson, D C; Chatterjee, A; Ingram, K K; Harrell, L E

1996-03-01

To identify cognitive predictors of competency performance and status in Alzheimer's disease (AD) using three differentially stringent legal standards for capacity to consent. Univariate and multivariate analyses of independent neuropsychological test measures with three dependent measures of competency to consent to treatment. University medical center. 15 normal older controls and 29 patients with probably AD (15 mild and 14 moderate). Subjects were administered a batter of neuropsychological measures theoretically linked to competency function, as well as two clinical vignettes testing capacity to consent to medical treatment under five legal standards (LSs). The present study focused on three differentially stringent LSs: the capacity simply to "evidence a treatment of choice" (LS1), which is a minimal standard; the capacity to "appreciate the consequences" of a treatment of choice (LS3), a moderately stringent standard; and the capacity to "understand the treatment situation and choices" (LS5), the most stringent standard. Control subject and AD patient neuropsychological test scores were correlated with scores on the three LSs. The resulting univariate correlates were than analyzed using stepwise regression and discriminant function to identify key multivariate predictors of competency performance and status under each LS. No neuropsychological measures predicted control group performance on the LSs. For the AD group, a measure of simple auditory comprehension predicted LS1 performance (r(2)=0.44, p < 0.0001), a word fluency measure predicted LS3 performance (r(2)=0.58, p < 0.0001), and measures of conceptualization and confrontation naming together predicted LS5 performance (r(2)=0.81, p < 0.0001). Under discriminant function analysis, confrontation naming was the best single predictor of LS1 competency status for all subjects, correctly classifying 96% of cases (42/44). Measures of visumotor tracking and confrontation naming were the best single predictors, respectively, of competency status under LS3 (91% [39/43]) and LS5 (98% [43/44]). Multiple cognitive functions are associated with loss of competency in AD. Deficits in conceptualization, semantic memory, and probably verbal recall are associated with the declining capacity of mild AD patients to understand a treatment situation and choices (LS5); executive dysfunction with the declining capacity of mild to moderate AD patients to identify the consequences of treatment choice (LS3); and receptive aphasia and severe dysnomia with the declining capacity of advanced AD patients to evidence a simple treatment choice (LS1). The results offer insight into the relationship between different legal thresholds of competency and the progressive cognitive changes characteristic of AD, and represent an initial step toward a neurologic model of competency.

Protocol for a randomised controlled implementation trial of point-of-care viral load testing and task shifting: the Simplifying HIV TREAtment and Monitoring (STREAM) study

PubMed Central

Garrett, Nigel; Quame-Amaglo, Justice; Samsunder, Natasha; Ngobese, Hope; Ngomane, Noluthando; Moodley, Pravikrishnen; Mlisana, Koleka; Schaafsma, Torin; Donnell, Deborah; Barnabas, Ruanne; Naidoo, Kogieleum; Abdool Karim, Salim; Celum, Connie; Drain, Paul K

2017-01-01

Introduction Achieving the Joint United Nations Programme on HIV and AIDS 90-90-90 targets requires models of HIV care that expand antiretroviral therapy (ART) coverage without overburdening health systems. Point-of-care (POC) viral load (VL) testing has the potential to efficiently monitor ART treatment, while enrolled nurses may be able to provide safe and cost-effective chronic care for stable patients with HIV. This study aims to demonstrate whether POC VL testing combined with task shifting to enrolled nurses is non-inferior and cost-effective compared with laboratory-based VL monitoring and standard HIV care. Methods and analysis The STREAM (Simplifying HIV TREAtment and Monitoring) study is an open-label, non-inferiority, randomised controlled implementation trial. HIV-positive adults, clinically stable at 6 months after ART initiation, will be recruited in a large urban clinic in South Africa. Approximately 396 participants will be randomised 1:1 to receive POC HIV VL monitoring and potential task shifting to enrolled nurses, versus laboratory VL monitoring and standard South African HIV care. Initial clinic follow-up will be 2-monthly in both arms, with VL testing at enrolment, 6 months and 12 months. At 6 months (1 year after ART initiation), stable participants in both arms will qualify for a differentiated care model involving decentralised ART pickup at community-based pharmacies. The primary outcome is retention in care and virological suppression at 12 months from enrolment. Secondary outcomes include time to appropriate entry into the decentralised ART delivery programme, costs per virologically suppressed patient and cost-effectiveness of the intervention compared with standard care. Findings will inform the scale up of VL testing and differentiated care in HIV-endemic resource-limited settings. Ethics and dissemination Ethical approval has been granted by the University of KwaZulu-Natal Biomedical Research Ethics Committee (BFC296/16) and University of Washington Institutional Review Board (STUDY00001466). Results will be presented at international conferences and published in academic peer-reviewed journals. Trial registration NCT03066128; Pre-results. PMID:28963304

Exotic energy injection with ExoCLASS: application to the Higgs portal model and evaporating black holes

NASA Astrophysics Data System (ADS)

Stöcker, Patrick; Krämer, Michael; Lesgourgues, Julien; Poulin, Vivian

2018-03-01

We devise a new user-friendly tool interfaced with the Boltzmann code CLASS to deal with any kind of exotic electromagnetic energy injection in the universe and its impact on anisotropies of the Cosmic Microwave Background. It makes use of the results from standard electromagnetic cascade calculations develop in the context of WIMP annihilation, generalized to incorporate any injection history. We first validate it on a specific WIMP scenario, the Higgs Portal model, confirming that the standard effective on-the-spot treatment is accurate enough. We then analyze the more involved example of evaporating Primordial Black Holes (PBHs) with masses in the range [3×1013,5×1016] g, for which the standard approximations break down. We derive robust CMB bounds on the relic density of evaporating PBHs, ruling out the possibility for PBHs with a monochromatic distribution of masses in the range [3×1013,2.5×1016] g to represent all of the Dark Matter in our Universe. Remarkably, we confirm with an accurate study that the CMB bounds are several orders of magnitude stronger than those from the galactic gamma-ray background in the range [3×1013,3×1014] g. A future CMB experiment like CORE+, or an experiment attempting at measuring the 21 cm signal from the Dark Ages could greatly improve the sensitivity to these models.

Investigation of Radiation Protection Methodologies for Radiation Therapy Shielding Using Monte Carlo Simulation and Measurement

NASA Astrophysics Data System (ADS)

Tanny, Sean

The advent of high-energy linear accelerators for dedicated medical use in the 1950's by Henry Kaplan and the Stanford University physics department began a revolution in radiation oncology. Today, linear accelerators are the standard of care for modern radiation therapy and can generate high-energy beams that can produce tens of Gy per minute at isocenter. This creates a need for a large amount of shielding material to properly protect members of the public and hospital staff. Standardized vault designs and guidance on shielding properties of various materials are provided by the National Council on Radiation Protection (NCRP) Report 151. However, physicists are seeking ways to minimize the footprint and volume of shielding material needed which leads to the use of non-standard vault configurations and less-studied materials, such as high-density concrete. The University of Toledo Dana Cancer Center has utilized both of these methods to minimize the cost and spatial footprint of the requisite radiation shielding. To ensure a safe work environment, computer simulations were performed to verify the attenuation properties and shielding workloads produced by a variety of situations where standard recommendations and guidance documents were insufficient. This project studies two areas of concern that are not addressed by NCRP 151, the radiation shielding workload for the vault door with a non-standard design, and the attenuation properties of high-density concrete for both photon and neutron radiation. Simulations have been performed using a Monte-Carlo code produced by the Los Alamos National Lab (LANL), Monte Carlo Neutrons, Photons 5 (MCNP5). Measurements have been performed using a shielding test port designed into the maze of the Varian Edge treatment vault.

A short history of pediatric endocrinology in North America.

PubMed

Fisher, Delbert A

2004-04-01

Pediatric endocrinology evolved as a subspecialty from the era of biochemical and metabolic clinical investigation led by John Howland, Edwards Park, and James Gamble at Johns Hopkins; Allan Butler at Boston University and Harvard University; Daniel Darrow at Yale University; and Irving McQuarrie at the University of Rochester and the University of Minnesota during the early 20th century. The father of the new subspecialty was Lawson Wilkins, a private pediatric practitioner in Baltimore, Maryland, who was invited by Dr. Edwards Park to establish an endocrine clinic at the Harriet Lane Home at Johns Hopkins in 1935. Dr. Wilkins managed his practice and the clinic until 1946, when, at the age of 52, he accepted a full-time position at the University. Dr. Nathan Talbot was invited to develop a pediatric endocrine clinic at Massachusetts General Hospital by Allan Butler in 1942. These units and their associated subspecialty training programs during the 1950s and 1960s provided the large majority of the second-generation pediatric endocrinologists who went on to establish endocrine subspecialty programs in university medical centers in North America as well as Europe and South America. Diabetes as a clinical pediatric discipline evolved in parallel from the early clinics of Elliott Joslin and Priscilla White in Boston, M.C. Hardin and Robert Jackson at the University of Iowa, George Guest at the University of Cincinnati Children's Hospital, and Alex Hartman at the St. Louis Children's Hospital. The Lawson Wilkins Pediatric Endocrine Society was founded in 1971, and the Council on Diabetes and Youth was established within the American Diabetes Association in 1980. Medical and economic factors led to increasing integration of pediatric diabetes and general endocrine care and training, and diabetes care now is a major activity within the subspecialty of pediatric endocrinology. The growth of pediatric endocrinology in North America has paralleled the growth of academic medicine during the past half-century. In 2002, there were 72 training programs in North America: 65 in the United States and seven in Canada. The endocrinology sub-board of the American Board of Pediatrics was established in 1978 to certify training and competence in endocrinology, including diabetes. By 2002, the board had certified 927 pediatric endocrinologists. Pediatric endocrine subspecialists during the past half-century have contributed major advances in our understanding of the ontogeny of endocrine systems and the diagnosis and treatment of fetal-perinatal endocrine disorders; newborn screening for endocrine and metabolic disorders; the physiology and therapies for disorders of sexual differentiation and pubertal maturation; the development of anthropometric standards for childhood growth and development; the characterization and physiology of hormone systems, including receptors and hormone actions; the molecular genetics of a number of congenital endocrine disorders and heritable endocrine diseases; development of pediatric endocrine diagnostics and reference standards; the pathophysiology and management of autoimmune endocrine disease; and development of a growing armamentarium of therapeutic agents for treatment of endocrine and metabolic diseases.

Is There a Cosmetic Advantage to Single-Incision Laparoscopic Surgical Techniques Over Standard Laparoscopic Surgery? A Systematic Review and Meta-analysis.

PubMed

Evans, Luke; Manley, Kate

2016-06-01

Single-incision laparoscopic surgery represents an evolution of minimally invasive techniques, but has been a controversial development. A cosmetic advantage is stated by many authors, but has not been found to be universally present or even of considerable importance by patients. This systematic review and meta-analysis demonstrates that there is a cosmetic advantage of the technique regardless of the operation type. The treatment effect in terms of cosmetic improvement is of the order of 0.63.

Lorenz Heister and oral disease with the original text from his papers.

PubMed

Shklar, Gerald; Chernin, David A

2007-01-01

Lorenz Heister (1683-1758) was the major academic surgeon of the eighteenth century. He served as an army surgeon in a number of campaigns and eventually became the professor of anatomy and surgery at Altdorf University. In 1739, he published a comprehensive book on surgery that became the standard text on the subject. It was widely reprinted and translated into many languages. The English version was the first systematic treatise on surgery to appear in that language. The book has many chapters devoted to diseases of the mouth and their treatment.

Addressing Early Retention in Antenatal Care Among HIV-Positive Women Through a Simple Intervention in Kinshasa, DRC: The Elombe "Champion" Standard Operating Procedure.

PubMed

Gill, Michelle M; Ditekemena, John; Loando, Aimé; Mbonze, Nana; Bakualufu, Jo; Machekano, Rhoderick; Nyombe, Cady; Temmerman, Marleen; Fwamba, Franck

2018-03-01

This cluster-randomized study aimed to assess the Elombe ("Champion") standard operating procedure (SOP), implemented by providers and Mentor Mothers, on HIV-positive pregnant women's retention between first and second antenatal visits. Sixteen facilities in Kinshasa were randomly assigned to intervention (SOP) or comparison (no SOP). Effect of the SOP was estimated using relative risk. Women in comparison facilities were more likely to miss second visits (RR 2.5, 95% CI 1.05-5.98) than women in intervention facilities (30.0%, n = 27 vs. 12.0%, n = 9, p < 0.002). Findings demonstrate that a simple intervention can reduce critical early loss to care in PMTCT programs providing universal, lifelong treatment.

Standards for University Libraries = Normes pour les bibliotheques universitaires = Richtwerte fur Universitatsbibliotheken = Normas de bibliotecas universitarias. IFLA Professional Reports No. 10.

ERIC Educational Resources Information Center

Lynch, Beverly P., Ed.

This statement prepared by the International Federation of Library Associations' Section of University Libraries and Other General Research Libraries presents standards of general principles designed to accomplish the following: (1) provide a means by which the quality of the library serving a university can be assessed; (2) offer guidance for…

The University of California's Use of the iNACOL Standards for Online Classes

ERIC Educational Resources Information Center

Heller, Kevin

2018-01-01

The Colin standards for online courses are widely used by educational institutions across the world, including the University of California (UC), which uses them in its formula for determining whether or not a high school course can be used to meet minimum eligibility requirements for admission to the University. To date, however, there has been…

Altering Public University Admission Standards to Preserve White Group Position in the United States: Results from a Laboratory Experiment

ERIC Educational Resources Information Center

Samson, Frank L.

2013-01-01

This study identifies a theoretical mechanism that could potentially affect public university admissions standards in a context of demographic change. I explore how demographic changes at a prestigious public university in the United States affect individuals' evaluations of college applications. Responding to a line graph that randomly displays a…

Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.

PubMed

Sjöström, Susanne; Kopp Kallner, Helena; Simeonova, Emilia; Madestam, Andreas; Gemzell-Danielsson, Kristina

2016-01-01

The objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established. A cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER) were calculated. The study was conducted at a university hospital in Stockholm, Sweden. The average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided. Early medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.

Preliminary Analysis of the Surgical Treatment of Anorectal Malformations in Russia.

PubMed

Morozov, Dmitry; Pimenova, Evgeniya; Oculov, Evgeniy; Gusev, Alexey; Utkina, Kseniya

2015-12-01

The article provides the analysis of a survey of the professional community of Russian pediatric surgeons, dedicated to the treatment of anorectal malformations (ARM). The authors evaluated the differences and similarities in classification, surgical procedures, time of definitive repair, and postoperative management of ARM in different hospitals and centers. This was done by a survey upon specialists and experts in Russia followed by a symposium with live surgery, open discussion, and vote. Overall, 85% of the delegates supported the idea to create several regional centers of pediatric coloproctology as the way to improve the treatment of ARM in Russia. Moreover, 80% of delegates agreed to create a universal database of ARM information. The development of neonatal surgery and videoendoscopic surgical methods in the treatment of patients with ARM requires creation of a national guideline by the Russian Association of Pediatric Surgeons. Next step will concern standardization of the diagnosis and surgical treatment of children with ARM. This study is a collaborative effort to provide Russian Consensus on treatment of ARM. Georg Thieme Verlag KG Stuttgart · New York.

Direct observation of respiratory treatments in cystic fibrosis: parent-child interactions relate to medical regimen adherence.

PubMed

Butcher, Jennifer L; Nasr, Samya Z

2015-01-01

Use a standardized system to code parent-child interactions during respiratory treatments for cystic fibrosis (CF) and analyze relations between behaviors during treatments and medical regimen adherence. A total of 15 families (53% girls; M age = 8.9 years; SD = 1.8) had three respiratory treatments recorded in the home environment and coded. Families provided six 24-hr recalls of child medical regimen activities, and electronic airway clearance time was recorded over 3 months to measure medical regimen adherence. Parent positive attention, instructions, and avoidance of negative statements were significantly related to child cooperation during respiratory treatments. Parental presence, positive attention, instructions, and child cooperation during treatments were related to higher respiratory adherence rates. Direct observation methodology has led to effective nutritional adherence intervention for children with CF. These preliminary data demonstrate that an observational method could also be used to develop interventions to promote respiratory medication adherence. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Barriers and facilitators to development of standard treatment guidelines in India.

PubMed

Sharma, Sangeeta; Sethi, Gulshan R; Gupta, Usha; Chaudhury, Ranjit Roy

2015-01-01

This paper describes 15 years' experience of the development process of the first set of comprehensive standard treatment guidelines (STGs) for India and their adoption or adaptation by various state governments. The aim is to shorten the learning curve for those embarking on a similar exercise, given the key role of high-quality STGs that are accepted by the clinical community in furthering universal health coverage. The main overall obstacles to STG development are: (i) weak understanding of the concept; (ii) lack of time, enthusiasm and availability of local expertise; and (iii) managing consensus between specialists and generalists. Major concerns to prescribers are: encroachment on professional autonomy, loss of treating the patient as an individual and applying the same standards at all levels of health care. Processes to address these challenges are described. At the policy level, major threats to successful completion and focused implementation are: frequent changes in governance, shifts in priorities and discontinuity. In the authors' experience, compared with each state developing their own STGs afresh, adaptation of pre-existing valid guidelines after an active adaptation process involving local clinical leaders is not only simpler and quicker but also establishes local ownership and facilitates acceptance of a quality document. Executive orders and in-service sensitization programmes to introduce STGs further enhance their adoption in clinical practice.

Prevalence, risk factors and outcome of childhood abuse reported by female university students in jeddah.

PubMed

Ibrahim, Nahla K; Jalali, Ekram A; Al-Ahmadi, Jawaher R; Al-Bar, Adnan A

2008-01-01

Child abuse constitutes all forms of physical and /or emotional ill treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power. The objective of the study was to determine the prevalence, types, main predictors and outcome of child abuse, retrospectively reported by female university students in Jeddah. A cross sectional study was conducted and the Standardized Arabic Version of Child Abuse Screening Tool for Young Adult (18-24 years old) was used. Ethical standards of confidentiality and freedom to participate were followed. Multistage stratified random sample was used with selection of 1,897 females. About two-thirds (68.3 %) of students reported exposure to some form of child abuse. Physical and emotional forms were recalled by 45.1 % & 50.6 % of students, respectively, while, 2.9 % reported exposure to forced contact sexual assault. Parents and siblings were the commonest perpetrators of both physical & emotional abuse, while other relatives and extra-familial persons were the main offenders of sexual violence. The predictors of exposure to three forms of abuse together were: existence of parent who hit the other (aOR= 2.54; 95 % CI: 1.88-3.42), non-university graduated mother (aOR =1.83; p

Risk of cutaneous squamous cell carcinoma after treatment of basal cell carcinoma with vismodegib.

PubMed

Bhutani, Tina; Abrouk, Michael; Sima, Camelia S; Sadetsky, Natalia; Hou, Jeannie; Caro, Ivor; Chren, Mary-Margaret; Arron, Sarah T

2017-10-01

Vismodegib is a first-in-class agent targeting the hedgehog signaling pathway for treatment of patients with locally advanced basal cell carcinoma (BCC) and metastatic BCC. There have been concerns about the development of squamous cell carcinoma (SCC) in patients treated with this drug. We sought to determine whether treatment with vismodegib is associated with an increase in the risk of cutaneous SCC. In this retrospective cohort study, patients treated with vismodegib as part of phase I and II clinical studies were compared with participants from the University of California, San Francisco, Nonmelanoma Skin Cancer Cohort who received standard therapy for primary BCC. In total, 1675 patients were included in the analysis, and the development of SCC after vismodegib exposure was assessed. The use of vismodegib was not associated with an increased risk of subsequent development of SCC (adjusted hazard ratio, 0.57; 95% confidence interval, 0.28-1.16). Covariates including age, sex, history of previous nonmelanoma skin cancer, and number of visits per year were significantly associated with the development of SCC. A limitation of the study was that a historic control cohort was used as a comparator. Vismodegib was not associated with an increased risk of subsequent SCC when compared with standard surgical treatment of BCC. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Development of a space universal modular architecture (SUMO)

NASA Astrophysics Data System (ADS)

Collins, Bernie F.

This concept paper proposes that the space community should develop and implement a universal standard for spacecraft modularity - to improve interoperability of spacecraft components. Pursuing a global industry consensus standard for open and modular spacecraft architecture will encourage trade, remove standards-related market barriers, and in the long run increase both value provided to customers and profitability of the space industrial sector. This concept paper sets out: (1) the goals for a SUMO standard and how it will benefit the space community; (2) background on spacecraft modularity and existing related standards; (3) the proposed technical scope of the current standardization effort; and (4) an approach for creating a SUMO standard.

[The use of fenspiride for the combined treatment of exacerbation of chronic laryngitis].

PubMed

Ryabova, M A

The present study was carried out based at the Department of Otorhinolaryngology of I.P. Pavlov First State Medical University of Saint-Petersburg. The objective of this work was to elucidate the efficacy and safety of fenspiride therapy for the treatment of exacerbation of chronic laryngitis associated with an acute respiratory infection. The patients comprising the main group received fenspiride (Eurespal, 'Servier', France) at the standard dose in addition to the conventional therapy with the use of antibiotics, inhalation, and voice rest. The patients in the group of comparison were treated following the conventional protocol without fenspiride. The clinical symptoms evaluated based on the scoring system, the results of videolaryngoscopy, and computer-assisted analysis of the voice were compared before and after treatment in the patients of both groups. The results of the study have confirmed the high effectiveness and safety of fenspiride therapy of exacerbation of chronic laryngitis.

Evaluation of empirical treatment for blood culture-negative endocarditis.

PubMed

Menu, Estelle; Gouriet, Frédérique; Casalta, Jean-Paul; Tissot-Dupont, Hervé; Vecten, Maude; Saby, Ludivine; Hubert, Sandrine; Salaun, Erwan; Theron, Alexis; Grisoli, Dominique; Lavoute, Cécile; Collart, Frédéric; Habib, Gilbert; Raoult, Didier

2017-01-01

Much progress has been made in understanding the main causes of blood culture-negative endocarditis (BCNE). Few studies concerning BCNE treatment (due to previous antibiotics used or fastidious pathogens) are available. We performed this study to evaluate the effectiveness of our therapeutic protocol in BCNE, based on compliance with the protocol, outcome and 1 year mortality. We collected prospectively and analysed retrospectively cases of BCNE between 2002 and 2014, using a simplified and standardized protocol developed by our multidisciplinary team. We apply two kinds of protocols to treat BCNE, which include only four intravenous antimicrobial agents: amoxicillin, vancomycin, gentamicin and amphotericin B. We had 177 patients with definite BCNE. There were 154 (87.0%) patients treated with both appropriate antimicrobial agents and appropriate duration of treatment. We analysed the causes of inappropriate treatment in 13 (7.3%) cases and inappropriate duration in 10 (5.6%) cases. The treatment changes were justified in all cases except one of discharge against medical advice. The fatality rate was 5.1% (nine cases) and all deaths occurred in the group of patients who were treated with appropriate treatment; however, four deaths were not attributable to empirical treatment failure. Concerning the other deaths, the lack of surgical management, in association with empirical treatment, could explain our protocol's failure, such as poorly tolerated surgery. Our protocol is efficient and our mortality rate was low, compared with the literature review. This may result from a strategy that uses a sampling procedure and a standardized protocol at the same time. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Evaluation of Standardized Instruments for Use in Universal Screening of Very Early School-Age Children: Suitability, Technical Adequacy, and Usability

ERIC Educational Resources Information Center

Miles, Sandra; Fulbrook, Paul; Mainwaring-Mägi, Debra

2018-01-01

Universal screening of very early school-age children (age 4-7 years) is important for early identification of learning problems that may require enhanced learning opportunity. In this context, use of standardized instruments is critical to obtain valid, reliable, and comparable assessment outcomes. A wide variety of standardized instruments is…

Evaluation of Arabic Language Learning Program for Non-Native Speakers in Saudi Electronic University According to Total Quality Standards

ERIC Educational Resources Information Center

Alowaydhi, Wafa Hafez

2016-01-01

The current study aimed at standardizing the program of learning Arabic for non-native speakers in Saudi Electronic University according to certain standards of total quality. To achieve its purpose, the study adopted the descriptive analytical method. The author prepared a measurement tool for evaluating the electronic learning programs in light…

Assessment of an undergraduate psychiatry course in an African setting.

PubMed

Baig, Benjamin J; Beaglehole, Anna; Stewart, Robert C; Boeing, Leonie; Blackwood, Douglas H; Leuvennink, Johan; Kauye, Felix

2008-04-22

International reports recommend the improvement in the amount and quality of training for mental health workers in low and middle income countries. The Scotland-Malawi Mental Health Education Project (SMMHEP) has been established to support the teaching of psychiatry to medical students in the University of Malawi. While anecdotally supportive medical educational initiatives appear of value, little quantitative evidence exists to demonstrate whether such initiatives can deliver comparable educational standards. This study aimed to assess the effectiveness of an undergraduate psychiatry course given by UK psychiatrists in Malawi by studying University of Malawi and Edinburgh University medical students' performance on an MCQ examination paper. An undergraduate psychiatry course followed by an MCQ exam was delivered by the SMMHEP to 57 Malawi medical students. This same MCQ exam was given to 71 Edinburgh University medical students who subsequently sat their own Edinburgh University examination. There were no significant differences between Edinburgh students' performance on the Malawi exam and their own Edinburgh University exam. (p = 0.65). This would suggest that the Malawi exam is a comparable standard to the Edinburgh exam. Malawi students marks ranged from 52.4%-84.6%. Importantly 84.4% of Malawi students scored above 60% on their exam which would equate to a hypothetical pass by UK university standards. The support of an undergraduate course in an African setting by high income country specialists can attain a high percentage pass rate by UK standards. Although didactic teaching has been surpassed by more novel educational methods, in resource poor countries it remains an effective and cost effective method of gaining an important educational standard.

Standardization of the Self Control and Self-Management Skills Scale (SCMS) on the Student of University of Najran

ERIC Educational Resources Information Center

Al-Smadi, Marwan Saleh; Bani-Abduh, Yahya Mohammed

2017-01-01

This study aimed to standardize self-control and self-management skills (SCMS), Mezo 2009 , on students in the university of Najran And to identify the psychometric properties of the scale in the Arab Environment the society of Najran University student by taking a number of Procedures (Validity and reliability of the Scale ) and to get the Arabic…

Combination therapy with cholinesterase inhibitors and memantine for Alzheimer's disease: a systematic review and meta-analysis.

PubMed

Matsunaga, Shinji; Kishi, Taro; Iwata, Nakao

2014-12-28

We performed an updated meta-analysis of randomized controlled trials of combination therapy with cholinesterase inhibitors and memantine in patients with Alzheimer's disease. We reviewed cognitive function, activities of daily living, behavioral disturbance, global assessment, discontinuation rate, and individual side effects. Seven studies (total n=2182) were identified. Combination therapy significantly affected behavioral disturbance scores (standardized mean difference=-0.13), activity of daily living scores (standardized mean difference=-0.10), and global assessment scores (standardized mean difference=-0.15). In addition, cognitive function scores (standardized mean difference=-0.13, P=.06) exhibited favorable trends with combination therapy. The effects of combination therapy were more significant in the moderate-to-severe Alzheimer's disease subgroup in terms of all efficacy outcome scores. The discontinuation rate was similar in both groups, and there were no significant differences in individual side effects. Combination therapy was beneficial for the treatment of moderate-to-severe Alzheimer's disease in terms of cognition, behavioral disturbances, activities of daily living, and global assessment was well tolerated. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Assessment of ferrous chloride and Portland cement for the remediation of chromite ore processing residue.

PubMed

Jagupilla, Santhi C; Wazne, Mahmoud; Moon, Deok Hyun

2015-10-01

Chromite Ore Processing Residue (COPR) is an industrial waste containing up to 7% chromium (Cr) including up to 5% hexavalent chromium [Cr(VI)]. The remediation of COPR has been challenging due to the slow release of Cr(VI) from a clinker like material and thereby the incomplete detoxification of Cr(VI) by chemical reagents. The use of sulfur based reagents such as ferrous sulfate and calcium polysulfide to detoxify Cr(VI) has exasperated the swell potential of COPR upon treatment. This study investigated the use of ferrous chloride alone and in combination with Portland cement to address the detoxification of Cr(VI) in COPR and the potential swell of COPR. Chromium regulatory tests, X-ray powder diffraction (XRPD) analyses and X-ray absorption near edge structure (XANES) analyses were used to assess the treatment results. The treatment results indicated that Cr(VI) concentrations for the acid pretreated micronized COPR as measured by XANES analyses were below the New Jersey Department of Environmental Protection (NJDEP) standard of 20 mg kg(-1). The Toxicity characteristic leaching procedure (TCLP) Cr concentrations for all acid pretreated samples also were reduced below the TCLP regulatory limit of 5 mg L(-1). Moreover, the TCLP Cr concentration for the acid pretreated COPR with particle size ⩽0.010 mm were less than the universal treatment standard (UTS) of 0.6 mg L(-1). The treatment appears to have destabilized all COPR potential swell causing minerals. The unconfined compressive strength (UCS) for the treated samples increased significantly upon treatment with Portland cement. Copyright © 2015 Elsevier Ltd. All rights reserved.

The role of ultrasound guidance in pediatric caudal block

PubMed Central

Erbüyün, Koray; Açıkgöz, Barış; Ok, Gülay; Yılmaz, Ömer; Temeltaş, Gökhan; Tekin, İdil; Tok, Demet

2016-01-01

Objectives: To compare the time interval of the procedure, possible complications, post-operative pain levels, additional analgesics, and nurse satisfaction in ultrasonography-guided and standard caudal block applications. Methods: This retrospective study was conducted in Celal Bayar University Hospital, Manisa, Turkey, between January and December 2014, included 78 pediatric patients. Caudal block was applied to 2 different groups; one with ultrasound guide, and the other using the standard method. Results: The time interval of the procedure was significantly shorter in the standard application group compared with ultrasound-guided group (p=0.020). Wong-Baker FACES Pain Rating Scale values obtained at the 90th minute was statistically lower in the standard application group compared with ultrasound-guided group (p=0.035). No statistically significant difference was found on the other parameters between the 2 groups. The shorter time interval of the procedure at standard application group should not be considered as a distinctive mark by the pediatric anesthesiologists, because this time difference was as short as seconds. Conclusion: Ultrasound guidance for caudal block applications would neither increase nor decrease the success of the treatment. However, ultrasound guidance should be needed in cases where the detection of sacral anatomy is difficult, especially by palpations. PMID:26837396

[ASSESSMENT OF THE KNOWLEDGE AND ATTITUDES OF NURSES ON THE SKIN CONDITION AND TREATMENT OF DAMAGE].

PubMed

Neuberg, M; Kozina, G; Novinšćak, T

2016-01-01

Practical experience and numerous studies have shown that, after finishing their studies nursing graduates are not sure in their independent assessment and treatment of wounds. It appears that nursing education lacks narrowly specialized educational content in this area, practical skills and connection between graduates and experts who follow the standards and guidelines in the area of wound healing. The aim of this study was to assess the knowledge through tests and attitudes of nurses/nursing graduates on the condition of the skin and damage treatment. In addition, the study was also aimed at learning about possible guidelines for the future content of the nursing curriculum studies in Croatia. The study was conducted on a sample of 71 students (six (8.5%) male and 65 (91.5%) female of Nursing Studies at University North. The subjects voluntarily and anonymously completed the survey electronically. A semi-structured standardized questionnaire was used, “Knowledge test about the basis of pressure ulcers in geriatric patients”, designed by Dr Andrija Štampar Department of Health Gerontology, Reference Center for Health Care of the Elderly of the Ministry of Health of the Republic of Croatia. The test administered to the sample of students of nursing, mostly aged 18-25 (64.8%) showed correct answers to 12 questions asked, in a range of 17.9% to 100% (median 60.6%, SD 24.1, Q1 53.8%, Q3 81%). Answers to question 13 (daily work with patients) revealed that 39.4% of students knew and often used modern approach to the prevention and treatment of pressure ulcers; the same percentage of students rarely used modern method of prevention and treatment of pressure ulcers, 26.8% were not familiar with the issue, while 2.8% were not interested in it. As for question 14 (given the existing contents on the treatment of pressure ulcers in the educational program for students of nursing), 47.9% of study subjects believed they needed more practical skills in treating pressure ulcers, 45.1% considered it necessary to introduce more contents on the treatment of pressure ulcers in regular courses, while 8.5% believed it was not necessary to introduce additional contents because there was enough knowledge on wound treatment. The results indicated that there was a relatively satisfactory partial knowledge to assess skin condition, prevention measures and treatment of pressure ulcers in the elderly, but also that more practical skills were needed in the treatment and modern dressing application, which can be considered as guidelines for future educational contents in the nursing studies. Based on the simple and standardized survey in a relatively broad sample of students of Nursing Studies at University North, student knowledge on the prevention and treatment of pressure ulcers with modern methods can be well assessed. Scarce practical knowledge in the field of modern pressure ulcer treatment, the lack of professional literature revision in terms of modern guidelines and theories, as well as poor collaboration of scientific educational and health institutions are the key problems of insufficient knowledge of nursing graduates in daily work of treating chronic wounds. Student insecurity related to prevention and therapy in modern treatment of pressure ulcers show a possible direction for future educational contents of nursing studies. Additional similar studies are warranted in order to get a more detailed insight into assessment of practical and theoretical knowledge of graduates about modern care of patients with chronic wounds.

Apatinib for advanced sarcoma: results from multiple institutions' off-label use in China.

PubMed

Xie, Lu; Guo, Wei; Wang, Ye; Yan, Taiqiang; Ji, Tao; Xu, Jie

2018-04-06

Anti-angiogenesis Tyrosine kinase inhibitors (TKIs) have been proved to show promising effects on prolonging progression-free survival (PFS) for advanced sarcoma after failure of standard multimodal Therapy. Methylsulfonic apatinib is one of those TKIs which specifically inhibits VEGFR-2. This paper summarizes the experience of three Peking University affiliated hospitals in off-label use of apatinib in the treatment of extensively pre-treated sarcoma. We retrospectively analysed files of patients with advanced sarcoma not amenable to curative treatment, who were receiving an apatinib-containing regimen between June 1, 2015 and December 1, 2016. Fifty-six patients were included: 22 osteosarcoma, 10 Ewing's sarcoma, 3 chondrosarcoma and 21 soft tissue sarcoma. With median follow-up time of 6 months (range, 0.7-18.0 m), thirty-five (62.5%) patients had partial response, and disease was stable in 11 (19.6%). The 4-month and 6-month progression-free survival rates were 46.3 and 36.5%, respectively. The median duration of response was 3.8 months (95% CI 1.9-5.6 m), with much variability among disease subtypes. The median overall survival was 9.9 months (95% CI 7.6-12.2 m). Grade 3 and 4 toxicities were observed in 8 (14.3%) patients, the most common being hypertension, pneumothorax, wound-healing problems, anorexia, and rash or desquamation. Apatinib might be effective, with a high objective response rate, in an off-label study of sarcoma patients with advanced, previously treated disease. The duration of response was consistent with reports in different subtypes of sarcomas. Prospective trials of apatinib in the treatment of selected subtypes of sarcomas are needed. Retrospectively registered in the Medical Ethics Committee of Peking University People's Hospital, Peking University Shougang Hospital and Peking University International Hospital. The trial registration number is 2017PHB176-03 and the date of registration is January 20th 2017.

Advantages of modified osteosynthesis in treatment of osteoporotic long bones fractures--experimental model.

PubMed

Sisljagić, Vladimir; Jovanović, Savo; Mrcela, Tomislav; Radić, Radivoje; Belovari, Tatjana

2009-12-01

In surgery of fractured long bones, a patient suffering from osteoporosis represents constant challenge to a surgeon and applied material and instruments that need to destroy as little as possible of an already damaged bone. One potential way of increasing the contact surface between the implants and osteoporotic bone is injection of bone cement (methyl-metacrilat, Palakos) into a prepared screw bed. This method of osteosynthesis was therefore subjected to experimental research to prove that application of modified osteosynthesis using bone cement in treatment of fractures in osteoporotic patients has advantage over the standard method of osteosynthesis because this modified method enables significantly greater firmness and stability of the osteosynthesis, which is the essential precondition of a successful fracture healing. The research was carried out on six macerated cadaveric preparations of a shin bone from the osteological collection from Institute for Anatomy, School of Medicine, University "J. J. Strossmayer". All samples of long bones were artificially broken in the middle part of the diaphysis and then standard osteosynthesis and modified osteosynthesis with screws filled with bone cement were performed on the samples. Results show that under identical static action of the moment of torsion in the modified osteosynthesis torsion angle deviation is lower than in the standard osteosynthesis. In modified osteosynthesis with bone cement the first results for angle of torsion deviation greater than 0.2 degrees were noticed after 120 minutes, while in the standard method of osteosynthesis they were noticed already in the first minute.

Changes in Financial Aid and Student Enrollment at Historically Black Colleges and Universities after the Tightening of PLUS Credit Standards: An Update for the 2013/14 School Year. REL 2017-254

ERIC Educational Resources Information Center

Johnson, Matthew; Bruch, Julie; Gill, Brian

2017-01-01

In 2011 the U.S. Department of Education tightened the credit standards for Parent Loans for Undergraduate Students (PLUS). Concerned about the possible effects of this change on historically Black colleges and universities (HBCUs), Regional Educational Laboratory Mid-Atlantic's Historically Black Colleges and Universities College Completion…

Bevacizumab continuation versus no continuation after first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer: a randomized phase III non-inferiority trial (SAKK 41/06).

PubMed

Koeberle, D; Betticher, D C; von Moos, R; Dietrich, D; Brauchli, P; Baertschi, D; Matter, K; Winterhalder, R; Borner, M; Anchisi, S; Moosmann, P; Kollar, A; Saletti, P; Roth, A; Frueh, M; Kueng, M; Popescu, R A; Schacher, S; Hess, V; Herrmann, R

2015-04-01

Chemotherapy plus bevacizumab is a standard option for first-line treatment in metastatic colorectal cancer (mCRC) patients. We assessed whether no continuation is non-inferior to continuation of bevacizumab after completing first-line chemotherapy. In an open-label, phase III multicentre trial, patients with mCRC without disease progression after 4-6 months of standard first-line chemotherapy plus bevacizumab were randomly assigned to continuing bevacizumab at a standard dose or no treatment. CT scans were done every 6 weeks until disease progression. The primary end point was time to progression (TTP). A non-inferiority limit for hazard ratio (HR) of 0.727 was chosen to detect a difference in TTP of 6 weeks or less, with a one-sided significance level of 10% and a statistical power of 85%. The intention-to-treat population comprised 262 patients: median follow-up was 36.7 months. The median TTP was 4.1 [95% confidence interval (CI) 3.1-5.4] months for bevacizumab continuation versus 2.9 (95% CI 2.8-3.8) months for no continuation; HR 0.74 (95% CI 0.58-0.96). Non-inferiority could not be demonstrated. The median overall survival was 25.4 months for bevacizumab continuation versus 23.8 months (HR 0.83; 95% CI 0.63-1.1; P = 0.2) for no continuation. Severe adverse events were uncommon in the bevacizumab continuation arm. Costs for bevacizumab continuation were estimated to be ∼30,000 USD per patient. Non-inferiority could not be demonstrated for treatment holidays versus continuing bevacizumab monotheray, after 4-6 months of standard first-line chemotherapy plus bevacizumab. Based on no impact on overall survival and increased treatment costs, bevacizumab as a single agent is of no meaningful therapeutic value. More efficient treatment approaches are needed to maintain control of stabilized disease following induction therapy. ClinicalTrials.gov, number NCT00544700. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Method of testing gear wheels in impact bending

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

Tikhonov, A.K.; Palagin, Y.M.

1995-05-01

Chemicothermal treatment processes are widely used in engineering to improve the working lives of important components, of which the most common is nitrocementation. That process has been applied at the Volga Automobile Plant mainly to sprockets in gear transmissions, which need high hardness and wear resistance in the surfaces with relatively ductile cores. Although various forms of chemicothermal treatment are widely used, there has been no universal method of evaluating the strengths of gear wheels. Standard methods of estimating strength ({sigma}{sub u}, {sigma}{sub t}, {sigma}{sub b}, and hardness) have a major shortcoming: They can determine only the characteristics of themore » cores for case-hardened materials. Here we consider a method of impact bending test, which enables one to evaluate the actual strength of gear teeth.« less

Estimated cost efficacy of systemic treatments that are approved by the US Food and Drug Administration for the treatment of moderate to severe psoriasis.

PubMed

D'Souza, Logan S; Payette, Michael J

2015-04-01

Newer psoriasis treatments tout higher efficacy but are generally more expensive. We sought to estimate the cost efficacy of systemic psoriasis treatments that have been approved by the US Food and Drug Administration (FDA). A literature review of systemic psoriasis treatments that have been approved by the FDA was performed for the primary end point of a 75% reduction in the Psoriasis Area and Severity Index score (PASI 75). Medication cost was referenced by wholesale acquisition cost (WAC), laboratory fees were obtained from the American Medical Association, and office visit fees are standard at our university. Total expenses were standardized by calculating cost per month of treatment considering the number needed to treat (NNT) to achieve PASI 75. Methotrexate ($794.05-1502.51) and cyclosporine ($1410.14-1843.55) had the lowest monthly costs per NNT to achieve PASI 75. The most costly therapies were infliximab ($8704.68-15,235.52) and ustekinumab 90 mg ($12,505.26-14,256.75). Monthly costs per NNT to achieve PASI 75 for other therapies were as follows: narrowband ultraviolet B light phototherapy ($2924.73), adalimumab ($3974.61-7678.78), acitretin ($4137.71-14,148.53), ustekinumab 45 mg ($7177.89-7263.99), psoralen plus ultraviolet A light phototherapy ($7499.46-8834.98), and etanercept ($8284.71-10,674.89). Drug rebates and incentives, potential adverse effects, comorbidity risk reduction, ambassador programs, and combination therapies were excluded. Our study provides meaningful cost efficacy data that may influence psoriasis treatment selection. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The Pattern of Use of Hypofractionated Radiation Therapy for Early-Stage Breast Cancer in New South Wales, Australia, 2008 to 2012

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

Delaney, Geoff P., E-mail: Geoff.delaney@swsahs.nsw.gov.au; Collaboration for Cancer Outcomes Research and Evaluation, University of New South Wales, Sydney; Ingham Health and Medical Research Institute, Sydney

Purpose: Increasing phase 3 evidence has been published about the safety and efficacy of hypofractionated radiation therapy, in comparison with standard fractionation, in early-stage, node-negative breast cancer. However, uptake of hypofractionation has not been universal. The aim of this study was to investigate the hypofractionation regimen variations in practice across public radiation oncology facilities in New South Wales (NSW). Methods and Materials: Patients with early breast cancer registered in the NSW Clinical Cancer Registry who received radiation therapy for early-stage breast cancer in a publicly funded radiation therapy department between 2008 and 2012 were identified. Data extracted and analyzed includedmore » dose and fractionation type, patient age at first fraction, address (for geocoding), year of diagnosis, year of treatment, laterality, and department of treatment. A logistic regression model was used to identify factors associated with fractionation type. Results: Of the 5880 patients fulfilling the study criteria, 3209 patients (55%) received standard fractionation and 2671 patients (45%) received hypofractionation. Overall, the use of hypofractionation increased from 37% in 2008 to 48% in 2012 (range, 7%-94% across departments). Treatment facility and the radiation oncologist prescribing the treatment were the strongest independent predictors of hypofractionation. Weaker associations were also found for age, tumor site laterality, year of treatment, and distance to facility. Conclusions: Hypofractionated regimens of whole breast radiation therapy have been variably administered in the adjuvant setting in NSW despite the publication of long-term trial results and consensus guidelines. Some factors that predict the use of hypofractionation are not based on guideline recommendations, including lower rates of left-sided treatment and increasing distance from a treatment facility.« less

40 CFR 262.101 - What is in this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project-Laboratory Environmental Management Standard § 262.101 What is in this subpart? This subpart provides a framework for a new management system for wastes that are generated in University laboratories. This...

40 CFR 273.53 - Storage time limits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Storage time limits. 273.53 Section 273.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.53 Storage time...

40 CFR 273.53 - Storage time limits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Storage time limits. 273.53 Section 273.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.53 Storage time...

40 CFR 273.53 - Storage time limits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Storage time limits. 273.53 Section 273.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR UNIVERSAL WASTE MANAGEMENT Standards for Universal Waste Transporters § 273.53 Storage time...

Assessment of an undergraduate psychiatry course in an African setting

PubMed Central

Baig, Benjamin J; Beaglehole, Anna; Stewart, Robert C; Boeing, Leonie; Blackwood, Douglas H; Leuvennink, Johan; Kauye, Felix

2008-01-01

Background International reports recommend the improvement in the amount and quality of training for mental health workers in low and middle income countries. The Scotland-Malawi Mental Health Education Project (SMMHEP) has been established to support the teaching of psychiatry to medical students in the University of Malawi. While anecdotally supportive medical educational initiatives appear of value, little quantitative evidence exists to demonstrate whether such initiatives can deliver comparable educational standards. This study aimed to assess the effectiveness of an undergraduate psychiatry course given by UK psychiatrists in Malawi by studying University of Malawi and Edinburgh University medical students' performance on an MCQ examination paper. Methods An undergraduate psychiatry course followed by an MCQ exam was delivered by the SMMHEP to 57 Malawi medical students. This same MCQ exam was given to 71 Edinburgh University medical students who subsequently sat their own Edinburgh University examination. Results There were no significant differences between Edinburgh students' performance on the Malawi exam and their own Edinburgh University exam. (p = 0.65). This would suggest that the Malawi exam is a comparable standard to the Edinburgh exam. Malawi students marks ranged from 52.4%–84.6%. Importantly 84.4% of Malawi students scored above 60% on their exam which would equate to a hypothetical pass by UK university standards. Conclusion The support of an undergraduate course in an African setting by high income country specialists can attain a high percentage pass rate by UK standards. Although didactic teaching has been surpassed by more novel educational methods, in resource poor countries it remains an effective and cost effective method of gaining an important educational standard. PMID:18430237

Information Technology: A Tool to Cut Health Care Costs

NASA Technical Reports Server (NTRS)

Mukkamala, Ravi; Maly, K. J.; Overstreet, C. M.; Foudriat, E. C.

1996-01-01

Old Dominion University embarked on a project to see how current computer technology could be applied to reduce the cost and or to improve the efficiency of health care services. We designed and built a prototype for an integrated medical record system (MRS). The MRS is written in Tool control language/Tool kit (Tcl/Tk). While the initial version of the prototype had patient information hard coded into the system, later versions used an INGRES database for storing patient information. Currently, we have proposed an object-oriented model for implementing MRS. These projects involve developing information systems for physicians and medical researchers to enhance their ability for improved treatment at reduced costs. The move to computerized patient records is well underway, several standards exist for laboratory records, and several groups are working on standards for other portions of the patient record.

Standards of Practice for West African Libraries; Proceedings of a Seminar Held at the Institute of Librarianship, University of Ibadan, 15-16 April 1967.

ERIC Educational Resources Information Center

Dean, John, Ed.

A seminar on standards for libraries in West Africa was held in April 1967. This proceedings volume presents the papers given by each of the participants. Discussed are the standards for collections, facilities, staff, technical processes and services for public, school, university and special libraries. The purpose was to focus upon the nature,…

Developing a holistic accreditation system for medical universities of the Islamic Republic of Iran.

PubMed

Yousefy, A; Changiz, T; Yamani, N; Zahrai, R H; Ehsanpour, S

2009-01-01

This report describes the steps in the development of an accreditation system for medical universities in the Islamic Republic of Iran. The national accreditation project, supported by the government, was performed from 2001 to 2005. The project was carried out in 3 main phases, each phase including a number of tasks. After a review of the international literature on accreditation and through national consensus, a set of national institutional accreditation standards was developed, including 95 standards and 504 indicators in 10 areas. By complying with accepted national standards, Iranian medical universities will play an important role in promoting health system performance.

Surgical management of early pregnancy failure: history, politics, and safe, cost-effective care.

PubMed

Harris, Lisa H; Dalton, Vanessa K; Johnson, Timothy R B

2007-05-01

Early pregnancy failure and induced abortion are often managed differently, even though safe uterine evacuation is the goal in both. Early pregnancy failure is commonly treated by curettage in operating room settings in anesthetized patients. Induced abortion is most commonly managed by office vacuum aspiration in awake or sedated patients. Medical evidence does not support routine operating room management of early pregnancy failure. This commentary reviews historical origins of these different care standards, explores political factors responsible for their perpetuation, and uses experience at University of Michigan to dramatize the ways in which history, politics, and biomedicine intersect to produce patient care. The University of Michigan initiated office uterine evacuations for early pregnancy failure treatment. Patients previously went to the operating room. These changes required faculty, staff, and resident education. Our efforts blurred the lines between spontaneous and induced abortion management, improved patient care and better utilized hospital resources.

TU-E-TOUR-T-00: Exhibit Hall Guided Tours-Microdosimeters for Therapy (Tuesday)

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

NONE

Tour Leader: Indra Das, NYU Langone Medical Center, New York, NY Tour Guides: Hsui Ai, Indiana University School of Medicine, Indianapolis, IN Aaron Andersen, Indiana University School of Medicine, Indianapolis, IN Olga Volotoskova, NYU Langone Medical Center, New York, NY Participating Vendors: IBA PTW – New York RTI Electronics, Inc. Standard Imaging, Inc. Sun Nuclear Corporation Small fields are increasing used in specialized radiation treatments such as Gammaknife, Cyberknife, Tomotherapy, IMRT, VMAT, SRS and SBRT. Due to small field size electron transport creates lateral electronic disequilibrium and thus dosimetry could be very difficult. Microdetectors are used for small field dosimetrymore » which will be discussed in preface of this tour as below: Understanding small field e.g. meaning and definition of small field IAEA definition and approach Characteristics of microdetectors in terms of perturbation, recombination, correction Suitability of microdetectors in small field dosimetry.« less

Proceedings of the ITS Standards Program Review and Interoperability Workshop

DOT National Transportation Integrated Search

1997-12-17

An ITS Standards Program Review and Interoperability Workshop was held on Dec. 17-18, 1997 in Arlington, Va. It was sponsored by the U.S. DOT, ITS America, George Mason University (GMU) and the University of Michigan. The purpose was to review the US...

Tech-Know: Integrating Engaging Activities through Standards-Based Learning

ERIC Educational Resources Information Center

Ernst, Jeremy V.; Taylor, Jerianne S.; Peterson, Richard E.

2005-01-01

In August 2001, North Carolina State University received a four-year grant from the National Science Foundation to develop standards-based instructional materials for 20 Technology Student Association (TSA) activities. The TECH-know Project represents a significant collaboration between selected state departments, universities, businesses, and…

Development of a resource allocation formula for substance misuse treatment services.

PubMed

Jones, Andrew; Hayhurst, Karen P; Whittaker, Will; Mason, Thomas; Sutton, Matt

2017-11-23

Funding for substance misuse services comprises one-third of Public Health spend in England. The current allocation formula contains adjustments for actual activity, performance and need, proxied by the Standardized Mortality Ratio for under-75s (SMR < 75). Additional measures, such as deprivation, may better identify differential service need. We developed an age-standardized and an age-stratified model (over-18s, under-18s), with the outcome of expected/actual cost at postal sector/Local Authority level. A third, person-based model incorporated predictors of costs at the individual level. Each model incorporated both needs and supply variables, with the relative effects of their inclusion assessed. Mean estimated annual cost (2013/14) per English Local Authority area was £5 032 802 (sd: 3 951 158). Costs for drug misuse treatment represented the majority (83%) of costs. Models achieved adjusted R-squared values of 0.522 (age-standardized), 0.533 (age-stratified over-18s), 0.232 (age-stratified under-18s) and 0.470 (person-based). Improvements can be made to the existing resource allocation formulae to better reflect population need. The person-based model permits inclusion of a range of needs variables, in addition to strong predictors of cost based on the receipt of treatment in the previous year. Adoption of this revised person-based formula for substance misuse would shift resources towards more deprived areas. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Application of digital design and three-dimensional printing technique on individualized medical treatment].

PubMed

Qin, Mian; Liu, Yaxiong; He, Jiankang; Wang, Ling; Lian, Qin; Li, Dichen; Jin, Zhongmin; He, Sanhu; Li, Gang; Liu, Yanpu; Wang, Zhen

2014-03-01

To summarize the latest research development of the application of digital design and three-dimensional (3-D) printing technique on individualized medical treatment. Recent research data and clinical literature about the application of digital design and 3-D printing technique on individualized medical treatment in Xi'an Jiaotong University and its cooperation unit were summarized, reviewed, and analyzed. Digital design and 3-D printing technique can design and manufacture individualized implant based on the patient's specific disease conditions. And the implant can satisfy the needs of specific shape and function of the patient, reducing dependence on the level of experience required for the doctor. So 3-D printing technique get more and more recognition of the surgeon on the individualized repair of human tissue. Xi'an Jiaotong University is the first unit to develop the commercial 3-D printer and conduct depth research on the design and manufacture of individualized medical implant. And complete technological processes and quality standards of product have been developed. The individualized medical implant manufactured by 3-D printing technique can not only achieve personalized match but also meet the functional requirements and aesthetic requirements of patients. In addition, the individualized medical implant has the advantages of accurate positioning, stable connection, and high strength. So 3-D printing technique has broad prospects in the manufacture and application of individualized implant.

Cleaning, Disinfection, and Sterilization Protocols Employed for Customized Implant Abutments: An International Survey of 100 Universities Worldwide.

PubMed

Canullo, Luigi; Tallarico, Marco; Chu, Stephen; Peñarrocha, David; Özcan, Mutlu; Pesce, Paolo

American and European standards recommend sterilization of customized abutments before connecting them to implants, as customized abutments are considered semi-critical medical devices. Since standardized procedures could not be identified in the literature on implantology, this survey evaluated the protocols employed at different universities worldwide to clean, disinfect, and/or sterilize customized abutments before their connection to bone-level implants. The survey took place between October 2015 and January 2016. A single question acquiring information on how customized abutments were treated prior to connection to the implants was sent by email to researchers affiliated at 100 universities worldwide. To avoid any bias, the survey was kept rigorously anonymous. A total of 100 universities from Europe (56), USA and Canada (25), Latin America (9), South Africa (1), Asia (6), and Australia and New Zealand (3) were invited to participate in the survey. Altogether, 85 universities responded to the survey question, and 22 (25.9%) declared that no cleaning protocols were adopted. More than half of the respondents (n = 49, 57.6%) performed only one of the three procedures required by the standards (cleaning, disinfection, or sterilization). Twelve respondents (14.1%) adopted two procedures, and only two universities performed all three required procedures (2.4%). This survey indicated substantial heterogeneity in treating customized abutments before connecting them to implants. This study demonstrated that the majority of the universities applied either cleaning, disinfection, or sterilization which may not meet the prevailing standards.

Neuropsychologic predictors of competency in Alzheimer's disease using a rational reasons legal standard.

PubMed

Marson, D C; Cody, H A; Ingram, K K; Harrell, L E

1995-10-01

To identify neuropsychologic predictors of competency performance and status in Alzheimer's disease (AD) using a specific legal standard (LS). This study is a follow-up to the competency assessment research reported in this issue of the archives. Univariate and multivariate analyses of independent neuropsychologic test measures with a dependent measure of competency to consent to treatment. University medical center. Fifteen normal older control subjects and 29 patients with probable AD. Subjects were administered a battery of neuropsychologic measures theoretically linked to competency function, as well as two clinical vignettes testing their capacity to consent to medical treatment under five different LSs. The present study focused on one specific LS: the capacity to provide "rational reasons" for a treatment choice (LS4). Neuropsychologic test scores were correlated with scores on LS4 for the normal control group and the AD group. The resulting univariate predictors were then analyzed using stepwise regression and discriminant function to identify the key multivariate predictors of competency performance and status under LS4. Measures of word fluency predicted the LS4 scores of controls (R2 = .33) and the AD group (R2 = .36). A word fluency measure also emerged as the best single predictor of competency status for the full subject sample (n = 44), correctly classifying 82% of cases. Dementia severity (Mini-Mental State Examination score) did not emerge as a multivariate predictor of competency performance or status. Interestingly, measures of verbal reasoning and memory were not strongly associated with LS4. Word fluency measures predicted the normative performance and intact competency status of older control subjects and the declining performance and compromised competency status of patients with AD on a "rational reasons" standard of competency to consent to treatment. Cognitive capacities related to frontal lobe function appear to underlie the capacity to formulate rational reasons for a treatment choice. Neuropsychologic studies of competency function have important theoretical and clinical value.

Common data elements collected among universities for sport-related concussion studies.

PubMed

Yang, Jingzhen; Peek-Asa, Corinne; Noble, James M; Torner, James; Schmidt, Paul; Cooper, Martha L

2018-02-12

Universities are increasingly implementing programs to effectively respond to and manage sport-related concussions (SRCs). One such effort is to develop common data elements (CDEs) and standardize data collection methods. The objectives of this study were to describe CDEs currently collected by Big Ten and Ivy League universities for SRC studies, and to compare the data collected with the core CDEs recommended by the National Institute of Neurological Disorders and Stroke (NINDS). We conducted an anonymous cross-sectional online survey among medical staff at the 14 Big Ten and 8 Ivy League universities (one per university) between September and October 2015. The survey instrument, including 9 questions corresponding to the concussion data collected before, during, and after a concussion, was developed and pilot-tested before field use. We analyzed patterns of the concussion CDEs being collected, including when, what, and how the data were collected and stored, and compared them with the NINDS' recommended core CDEs. A total of 19 out of 22 universities were included, with 13 from Big Ten and 6 from Ivy-League universities. All 19 participating universities currently collected concussion data with athletes before, during, and after a concussion. Great similarities in data collection were observed at baseline and acutely post-concussion across participating universities. All 19 universities collected at least one of the ten recommended acute symptoms checklists, and 18 universities collected one of the four recommended core neuropsychological function cognitive measures. However, CDEs in the sub-acute and chronic timeframes were limited, with only 9 (47%) universities collecting post-concussion short to long term outcome data. While over 60% of universities collected and stored concussion data electronically, only 17% to 42% of data collected were readily available for research. Significant inter-institutional similarities in acute concussion CDEs were found. Further efforts should focus on collecting sub-acute and chronic timeframe core CDEs and creating data access protocols to facilitate evidence-based concussion prevention and treatment for all collegiate athletes.

Teaching Practise Utilising Embedded Indigenous Cultural Standards

ERIC Educational Resources Information Center

Gilbert, Stephanie

2017-01-01

The Wollotuka Institute, University of Newcastle, New South Wales, is the first university or organisation to enter into the accreditation process with the World Indigenous Higher Education Consortium (WINHEC). Part of that process includes identifying the local cultural standards and protocols that drive and shape our work as a cultural entity.…

Raising the Bar on Faculty Productivity: Realigning Performance Standards to Enhance Quality Trajectories

ERIC Educational Resources Information Center

Hardré, Patricia L.

2014-01-01

Many universities have observed needs and shared goals that include increasing faculty members' research productivity (in quantity or quality). Strategies for raising faculty performance include revising standards and supporting valued outcomes with rewards and incentives. One college at a research-extensive university received institutional…

One Burn, One Standard

DTIC Science & Technology

2014-09-01

Johannes Kepler University Linz Software GmbH Research Department Medical Informatics Hagenberg, Austria Herbert L. Haller, MD Trauma Hospital Linz of...0000000000000004 Address correspondence to M. Giretzlehner, PhD, Johannes Kepler University Linz, RISC Software GmbH, Research Department Medical Informatics, Softwarepark 35, 4232 Hagenberg, Austria. One Burn, One Standard LETTER TO THE EDITOR

TEQSA and Risk-Based Regulation: Considerations for University Governing Bodies

ERIC Educational Resources Information Center

Baird, Jeanette

2013-01-01

The advent of a new national regulatory and quality assurance regime in Australia, through the Tertiary Education Quality and Standards Agency (TEQSA), presents additional requirements to university governing bodies, for compliance with standards and for risk management. This paper discusses TEQSA's approach and potential vulnerabilities for TEQSA…

Cost effectiveness of EML4-ALK fusion testing and first-line crizotinib treatment for patients with advanced ALK-positive non-small-cell lung cancer.

PubMed

Djalalov, Sandjar; Beca, Jaclyn; Hoch, Jeffrey S; Krahn, Murray; Tsao, Ming-Sound; Cutz, Jean-Claude; Leighl, Natasha B

2014-04-01

ALK-targeted therapy with crizotinib offers significant improvement in clinical outcomes for the treatment of EML4-ALK fusion-positive non-small-cell lung cancer (NSCLC). We estimated the cost effectiveness of EML4-ALK fusion testing in combination with targeted first-line crizotinib treatment in Ontario. A cost-effectiveness analysis was conducted using a Markov model from the Canadian Public health (Ontario) perspective and a lifetime horizon in patients with stage IV NSCLC with nonsquamous histology. Transition probabilities and mortality rates were calculated from the Ontario Cancer Registry and Cancer Care Ontario New Drug Funding Program (CCO NDFP). Costs were obtained from the Ontario Case Costing Initiative, CCO NDFP, University Health Network, and literature. Molecular testing with first-line targeted crizotinib treatment in the population with advanced nonsquamous NSCLC resulted in a gain of 0.011 quality-adjusted life-years (QALYs) compared with standard care. The incremental cost was Canadian $2,725 per patient, and the incremental cost-effectiveness ratio (ICER) was $255,970 per QALY gained. Among patients with known EML4-ALK-positive advanced NSCLC, first-line crizotinib therapy provided 0.379 additional QALYs, cost an additional $95,043 compared with standard care, and produced an ICER of $250,632 per QALY gained. The major driver of cost effectiveness was drug price. EML4-ALK fusion testing in stage IV nonsquamous NSCLC with crizotinib treatment for ALK-positive patients is not cost effective in the setting of high drug costs and a low biomarker frequency in the population.

Academic performance of students who underwent psychiatric treatment at the students' mental health service of a Brazilian university.

PubMed

Campos, Cláudia Ribeiro Franulovic; Oliveira, Maria Lilian Coelho; Mello, Tânia Maron Vichi Freire de; Dantas, Clarissa de Rosalmeida

2017-01-01

University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students' mental health service (SAPPE) and to compare their academic performance with that of non-patient students. Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC) and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1%) and anxiety disorders/phobias (33.2%) were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7%) and bipolar disorder (1.9%) were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025), but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.

Improving post-stroke dysphagia outcomes through a standardized and multidisciplinary protocol: an exploratory cohort study.

PubMed

Gandolfi, Marialuisa; Smania, Nicola; Bisoffi, Giulia; Squaquara, Teresa; Zuccher, Paola; Mazzucco, Sara

2014-12-01

Stroke is a major cause of dysphagia. Few studies to date have reported on standardized multidisciplinary protocolized approaches to the management of post-stroke dysphagia. The aim of this retrospective cohort study was to evaluate the impact of a standardized multidisciplinary protocol on clinical outcomes in patients with post-stroke dysphagia. We performed retrospective chart reviews of patients with post-stroke dysphagia admitted to the neurological ward of Verona University Hospital from 2004 to 2008. Outcomes after usual treatment for dysphagia (T- group) were compared versus outcomes after treatment under a standardized diagnostic and rehabilitative multidisciplinary protocol (T+ group). Outcome measures were death, pneumonia on X-ray, need for respiratory support, and proportion of patients on tube feeding at discharge. Of the 378 patients admitted with stroke, 84 had dysphagia and were enrolled in the study. A significantly lower risk of in-hospital death (odds ratio [OR] 0.20 [0.53-0.78]), pneumonia (OR 0.33 [0.10-1.03]), need for respiratory support (OR 0.48 [0.14-1.66]), and tube feeding at discharge (OR 0.30 [0.09-0.91]) was recorded for the T+ group (N = 39) as compared to the T- group (N = 45). The adjusted OR showed no difference between the two groups for in-hospital death and tube feeding at discharge. Use of a standardized multidisciplinary protocolized approach to the management of post-stroke dysphagia may significantly reduce rates of aspiration pneumonia, in-hospital mortality, and tube feeding in dysphagic stroke survivors. Consistent with the study's exploratory purposes, our findings suggest that the multidisciplinary protocol applied in this study offers an effective model of management of post-stroke dysphagia.

Standard UBV Observations at the Çanakkale University Observatory (ÇUO)

NASA Astrophysics Data System (ADS)

Bakis, Hicran; Bakis, Volkan; Demircan, Osman; Budding, Edwin

2005-07-01

By using standard and comparison star observations carried out at different times of the year, at Çanakkale Onsekiz Mart University Observatory, we obtained the atmospheric extinction coefficients at the observatory. We also obtained transformation coefficients and zero-point constants for the transformation to the standard Johnson UBV system, of observations in the local system carried out with the SSP5A photometer and T40 telescope. The transmission curves and the mean wavelengths of the UBV filters as measured in the laboratory appear not much different from those of the standard Johnson system and found inside the transmission curve of the standard mean atmosphere.

[Idiopathic inflammatory bowel disease - advancements in surgical treatment].

PubMed

Ulrych, J; Krška, Z

2012-10-01

Treatment of idiopathic inflammatory bowel disease is constantly developing. Biological therapy has become a standard part of conservative treatment, and gene and cell therapy of these diseases is in preclinical phase. Surgical therapy also offers some progress in the treatment, such as the increasingly preferred laparoscopic approach offering the numerous benefits of minimally invasive surgery or a tendency to perform stapled anastomosis. A retrospective analysis of patients with a diagnosis of idiopathic inflammatory bowel operated on at the First Department of Surgery, General University Hospital in the years 2007-2011 was performed. Within this period, 179 patients diagnosed with Crohns disease were operated on. 30 patients underwent acute operation and 149 patients were indicated for elective surgery. In the same period, 40 patients with ulcerative colitis were indicated for surgery, of whom 22 patients for acute surgery and 18 for elective surgery. Multidisciplinary approach in the treatment of patients with inflammatory bowel disease is crucial and patients should be treated in specialized centres. New possibilities of conservative treatment and progress in surgical therapy mutually correlate, and thus the choice of a correct therapeutic procedure requires specific cooperation between the surgeon and the gastroenterologist.

[International collaboration to develop a nurse practitioner master's program].

PubMed

Tang, Woung-Ru

2007-12-01

Because of the shortage of resident doctors and in order to raise standards, hospitals and medical centers have trained their own nurse practitioners (NPs). Given the absence of standard training criteria and an unevenness of faculty quality, however, many NPs play the role of medical substitute, which is far from the independent role performed by NPs in foreign countries. It is therefore necessary to include NP training within higher education. The Graduate Institute of Nursing at Chang Gung University established the first NP in-service training program in 2003 through international collaboration, with the purpose of cultivating advanced clinical nursing talents. The program emphasizes the importance of clinical reasoning and practical training, in order to enable students to perform the multiple roles of treatment and caring undertaken by NPs. Experts in advanced nursing and clinical medicine from Taiwan and abroad were invited to serve as lecturers. The students also had the opportunity to take NP courses at Oregon Health and Science University (USA) and participate in clinical visits. The results have been widely praised. International collaboration is built upon the mutual trust of the parties, and its success is determined by the measures that it involves, as well as by the global vision and competence of participants. This paper shares the advantages and disadvantages of the NP master's program through international collaboration.

Protocol for a randomised controlled implementation trial of point-of-care viral load testing and task shifting: the Simplifying HIV TREAtment and Monitoring (STREAM) study.

PubMed

Dorward, Jienchi; Garrett, Nigel; Quame-Amaglo, Justice; Samsunder, Natasha; Ngobese, Hope; Ngomane, Noluthando; Moodley, Pravikrishnen; Mlisana, Koleka; Schaafsma, Torin; Donnell, Deborah; Barnabas, Ruanne; Naidoo, Kogieleum; Abdool Karim, Salim; Celum, Connie; Drain, Paul K

2017-09-27

Achieving the Joint United Nations Programme on HIV and AIDS 90-90-90 targets requires models of HIV care that expand antiretroviral therapy (ART) coverage without overburdening health systems. Point-of-care (POC) viral load (VL) testing has the potential to efficiently monitor ART treatment, while enrolled nurses may be able to provide safe and cost-effective chronic care for stable patients with HIV. This study aims to demonstrate whether POC VL testing combined with task shifting to enrolled nurses is non-inferior and cost-effective compared with laboratory-based VL monitoring and standard HIV care. The STREAM (Simplifying HIV TREAtment and Monitoring) study is an open-label, non-inferiority, randomised controlled implementation trial. HIV-positive adults, clinically stable at 6 months after ART initiation, will be recruited in a large urban clinic in South Africa. Approximately 396 participants will be randomised 1:1 to receive POC HIV VL monitoring and potential task shifting to enrolled nurses, versus laboratory VL monitoring and standard South African HIV care. Initial clinic follow-up will be 2-monthly in both arms, with VL testing at enrolment, 6 months and 12 months. At 6 months (1 year after ART initiation), stable participants in both arms will qualify for a differentiated care model involving decentralised ART pickup at community-based pharmacies. The primary outcome is retention in care and virological suppression at 12 months from enrolment. Secondary outcomes include time to appropriate entry into the decentralised ART delivery programme, costs per virologically suppressed patient and cost-effectiveness of the intervention compared with standard care. Findings will inform the scale up of VL testing and differentiated care in HIV-endemic resource-limited settings. Ethical approval has been granted by the University of KwaZulu-Natal Biomedical Research Ethics Committee (BFC296/16) and University of Washington Institutional Review Board (STUDY00001466). Results will be presented at international conferences and published in academic peer-reviewed journals. NCT03066128; 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.

Prediction and standard error estimation for a finite universe total when a stratum is not sampled

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

Wright, T.

1994-01-01

In the context of a universe of trucks operating in the United States in 1990, this paper presents statistical methodology for estimating a finite universe total on a second occasion when a part of the universe is sampled and the remainder of the universe is not sampled. Prediction is used to compensate for the lack of data from the unsampled portion of the universe. The sample is assumed to be a subsample of an earlier sample where stratification is used on both occasions before sample selection. Accounting for births and deaths in the universe between the two points in time,more » the detailed sampling plan, estimator, standard error, and optimal sample allocation, are presented with a focus on the second occasion. If prior auxiliary information is available, the methodology is also applicable to a first occasion.« less

Rituximab treatment for fibrillary glomerulonephritis.

PubMed

Hogan, Jonathan; Restivo, Michaela; Canetta, Pietro A; Herlitz, Leal C; Radhakrishnan, Jai; Appel, Gerald B; Bomback, Andrew S

2014-10-01

Approximately 50% of patients with fibrillary glomerulonephritis (GN) progress to end-stage renal disease (ESRD) within 2 years of diagnosis, and no standard therapy exists. The data on rituximab therapy for fibrillary GN are limited and have inconsistent outcomes. Here, we report the largest case series to date using rituximab for fibrillary GN. Retrospective chart reviews were conducted on 12 patients with fibrillary GN who were treated with rituximab (1 g i.v. × 2 doses or 375 mg/m(2) × 4 doses) at the Center for Glomerular Diseases at Columbia University Medical Center. Non-progression of disease was defined as stable/improved serum creatinine (SCr) with a minimum of 1 year of follow-up. The median SCr was 2.1 (range 0.7-2.7) mg/dL, median estimated glomerular filtration rate (eGFR) 39 (range 21-98) mL/min/1.73 m(2) and median proteinuria 4497 (range 210-7542) mg/day at the time of rituximab initiation. Four patients had received immunosuppression before rituximab, and nine received immunosuppression after rituximab, with four receiving a second rituximab course. Four of 12 patients were non-progressors, 3 of 12 had progressive renal dysfunction without reaching ESRD, and 5 patients reached ESRD. The median follow-up for patients who did not reach ESRD was 38 (range 14-76) months after rituximab treatment. Non-progressors had lower SCr values, higher eGFRs and shorter median duration from diagnosis to treatment than progressors. No serious adverse events were noted. Rituximab therapy was associated with non-progression of renal disease in 4 of 12 patients. At the time of treatment, these non-progressors had better renal function and shorter time from diagnosis to treatment than progressors. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Clinical trials supported by the Tinnitus Research Consortium: Lessons learned, the Southern Illinois University experience.

PubMed

Bauer, Carol A; Berry, Jennifer; Brozoski, Thomas J

2016-04-01

The Tinnitus Research Consortium funded three clinical trials investigating treatments for chronic bothersome tinnitus at Southern Illinois University School of Medicine. The trials were designed to measure the subjective changes in tinnitus distress using standardized questionnaires and objective changes in tinnitus loudness using psychophysical matching procedures. The results of the first two trials have been published and are summarized here. The first trial investigated the effect of gabapentin on the loudness and annoyance of tinnitus in adults with chronic bothersome tinnitus with and without a history of acoustic trauma. A small but significant number of subjects reported decreased tinnitus annoyance that corresponded with a decrease in objective measures of tinnitus loudness during active drug treatment with a washout effect during placebo treatment. The second trial compared the effect of tinnitus retraining therapy (TRT) on adults with normal to near-normal hearing and chronic bothersome tinnitus to treatment with general counseling without acoustic enrichment. Significant improvements in tinnitus severity, but not in objective psychometric measures of tinnitus loudness, occurred in both treatment groups, however a greater effect was observed in the TRT group compared with the control group. The third trial is nearing completion and investigates the long-term results of tinnitus retraining therapy on chronic bothersome tinnitus in adults with hearing loss. Significant lessons and observations on conducting tinnitus clinical trials were learned from these three trials. The challenges of recruiting and retaining study participants is discussed. More importantly, the reliability and stability of the Tinnitus Handicap Inventory (THI) over long intervals is presented. The implications of this variability for the design and interpretation of future tinnitus studies is discussed. This article is part of a Special Issue entitled . Copyright © 2015 Elsevier B.V. All rights reserved.

USL/DBMS NASA/RECON working paper series. Standards

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Chum, Frank Y.

1984-01-01

The USL/DBMS NASA/RECON Working Paper Series contains a collection of reports representing results of activities being conducted by the Computer Science Department of the University of Southwestern Louisiana pursuant to the specifications of NASA Contract number NASw-3846. The work on this portion of the contract is being performed jointly by the University of Southwestern Louisiana and Southern University. This report contains the full set of standards for the development, formatting, reviewing, and issuance of entries within the USL/DBMS NASA/RECON Working Paper Series.

Addressing Beyond Standard Model physics using cosmology

NASA Astrophysics Data System (ADS)

Ghalsasi, Akshay

We have consensus models for both particle physics (i.e. standard model) and cosmology (i.e. LambdaCDM). Given certain assumptions about the initial conditions of the universe, the marriage of the standard model (SM) of particle physics and LambdaCDM cosmology has been phenomenally successful in describing the universe we live in. However it is quite clear that all is not well. The three biggest problems that the SM faces today are baryogenesis, dark matter and dark energy. These problems, along with the problem of neutrino masses, indicate the existence of physics beyond SM. Evidence of baryogenesis, dark matter and dark energy all comes from astrophysical and cosmological observations. Cosmology also provides the best (model dependent) constraints on neutrino masses. In this thesis I will try address the following problems 1) Addressing the origin of dark energy (DE) using non-standard neutrino cosmology and exploring the effects of the non-standard neutrino cosmology on terrestrial and cosmological experiments. 2) Addressing the matter anti-matter asymmetry of the universe.

Standardization of the Functional Assessment and Intervention Program (FAIP) with Children Who Have Externalizing Behaviors

ERIC Educational Resources Information Center

Hartwig, Laurie; Heathfield, Lora Tuesday; Jenson, William R.

2004-01-01

The purpose of this study was to develop standardization data for the Functional Assessment Intervention Program (FAIP; University of Utah, Utah State University, & Utah State Office of Education, 1999), a computerized, functional behavioral assessment expert system. Reliability, validity, and utility analyses were conducted with students serving…

Fifty Years of A-Level Mathematics: Have Standards Changed?

ERIC Educational Resources Information Center

Jones, Ian; Wheadon, Chris; Humphries, Sara; Inglis, Matthew

2016-01-01

Advanced-level (A-level) mathematics is a high-profile qualification taken by many school leavers in England, Wales, Northern Ireland and around the world as preparation for university study. Concern has been expressed in these countries that standards in A-level mathematics have declined over time, and that school leavers enter university or the…

Higher Education Quality Assessment Model: Towards Achieving Educational Quality Standard

ERIC Educational Resources Information Center

Noaman, Amin Y.; Ragab, Abdul Hamid M.; Madbouly, Ayman I.; Khedra, Ahmed M.; Fayoumi, Ayman G.

2017-01-01

This paper presents a developed higher education quality assessment model (HEQAM) that can be applied for enhancement of university services. This is because there is no universal unified quality standard model that can be used to assess the quality criteria of higher education institutes. The analytical hierarchy process is used to identify the…

Endovascular therapy of acute ischemic stroke: report of the Standards of Practice Committee of the Society of NeuroInterventional Surgery.

PubMed

Blackham, K A; Meyers, P M; Abruzzo, T A; Albuquerque, F C; Alberquerque, F C; Fiorella, D; Fraser, J; Frei, D; Gandhi, C D; Heck, D V; Hirsch, J A; Hsu, D P; Hussain, M Shazam; Jayaraman, M; Narayanan, S; Prestigiacomo, C; Sunshine, J L

2012-03-01

To summarize and classify the evidence for the use of endovascular techniques in the treatment of patients with acute ischemic stroke. Recommendations previously published by the American Heart Association (AHA) (Guidelines for the early management of adults with ischemic stroke (Circulation 2007) and Scientific statement indications for the performance of intracranial endovascular neurointerventional procedures (Circulation 2009)) were vetted and used as a foundation for the current process. Building on this foundation, a critical review of the literature was performed to evaluate evidence supporting the endovascular treatment of acute ischemic stroke. The assessment was based on guidelines for evidence based medicine proposed by the Stroke Council of the AHA and the University of Oxford, Centre for Evidence Based Medicine (CEBM). Procedural safety, technical efficacy and impact on patient outcomes were specifically examined.

[Stabilizing the social and health status of drug dependent patients with methadone. Long-term maintainance therapy--Vienna results].

PubMed

Loimer, N; Werner, E; Hollerer, E; Pfersmann, V; Schmid-Siegel, B; Presslich, O

1991-01-01

On September 25th, 1987 methadone was legalized in Austria for therapeutic use in drug addiction treatment in case of: 1. Long-term drug addiction with intravenous application of the drug, and several unsuccessful withdrawal therapies and/or 2. opiate addiction through intravenous application of the drug along with an existing HIV-1 infection. Since than, 291 patients were treated with methadone at the drug-dependency outpatient clinic of the Psychiatric Clinic of the University of Vienna. In 1990, 96 patients treated for more than one year were investigated using a standardized questionnaire. The image in which crime, prostitution, poverty, ill health all merge was broken by this decriminalization. Methadone treatment offers a first step toward social rehabilitation for drug addicts who have been living as criminals on the fringe of society.

Summary of Resource Conservation and Recovery Act State Authorization Rule Checklist 179

EPA Pesticide Factsheets

Land Disposal Restrictions -- Phase IV: Treatment Standards for Wood Preserving Wastes, Treatment Standards for Metal Wastes, Zinc Micronutrient Fertilizers, Carbamate Treatment Standards, and K088 Treatment Standards

Several organic parameters on underlying hazardous constituents list can not be measured at the universal treatment standards

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

Johnson, H.C.

1998-07-01

The Idaho National Engineering and Environmental Laboratory (INEEL) has several permitted treatment, storage and disposal facilities. The INEEL Sample Management Office (SMO) conducts all analysis subcontracting activities for Department of Energy Environmental Management programs at the INEEL. In this role, the INEEL SMO has had the opportunity to subcontract the analyses of various wastes (including ash from an interim status incinerator) requesting a target analyte list equivalent to the constituents listed in 40 Code of Federal Regulations. These analyses are required to ensure that treated wastes do not contain underlying hazardous constituents (UHC) at concentrations greater than the universal treatmentmore » standards (UTS) prior to land disposal. The INEEL SMO has conducted a good-faith effort by negotiating with several commercial laboratories to identify the lowest possible quantitation and detection limits that can be achieved for the organic UHC analytes. The results of this negotiating effort has been the discovery that no single laboratory (currently under subcontract with the INEEL SMO) can achieve a detection level that is within an order of magnitude of the UTS for all organic parameters on a clean sample matrix (e.g., sand). This does not mean that there is no laboratory that can achieve the order of magnitude requirements for all organic UHCs on a clean sample matrix. The negotiations held to date indicate that it is likely that no laboratory can achieve the order of magnitude requirements for a difficult sample matrix (e.g., an incinerator ash). The authors suggest that the regulation needs to be revised to address the disparity between what is achievable in the laboratory and the regulatory levels required by the UTS.« less

The Effect of New Model PREPARED on Obtaining Informed Consent Skill in Midwifery Students of Shahid Sadoughi University of Medical Sciences

PubMed Central

Farajkhoda, Tahmineh; Bokaie, Mahshid; Abbasi, Mahmoud; NajafiHedeshi, Saeedeh; Alavi, Zahra; Rahimdel, Mahin

2017-01-01

Background: Professional ethics culture should be taught to students appropriately. Studies have shown that midwifery students are not entirely familiar with the skill of obtaining informed consent. Using a new and applicable model to teach this skill to midwifery students is necessary. This study was conducted to determine the effect of a new standard model, PREPARED, on the skill of obtaining informed consent in midwifery students of Shahid Sadoughi University of Medical Sciences. Materials and Methods: This interventional study was conducted on 37 5th semester midwifery students through a census method. After determining psychometric indices, in two phases with a 4-week interval (before and after the training), the PREPARED checklist was completed by the professors of the research team in the presence of students in the delivery room while they were performing midwifery care considering their compliance to the checklist. Descriptive statistics paired t-test were used for data analysis. Results: The lowest mean score before the training belonged to alternative methods (1.00) and treatment expenses (1.00). After the training, treatment plan had the highest mean score (3.54 (0.69)). The mean and standard deviation of scores before and after training the students were 9.12 (2.00) and 30.6824 (5.25), respectively. Based on the results of the paired t-test (P = 0.001), the difference was statistically significant. Conclusion: Results showed that the implementation of the new model of PREPARED would increase the skill of obtaining informed consent in midwifery students and could be applied for educating students of other medical majors in Iran. PMID:28904537

Providers and Patients Caught Between Standardization and Individualization: Individualized Standardization as a Solution Comment on "(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare".

PubMed

Ansmann, Lena; Pfaff, Holger

2017-08-12

In their 2017 article, Mannion and Exworthy provide a thoughtful and theory-based analysis of two parallel trends in modern healthcare systems and their competing and conflicting logics: standardization and customization. This commentary further discusses the challenge of treatment decision-making in times of evidence-based medicine (EBM), shared decision-making and personalized medicine. From the perspective of systems theory, we propose the concept of individualized standardization as a solution to the problem. According to this concept, standardization is conceptualized as a guiding framework leaving room for individualization in the patient physician interaction. The theoretical background is the concept of context management according to systems theory. Moreover, the comment suggests multidisciplinary teams as a possible solution for the integration of standardization and individualization, using the example of multidisciplinary tumor conferences and highlighting its limitations. The comment also supports the authors' statement of the patient as co-producer and introduces the idea that the competing logics of standardization and individualization are a matter of perspective on macro, meso and micro levels. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Shaking up the system: the role of change in maternal-adolescent communication quality and adolescent weight loss.

PubMed

Hadley, Wendy; McCullough, Mary Beth; Rancourt, Diana; Barker, David; Jelalian, Elissa

2015-01-01

The association between directly observed mother-adolescent weight-related communication quality and adolescent percent overweight within the context of an adolescent weight control study was examined. As part of a larger study examining the impact of a behavioral weight control intervention that included attention to parent-adolescent communication (Standard Behavioral Treatment + Enhanced Parenting, SBT + EP) compared with an efficacious Standard Behavioral Treatment (SBT), 38 mother-adolescent dyads participated in a weight-related videotaped discussion. Discussions were taped and collected pre- and postintervention. No significant differences emerged in the quality of mother-adolescent communication between SBT (n = 19) and SBT + EP (n = 19) participants, nor was baseline mother-adolescent communication quality associated with adolescents' weight loss in either condition. However, a decline in communication quality was associated with better outcomes for adolescents participating in the SBT group. This study provides preliminary evidence that a change in mother-adolescent communication is associated with successful weight loss among adolescents. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Economic Evaluation of Manitoba Health Lines in the Management of Congestive Heart Failure

PubMed Central

Cui, Yang; Doupe, Malcolm; Katz, Alan; Nyhof, Paul; Forget, Evelyn L.

2013-01-01

Objective: This one-year study investigated whether the Manitoba Provincial Health Contact program for congestive heart failure (CHF) is a cost-effective intervention relative to the standard treatment. Design: Individual patient-level, randomized clinical trial of cost-effective model using data from the Health Research Data Repository at the Manitoba Centre for Health Policy, University of Manitoba. Methods: A total of 179 patients aged 40 and over with a diagnosis of CHF levels II to IV were recruited from Winnipeg and Central Manitoba and randomized into three treatment groups: one receiving standard care, a second receiving Health Lines (HL) intervention and a third receiving Health Lines intervention plus in-house monitoring (HLM). A cost-effectiveness study was conducted in which outcomes were measured in terms of QALYs derived from the SF-36 and costs using 2005 Canadian dollars. Costs included intervention and healthcare utilization. Bootstrap-resampled incremental cost-effectiveness ratios were computed to take into account the uncertainty related to small sample size. Results: The total per-patient mean costs (including intervention cost) were not significantly different between study groups. Both interventions (HL and HLM) cost less and are more effective than standard care, with HL able to produce an additional QALY relative to HLM for $2,975. The sensitivity analysis revealed that there is an 85.8% probability that HL is cost-effective if decision-makers are willing to pay $50,000. Conclusion: Findings demonstrate that the HL intervention from the Manitoba Provincial Health Contact program for CHF is an optimal intervention strategy for CHF management compared to standard care and HLM. PMID:24359716

Accidental hypothermia: rewarming treatments, complications and outcomes from one university medical centre.

PubMed

van der Ploeg, Gert-Jan; Goslings, J Carel; Walpoth, Beat H; Bierens, Joost J L M

2010-11-01

Accidental hypothermia (AH) is a complex and life threatening condition. Knowledge about epidemiology, rewarming treatments, complications and outcome is limited. This study was initiated to obtain data on causes, rewarming treatments and complications. A retrospective cohort study of all patients with a body temperature ≤ 35°C admitted to the Emergency Department (ED) of the VU university medical centre, Amsterdam, The Netherlands, between January 1, 2000 and August 31, 2008. A predefined set of epidemiological and clinical data was retrieved. Eighty-four patients were included (median age: 47 years). Categories of hypothermia included immersion (18), submersion (29) and exposure to cold (37); concomitant factors were intoxication (26), trauma (40) and homelessness (7). Temperature at admission in the ED was 31.6 ± 2.6°C (mean ± SD), lowest temperature 24.2°C. Fourteen different rewarming treatments were used resulting in a wide range of rewarming speeds. Seventy-nine complications occurred: pulmonary, renal and neurological complications in 20, 17 and 10 patients respectively. Seventeen patients had 2 or more late complications. Twenty-four patients (28.6%) died: 10 during rewarming and 14 after rewarming was completed. Prognosis was poor in older and colder patients and after indoor exposure and submersion. AH is a rare diagnosis in an inhomogeneous population, treated with a large variety of rewarming techniques. Most complications and death occurred late, after rewarming was completed. Because individual teams gain little clinical experiences, we suggest multiple centre data collection as a first step towards an evidence-based standard of care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[Passive euthanasia in clinical practice--the medical decision reflected in the legal position].

PubMed

Möller, T; Grabensee, B; Frister, H

2008-05-01

Doctors are often confronted with end-of-life decisions. When deciding on the withdrawal of medical treatment physicians have to consider the legal position. This study was done to evaluated how far doctors at the university medical center in Düsseldorf had acted in conformity with the established case law in Germany. Between April and August 2006 doctors at the university medical center in Düsseldorf filled in a standardized questionnaire about the decisions they had taken to withdraw life-support treatment. 128 of a total of 512 doctors questioned replied (25 %; 32,8 % females and 67,2 % males) . The survey showed that the judicial decision (that it is not necessary to provide treatment if life-support measures are not indicated) is largely determined by non-medical criteria. The clinical decision by doctors depended mainly on his personal opinion. Furthermore the survey showed that only a few doctors made use of the - lawful - option to withdraw medical treatment when this was not indicated. Finally the survey revealed that, in case of conflict between indication and perceived patients' wishes, the vast majority of doctors behaved in contravention of the decisions established by case law. There is the need to discuss what non-medical issues should be taken into account when determining the indication of withdrawal of life-support measures. The results also highlighted the uncertainties that exist regarding a doctor's decisions about it. Not only should legislation clarify whether "passive euthanasia" is allowed, but it would also be useful to delegate end-of-life decisions to a review board.

Descriptive epidemiology of colorectal cancer in University Malaya Medical Centre, 2001 to 2010.

PubMed

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

2014-01-01

Colorectal cancer is the second most frequent cancer in Malaysia. Nevertheless, there is little information on treatment and outcomes nationally. We aimed to determine the demographic, clinical and treatment characteristics of colorectal cancer patients treated at the University Malaya Medical Centre (UMMC) as part of a larger project on survival and quality of life outcomes. Medical records of 1,212 patients undergoing treatment in UMMC between January 2001 and December 2010 were reviewed. A retrospective-prospective cohort study design was used. Research tools included the National Cancer Patient Registration form. Statistical analysis included means, standard deviations (SD), proportions, chi square, t-test/ ANOVA. P-value significance was set at 0.05. The male: female ratio was 1.2:1. The mean age was 62.1 (SD12.4) years. Patients were predominantly Chinese (67%), then Malays (18%), Indians (13%) and others (2%). Malays were younger than Chinese and Indians (mean age 57 versus 62 versus 62 years, p<0.001). More females (56%) had colon cancers compared to males (44%) (p=0.022). Malays (57%) had more rectal cancer compared to Chinese (45%) and Indians (49%) (p=0.004). Dukes' stage data weres available in 67%, with Dukes' C and D accounting for 64%. Stage was not affected by age, gender, ethnicity or tumor site. Treatment modalities included surgery alone (40%), surgery and chemo/radiotherapy 32%, chemo and radiotherapy (8%) and others (20%). Significant ethnic differences in age and site distribution, if verified in population-based settings, would support implementation of preventive measures targeting those with the greatest need, at the right age.

Effect of production variables on microbiological removal in locally-produced ceramic filters for household water treatment.

PubMed

Lantagne, Daniele; Klarman, Molly; Mayer, Ally; Preston, Kelsey; Napotnik, Julie; Jellison, Kristen

2010-06-01

Diarrhoeal diseases cause an estimated 1.87 million child deaths per year. Point-of-use filtration using locally made ceramic filters improves microbiological quality of stored drinking water and prevents diarrhoeal disease. Scaling-up ceramic filtration is inhibited by lack of universal quality control standards. We investigated filter production variables to determine their affect on microbiological removal during 5-6 weeks of simulated normal use. Decreases in the clay:sawdust ratio and changes in the burnable decreased effectiveness of the filter. Method of silver application and shape of filter did not impact filter effectiveness. A maximum flow rate of 1.7 l(-hr) was established as a potential quality control measure for one particular filter to ensure 99% (2- log(10)) removal of total coliforms. Further research is indicated to determine additional production variables associated with filter effectiveness and develop standardized filter production procedures prior to scaling-up.

A computer aided treatment event recognition system in radiation therapy.

PubMed

Xia, Junyi; Mart, Christopher; Bayouth, John

2014-01-01

To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012-November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors' clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when executed on either a desktop computer or a mobile device. CATERS offers an effective tool to detect and report treatment events. Automation and rapid processing enables electronic record interrogation daily, alerting the medical physicist of deviations potentially days prior to performing weekly check. The output of CATERS could also be utilized as an important input to failure mode and effects analysis.

The ultimate question of origins: God and the beginning of the Universe.

NASA Astrophysics Data System (ADS)

Craig, W. L.

Both cosmology and philosophy trace their roots to the wonder felt by the ancient Greeks as they contemplated the Universe. The ultimate question remains why the Universe exists rather than nothing. This question led Leibniz to postulate the existence of a metaphysically necessary being, which he identified as God. Leibniz's critics, however, disputed this identification, claiming that the space-time universe itself may be the metaphysically necessary being. The discovery during this century that the Universe began to exist, however, calls into question the Universe's status as metaphysically necessary, since any necessary being must be eternal in its existence. Although various cosmogonic models claiming to avert the beginning of the Universe predicted by the standard model have been and continue to be offered, no model involving an eternal universe has proved as plausible as the standard model. Unless we are to assert that the Universe simply sprang into being uncaused out of nothing, we are thus led to Leibniz's conclusion. Several objections to inferring a supernatural cause of the origin of the Universe are considered and found to be unsound.

The Ultimate Question of Origins: God and the Beginning of the Universe

NASA Astrophysics Data System (ADS)

Craig, William Lane

1999-12-01

Both cosmology and philosophy trace their roots to the wonder felt by the ancient Greeks as they contemplated the universe. The ultimate question remains why the universe exists rather than nothing. This question led Leibniz to postulate the existence of a metaphysically necessary being, which he identified as God. Leibniz's critics, however, disputed this identification, claiming that the space-time universe itself may be the metaphysically necessary being. The discovery during this century that the universe began to exist, however, calls into question the universe's status as metaphysically necessary, since any necessary being must be eternal in its existence. Although various cosmogonic models claiming to avert the beginning of the universe predicted by the standard model have been and continue to be offered, no model involving an eternal universe has proved as plausible as the standard model. Unless we are to assert that the universe simply sprang into being uncaused out of nothing, we are thus led to Leibniz's conclusion. Several objections to inferring a supernatural cause of the origin of the universe are considered and found to be unsound.

Bonding performance of universal adhesives to er,cr:YSGG laser-irradiated enamel.

PubMed

Ayar, Muhammet Kerim; Erdemir, Fatih

2017-04-01

Universal adhesives have been recently introduced for use as self-etch or etch-and-rinse adhesives depending on the dental substrate and clinical condition. However, their bonding effectiveness to laser-irradiated enamel is still not well-known. Thus, the aim of this study was to compare the shear bond strength (SBS) of universal adhesives (Single Bond Universal; Nova Compo-B Plus) applied to Er,Cr:YSGG laser-irradiated enamel with SBS of the same adhesives applied in self-etch and acid-etching modes, respectively. Crown segments of sixty bovine incisors were embedded into standardized acrylic blocks. Flattened enamel surfaces were prepared. Specimens were divided into six groups according to universal adhesives and application modes randomly (n = 10), as follows: Single Bond Universal/acid-etching mode; Nova Compo-B Plus/acid-etching mode; Single Bond Universal/self-etching mode; Nova Compo-B Plus/self-etching mode; and Single Bond Universal/Er,Cr:YSGG Laser-etching mode; Nova Compo-B Plus/Er,Cr:YSGG Laser-etching mode. After surface treatments, universal adhesives were applied onto surfaces. SBS was determined after storage in water for 24 h using a universal testing machine with a crosshead speed of 0.5 mm min -1 . Failure modes were evaluated using a stereomicroscope. Data was analyzed using two-way of analyses of variances (ANOVA) (p = 0.05). Two-way ANOVA revealed that adhesive had no effect on SBS (p = 0.88), but application mode significantly influenced SBS (p = 0.00). Acid-etching significantly increased SBS, whereas there are no significant differences between self-etch mode and laser-etching for both adhesives. The bond strength of universal adhesives may depend on application mode. Acid etching may significantly increase bond strength, while laser etching may provide similar bond strength when compared to self-etch mode. © 2016 Wiley Periodicals, Inc.

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth.

PubMed

Acierno, Ron; Knapp, Rebecca; Tuerk, Peter; Gilmore, Amanda K; Lejuez, Carl; Ruggiero, Kenneth; Muzzy, Wendy; Egede, Leonard; Hernandez-Tejada, Melba A; Foa, Edna B

2017-02-01

This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients' homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness. Published by Elsevier Ltd.

Endovascular treatment of a spontaneous aneurysm in the axillary artery.

PubMed

Park, Sung Kyun; Hwang, Jeong Kye; Park, Sun Cheol; Kim, Sang Dong

2015-01-01

Spontaneous aneurysm in the axillary artery is extremely rare. The standard treatment for axillary artery aneurysm has been surgical repair, but endovascular management of select aneurysms using stent grafts has become more prevalent with the development of endoluminal technology. We report the case of a 36-year old man with a spontaneous aneurysm in the axillary artery. He experienced a tingling sensation and intermittent pain in the left upper extremity and had no history of trauma to the axilla. We performed endovascular treatment [placement of a Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA)] for a spontaneous aneurysm in the axillary artery. Following the procedure, his symptoms disappeared completely. After 6, 12 and 24 months, we carried out computed tomography angiography; all scans showed no complications. Now, the patient has no symptoms related to aneurysm in the axilla. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Cost-effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis.

PubMed

Cardona-Arias, Jaiberth Antonio; López-Carvajal, Liliana; Tamayo Plata, Mery Patricia; Vélez, Iván Darío

2017-05-01

The treatment of cutaneous leishmaniasis is toxic, has contraindications, and a high cost. The objective of this study was to estimate the cost-effectiveness of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis. Effectiveness was the proportion of healing and safety with the adverse effects; these parameters were estimated from a controlled clinical trial and a meta-analysis. A standard costing was conducted. Average and incremental cost-effectiveness ratios were estimated. The uncertainty regarding effectiveness, safety, and costs was determined through sensitivity analyses. The total costs were $66,807 with Glucantime and $14,079 with thermotherapy. The therapeutic effectiveness rates were 64.2% for thermotherapy and 85.1% for Glucantime. The average cost-effectiveness ratios ranged between $721 and $1275 for Glucantime and between $187 and $390 for thermotherapy. Based on the meta-analysis, thermotherapy may be a dominant strategy. The excellent cost-effectiveness ratio of thermotherapy shows the relevance of its inclusion in guidelines for the treatment. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

40 CFR 268.43 - Treatment standards expressed as waste concentrations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Treatment Standards § 268.43 Treatment standards expressed as waste concentrations. For the requirements previously found in this section and for treatment... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Treatment standards expressed as waste...

Characteristics and Clinical Outcome of Lyme Neuroborreliosis in a High Endemic Area, 1995-2014: A Retrospective Cohort Study in Denmark.

PubMed

Knudtzen, Fredrikke Christie; Andersen, Nanna Skaarup; Jensen, Thøger Gorm; Skarphédinsson, Sigurdur

2017-10-16

Despite a well-described symptomatology, treatment delay and sequelae are common in patients with Lyme neuroborreliosis (LNB). The aim of this study was to contribute to the knowledge about the symptomatology and epidemiology of LNB. We conducted a retrospective study of all LNB cases verified by a positive Borrelia intrathecal antibody index test performed at the Department of Microbiology, Odense University Hospital, Denmark, from 1995 through 2014. The study included 431 patients; 126 were children. The mean incidence was 4.7 per 100 000 inhabitants per year. The median delay from neurological symptom debut to first hospital contact was 20 days and significantly longer for patients with symptom debut in the winter/early spring. The most common clinical symptoms were painful radiculitis (65.9%), cranial nerve palsy (43.4%), and headache (28.3%). A total of 30.6% were seen in >1 hospital department, and 85.6% were admitted during their course of treatment. Serum Borrelia immunoglobulin M and immunoglobulin G at the time of positive Borrelia intrathecal antibody index test were negative in 67 patients (15.5%). We found a median treatment delay of 24 days, with no improvement in our 20-year study period. Residual symptoms following treatment were found in 28.1% of patients, and risk of residual symptoms was significantly associated with delay from symptom debut to initiation of treatment. The association between treatment delay and residual symptoms and the lack of improvement in treatment delay during the study period highlight the need for standardized diagnostic routines and a better follow-up for LNB patients. Our findings disprove that all patients with LNB develop positive serum Borrelia antibodies within 6 weeks after infection. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Telecommunications Policy Research Conference. Standards and Standardization Section. Papers.

ERIC Educational Resources Information Center

Telecommunications Policy Research Conference, Inc., Washington, DC.

These three papers consider various models and mechanisms for the achievement of industrial standardization. The first, "Duopoly Compatibility Standards with Partial Cooperation and Standards Leadership" (Sanford V. Berg, University of Florida) presents a model of duopolists producing differentiated substitutes, and considers the…

No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity.

PubMed

Trier, C; Fonvig, C E; Bøjsøe, C; Mollerup, P M; Gamborg, M; Pedersen, O; Hansen, T; Holm, J-C

2016-12-01

Increased consumption of sweetened beverages has previously been linked to the degree of childhood obesity. The aim of the present study was to assess whether the intake of sweetened beverages, candy, snacks or fast food at baseline in a multidisciplinary childhood obesity treatment program was associated with the baseline degree of obesity or the treatment effect. This prospective study included 1349 overweight and obese children (body mass index standard deviation scores (BMI SDS) ≥ 1.64) enrolled in treatment at The Children's Obesity Clinic, Copenhagen University Hospital Holbaek. The children were evaluated at baseline and after up to 5.9 years of treatment (median 1.3 years). Both boys and girls decreased their BMI SDS during treatment with a mean decrease in boys of 0.35 (p < 0.0001) and in girls of 0.22 (p < 0.0001) after 1 year of treatment. There were no associations between the baseline intake of sweetened beverages, candy, snacks, and/or fast food and BMI SDS at baseline or the change in BMI SDS during treatment. The intake of sweetened beverages, candy, snacks or fast food when entering a childhood obesity treatment program was not associated with the degree of obesity at baseline or the degree of weight loss during treatment. © 2016 World Obesity Federation.

University Students' Knowledge of Alcoholic Drinks and Their Perception of Alcohol-Related Harm

ERIC Educational Resources Information Center

Hasking, Penelope; Shortell, Carly; Machalek, Mireille

2005-01-01

A total of 371 university students were asked to estimate the amount of alcohol contained in a standard drink and to estimate the number of standard drinks contained in popular alcoholic beverages. In addition, students completed questionnaires assessing their perception of short and long term harm related to the consumption of beer, wine, spirits…

The Collegiate Learning Assessment: Setting Standards for Performance at a College or University. Technical Report

ERIC Educational Resources Information Center

Hardison, Chaitra M.; Vilamovska, Anna-Marie

2009-01-01

The Collegiate Learning Assessment (CLA) is a measure of how much students' critical thinking improves after attending college or university. This report illustrates how institutions can set their own standards on the CLA using a method that is appropriate for the CLA's unique characteristics. The authors examined evidence of reliability and…

Cost in Higher Education

DTIC Science & Technology

2007-06-01

ABSTRACT (maximum 200 words) State and Federal legislature require that standard data on education -related expenditures be provided by universities and... education , namely the Naval Postgraduate School (NPS) and California State University of Monterey Bay (CSUMB). The financial data that determines the...Policy iv THIS PAGE INTENTIONALLY LEFT BLANK v COST IN HIGHER EDUCATION ABSTRACT State and Federal legislatures require that standard data

Listening to Students: Customer Journey Mapping at Birmingham City University Library and Learning Resources

ERIC Educational Resources Information Center

Andrews, Judith; Eade, Eleanor

2013-01-01

Birmingham City University's Library and Learning Resources' strategic aim is to improve student satisfaction. A key element is the achievement of the Customer Excellence Standard. An important component of the standard is the mapping of services to improve quality. Library and Learning Resources has developed a methodology to map these…

Constructing Standards: A Study of Nurses Negotiating with Multiple Modes of Knowledge

ERIC Educational Resources Information Center

Nes, Sturle; Moen, Anne

2010-01-01

Purpose: The aim of the paper is to explore how multiple modes of knowledge play out in the consolidation of nursing procedures in construction of "local universality". The paper seeks to explore processes where nurses negotiate universal procedures that are to become local standards in a hospital. Design/methodology/approach: The paper…

From Data Entry to Evidence-Based Decision-Making: How Data and Analysis Can Drive Improvements in Admissions Policies

ERIC Educational Resources Information Center

Hourigan, Clare

2011-01-01

Academic standards and performance outcomes are a major focus of the current Cycle 2 Australian Universities Quality Agency (AUQA) audits. AUQA has clearly stated that universities will need to provide "evidence of setting, maintaining, and reviewing institutional academic standards and outcomes" (2010, p. 27). To do this, universities…

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 2: Policies and Standards.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Seven papers and one abstract of a paper are presented from the 1995 CAUSE conference track on policies and standards issues faced by managers of information technology at colleges and universities. The papers include: (1) "University/College Information System Structures and Policies: Do They Make a Difference? An Initial Assessment"…

Efficacy of right unilateral ultrabrief pulse width ECT: a preliminary report.

PubMed

Magid, Michelle; Truong, Liz; Trevino, Kenneth; Husain, Mustafa

2013-12-01

Ultrabrief (right unilateral) electroconvulsive therapy (UB-RU ECT) is a newer form of ECT, which uses a shorter pulse width than the standard ECT (0.3 vs 1.0 millisecond, respectively). As a result, the use of UB ECT may provide a means of further decreasing ECT-related cognitive adverse effects. In 2011, the University of Texas Southwestern Department of ECT in Austin adopted a UB ECT protocol. The purpose of this study was to perform a preliminary evaluation of the effectiveness and efficiency of UB-RU ECT. This study also examined whether sex, age, or diagnosis affected response rates. This retrospective chart review identified 62 patients treated with the UB ECT protocol. An analysis of ECT response rates and demographic characteristics was conducted based on the data from clinical evaluations and Patient Health Questionnaire 9. Sixty-eight percent of patients in the study responded to ECT; 55% responded to UB pulse width RU ECT with another 13% responding when switched to standard pulse width bilateral ECT. The mean number of treatments in an index ECT series was 12.5. There was no statistically significant difference in response rates between bipolar and unipolar depressed patients. Men required progression to bilateral treatment more than women. This UB ECT protocol demonstrated a similar response rate when compared to standard ECT protocols; however, an increase in the number of treatments was required. Ultrabrief protocols are a viable option for both bipolar and unipolar depression. In men, UB ECT protocols may be less advantageous due to a need to overcome a potentially higher seizure threshold in men; however, additional research is needed to confirm this finding.

Pharmaceutical Equivalence of Distributed Generic Antiretroviral (ARV) in Asian Settings: The Cross-Sectional Surveillance Study - PEDA Study.

PubMed

Sapsirisavat, Vorapot; Vongsutilers, Vorasit; Thammajaruk, Narukjaporn; Pussadee, Kanitta; Riyaten, Prakit; Kerr, Stephen; Avihingsanon, Anchalee; Phanuphak, Praphan; Ruxrungtham, Kiat

2016-01-01

Ensuring that medicines meet quality standards is mandatory for ensuring safety and efficacy. There have been occasional reports of substandard generic medicines, especially in resource-limiting settings where policies to control quality may be less rigorous. As HIV treatment in Thailand depends mostly on affordable generic antiretrovirals (ARV), we performed quality assurance testing of several generic ARV available from different sources in Thailand and a source from Vietnam. We sampled Tenofovir 300mg, Efavirenz 600mg and Lopinavir/ritonavir 200/50mg from 10 primary hospitals randomly selected from those participating in the National AIDS Program, 2 non-government organization ARV clinics, and 3 private drug stores. Quality of ARV was analyzed by blinded investigators at the Faculty of Pharmaceutical Science, Chulalongkorn University. The analysis included an identification test for drug molecules, a chemical composition assay to quantitate the active ingredients, a uniformity of mass test and a dissolution test to assess in-vitro drug release. Comparisons were made against the standards described in the WHO international pharmacopeia. A total of 42 batches of ARV from 15 sources were sampled from January-March 2015. Among those generics, 23, 17, 1, and 1 were Thai-made, Indian-made, Vietnamese-made and Chinese-made, respectively. All sampled products, regardless of manufacturers or sources, met the International Pharmacopeia standards for composition assay, mass uniformity and dissolution. Although local regulations restrict ARV supply to hospitals and clinics, samples of ARV could be bought from private drug stores even without formal prescription. Sampled generic ARVs distributed within Thailand and 1 Vietnamese pharmacy showed consistent quality. However some products were illegally supplied without prescription, highlighting the importance of dispensing ARV for treatment or prevention in facilities where continuity along the HIV treatment and care cascade is available.

Trial of Optimal Personalised Care After Treatment for Gynaecological cancer (TOPCAT-G): a study protocol for a randomised feasibility trial.

PubMed

Pye, Kirstie; Totton, Nicola; Stuart, Nicholas; Whitaker, Rhiannon; Morrison, Val; Edwards, Rhiannon Tudor; Yeo, Seow Tien; Timmis, Laura J; Butterworth, Caryl; Hall, Liz; Rai, Tekendra; Hoare, Zoe; Neal, Richard D; Wilkinson, Clare; Leeson, Simon

2016-01-01

Gynaecological cancers are diagnosed in over 1000 women in Wales every year. We estimate that this is costing the National Health Service (NHS) in excess of £1 million per annum for routine follow-up appointments alone. Follow-up care is not evidence-based, and there are no definitive guidelines from The National Institute for Health and Care Excellence (NICE) for the type of follow-up that should be delivered. Standard care is to provide a regular medical review of the patient in a hospital-based outpatient clinic for a minimum of 5 years. This study is to evaluate the feasibility of a proposed alternative where the patients are delivered a specialist nurse-led telephone intervention known as Optimal Personalised Care After Treatment for Gynaecological cancer (OPCAT-G), which comprised of a protocol-based patient education, patient empowerment and structured needs assessment. The study will recruit female patients who have completed treatment for cervical, endometrial, epithelial ovarian or vulval cancer within the previous 3 months in Betsi Cadwaladr University Health Board (BCUHB) in North Wales. Following recruitment, participants will be randomised to one of two arms in the trial (standard care or OPCAT-G intervention). The primary outcomes for the trial are patient recruitment and attrition rates, and the secondary outcomes are quality of life, health status and capability, using the EORTC QLQ-C30, EQ-5D-3L and ICECAP-A measures. Additionally, a client service receipt inventory (CSRI) will be collected in order to pilot an economic evaluation. The results from this feasibility study will be used to inform a fully powered randomised controlled trial to evaluate the difference between standard care and the OPCAT-G intervention. ISRCTN45565436.

Finance Committee actions ready health reform debate for House, Senate floors.

PubMed

1994-07-07

The activity of the US Senate Finance Committee was reported for the health care reform bill, which was sent out of committee to the floor of the Senate on July 2, 1994. The bill out of committee did not include provision for universal insurance coverage, and included amendments that might remove abortion, family planning, and reproductive health services from the standard package of required employee benefits. Other health reform measures where reported out of the Senate Labor and Human Resources Committee, the House Ways and Means Committee, and the Education and Labor Committee, which all contained a provision for universal insurance coverage through employer mandates, a standard benefits package, and comprehensive family planning services and reproductive health care. The Labor and Human Resources bill included counseling and education for family planning. Both House bills exempted family planning services from cost sharing requirements. Abortion coverage in these three bills was covered under "services for pregnant women." The Senate Finance Committee bill adopted "market reforms" which would reduce the cost of coverage for employers. A standard benefits package would be determined by all employers, regardless of whether employers contributed to coverage. The critical point of the Senate Finance bill is that it provides the opportunity to deny services for abortion on religious or moral grounds and to deny services for contraception, AIDS treatment, or substance abuse, by making acceptance optional by states and by insurers and by employers. The House Rules Committee will begin the first week in August to reconcile differences in the House bills. The Senate will reconcile differences in some fashion, without a prescribed procedure.

40 CFR 262.103 - What is the scope of the laboratory environmental management standard?

Code of Federal Regulations, 2010 CFR

2010-07-01

... University Laboratories XL Project-Laboratory Environmental Management Standard § 262.103 What is the scope of the laboratory environmental management standard? The Laboratory Environmental Management Standard... environmental management standard? 262.103 Section 262.103 Protection of Environment ENVIRONMENTAL PROTECTION...

The use of laser phototherapy in the management of trigeminal neuralgia pain: two decades of clinical experience

NASA Astrophysics Data System (ADS)

Pinheiro, Antonio L. B.; Marques, Aparecida Maria C.; Soares, Luiz Guiherme P.; de Carvalho, Fabiola B.; de Oliveira, Susana Carla P. S.; Cangussú, Maria Cristina T.

2017-02-01

Trigeminal neuralgia (TN) is a disabling syndrome and one of the most painful conditions that are often reported in female patients older than 50 years of age. The treatment generally includes drugs or surgical approaches. Laser Phototherapy -LPT has also been proposed as a safe and effective treatment modality. This work reports a series of patients of the Center of Biophotonics of the Federal University of Bahia (2000-2016) treated with LPT. Following standard anamneses, clinical and imaginologic examination and with the diagnosis of Trigeminal Neuralgia, the patients were set for light treatment. Treatment consisted of three sessions a week during six week. Prior irradiation, the patients were asked to score their pain using a VAS. λ780, λ 790, λ 830nm lasers were used on each session. Most patients were female (74.8%). At the end of the 12 sessions the patients were again examined and score their pain using VAS. No other intervention was carried out during the treatment. The results were statistically analyzed and showed that, the use of lower Energy Density in smaller number of session in younger patients presents higher effectivity on treating the pain on TN patients.

Topical Calendula officinalis L. successfully treated exfoliative cheilitis: a case report

PubMed Central

2009-01-01

Authors describe a case of recurrent exfoliative cheilitis that responded to treatment with a standardized topical preparation of Calendula officinalis L. An eighteen-year-old man was referred to UNESP - São Paulo State University, Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School to investigate a chronic dry scaling lesion on his lips. The patient's main chief was aesthetic compromising. Corticoid therapy was suspended and Calendula officinalis ointment 10% for ad libitum use has been prescribed. The results presented allow the authors to consider Calendula officinalis L. as a potential therapy in cases of cheilitis exfoliative. PMID:20062714

Re-ionization and decaying dark matter

NASA Technical Reports Server (NTRS)

Dodelson, Scott; Jubas, Jay M.

1991-01-01

Gunn-Peterson tests suggest that the Universe was reionized after the standard recombination epoch. A systematic treatment is presented of the ionization process by deriving the Boltzmann equations appropriate to this regime. A compact solution for the photon spectrum is found in terms of the ionization ratio. These equations are then solved numerically for the Decaying Dark Matter scenario, wherein neutrinos with mass of order 30 eV radiatively decay producing photons which ionize the intergalactic medium. It was found that the neutrino mass and lifetime are severely constrained by Gunn-Peterson tests, observations of the diffuse photon spectrum in the ultraviolet regime, and the Hubble parameter.

Novel mechanism of dissipation in synthetic rotary motors

NASA Astrophysics Data System (ADS)

Barbu, Corina; Crespi, Vincent

2007-03-01

We study novel mechanisms of dissipation in nanoscale and molecular-scale motors. In traditional treatments of such systems, the background degrees of freedom are integrated out into a thermal bath, and the rotator is coupled directly to this bath via phenomenological terms such as viscous damping or Langevin forces. We have investigated a situation in which one degree of freedom is pulled out from the thermal bath and into the explicit equations of motion, interposed between the bath and the motor. We describe a regime in which the deceleration of an unpowered rotor follows a universal power law, rather than a standard exponential decay.

Osteopenia of Prematurity: Does Physical Activity Improve Bone Mineralization in Preterm Infants?

PubMed

Stalnaker, Kelsey A; Poskey, Gail A

2016-01-01

Bone mineralization of preterm infants is significantly less than full-term infants at birth, placing preterm infants at risk for osteopenia of prematurity and other metabolic bone diseases. Advances in nutritional supplementation and standard nursing care alone have been unsuccessful in improving bone mineralization postnatally. Research supports a daily physical activity protocol of passive range of motion and gentle joint compression when combined with adequate nutritional supplementation reduces osteopenia of prematurity. This article provides a systematic review of the current evidence surrounding early physical activity and neonatal massage for the treatment of osteopenia and indicates the need for universal handling protocols in caring for this unique population.

Effect of various bleaching treatments on shear bond strength of different universal adhesives and application modes

PubMed Central

2018-01-01

Objectives The aim of this in vitro study was to evaluate the bond strength of 2 universal adhesives used in different application modes to bleached enamel. Materials and Methods Extracted 160 sound human incisors were used for the study. Teeth were divided into 4 treatment groups: No treatment, 35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide. After bleaching treatments, groups were divided into subgroups according to the adhesive systems used and application modes (n = 10): 1) Single Bond Universal, etch and rinse mode; 2) Single Bond Universal, self-etch mode; 3) Gluma Universal, etch and rinse mode; 4) Gluma Universal, self-etch mode. After adhesive procedures nanohybrid composite resin cylinders were bonded to the enamel surfaces. All specimens were subjected to shear bond strength (SBS) test after thermocycling. Data were analyzed using a 3-way analysis of variance (ANOVA) and Tukey post hoc test. Results No significant difference were found among bleaching groups (35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide, and no treatment groups) in the mean SBS values. There was also no difference in SBS values between Single Bond Universal and Gluma Universal at same application modes, whereas self-etch mode showed significantly lower SBS values than etch and rinse mode (p < 0.05). Conclusions The bonding performance of the universal adhesives was enhanced with the etch and rinse mode application to bleached enamel and non-bleached enamel. PMID:29765900

Optometrists Association Australia Universal (entry-level) and Therapeutic Competency Standards for Optometry 2008.

PubMed

Kiely, Patricia M

2009-07-01

Competency standards for entry-level to the profession of optometry in Australia were first developed in 1993, revised in 1997 and expanded in 2000 to include therapeutic competency standards. The entry-level standards cover the competencies required by a person entering the profession without therapeutic endorsement of their registration. The therapeutic competency standards address the additional competencies required for therapeutic endorsement of registration. This paper presents a revised version of the universal (entry-level) and therapeutic competency standards for the profession of optometry in Australia in 2008. Expert members of the profession and representatives from schools of optometry, registration boards in Australia, state divisions of Optometrists Association Australia and the New Zealand Association of Optometrists were consulted in the process of updating the standards. Three new elements of competency have been added to the standards. Twenty-three new performance criteria with associated indicators have been added. Some performance criteria from the earlier document have been combined. Substantial alterations were made to the presentation of indicators throughout the document. The updated entry-level (universal) and therapeutic competency standards were adopted on behalf of the profession by the National Council of Optometrists Association Australia in November 2008. Competency standards are used by Australian and New Zealand registration authorities for the purposes of registration and therapeutic endorsement of registration via the Optometry Council of Australia and New Zealand accreditation and assessment processes. They have also been used as the basis of the World Council of Optometry Global Competency-Based Model.

Are Universities Really Out of Touch?

ERIC Educational Resources Information Center

Farquhar, Robin H.

It is proposed that there are three common misconceptions and criticisms held by the general public concerning Canadian universities: (1) the view that universities are hotbeds of radicalism, alcoholism, and sexism, (2) that there is a decline in the quality of work produced by universities and in their academic standards, and (3) that…

24 CFR 35.1335 - Standard treatments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Lead-Paint Hazard Evaluation and Hazard Reduction Activities § 35.1335 Standard treatments. Standard treatments shall be conducted in accordance with this section. (a) Paint stabilization. All deteriorated... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Standard treatments. 35.1335...

Sequestering the standard model vacuum energy.

PubMed

Kaloper, Nemanja; Padilla, Antonio

2014-03-07

We propose a very simple reformulation of general relativity, which completely sequesters from gravity all of the vacuum energy from a matter sector, including all loop corrections and renders all contributions from phase transitions automatically small. The idea is to make the dimensional parameters in the matter sector functionals of the 4-volume element of the Universe. For them to be nonzero, the Universe should be finite in spacetime. If this matter is the standard model of particle physics, our mechanism prevents any of its vacuum energy, classical or quantum, from sourcing the curvature of the Universe. The mechanism is consistent with the large hierarchy between the Planck scale, electroweak scale, and curvature scale, and early Universe cosmology, including inflation. Consequences of our proposal are that the vacuum curvature of an old and large universe is not zero, but very small, that w(DE) ≃ -1 is a transient, and that the Universe will collapse in the future.

Permanence of Two Self-Managed Treatments of Overweight in University and Community Populations

ERIC Educational Resources Information Center

And Others; Hall, Robert G.

1974-01-01

Males and females from community and university samples were assigned to two self-management treatments, nonspecific, or no-treatment controls. At six month follow-up, differences were not significant. Results are discussed in terms of conceptualizations of self-management and the utility of treatments employed. (Author)

Comparison of university and private-practice orthodontic treatment outcomes with the American Board of Orthodontics objective grading system.

PubMed

Cook, Devon R; Harris, Edward F; Vaden, James L

2005-06-01

Treatment outcomes and duration of treatment for patients treated in university graduate orthodontic programs and private orthodontic practices were assessed and compared with the ABO objective grading system. The treatment records of 139 randomly selected adolescents who had received comprehensive orthodontic treatment were examined. Seventy-seven subjects had been treated in 3 postgraduate orthodontic clinics, and 62 had been treated in 3 private orthodontic practices. Pretreatment, all subjects had Class II Division 1 malocclusions and ANB angles equal to or greater than 4 degrees . All patients were treated with premolar extractions. Posttreatment dental casts were measured and scored with the ABO objective grading system. No significant differences were found between the groups in the alignment, buccolingual inclination, and overjet components. Patients treated in private practice had significantly lower scores for marginal ridge height and occlusal relationship. Patients treated in the university programs had significantly lower scores for occlusal contact and interproximal contact components. There was no significant difference in the overall score, thus no significant difference in the overall quality of orthodontic treatment outcome between patients treated in university programs and private practices. However, the university group had a significantly larger sample variance for the overall score. There was no significant difference in the duration of the treatment between patients treated in a university setting and in a private practice.

Enamel Bond Strength of New Universal Adhesive Bonding Agents.

PubMed

McLean, D E; Meyers, E J; Guillory, V L; Vandewalle, K S

2015-01-01

Universal bonding agents have been introduced for use as self-etch or etch-and-rinse adhesives depending on the dental substrate and clinician's preference. The purpose of this study was to evaluate the shear bond strength (SBS) of composite to enamel using universal adhesives compared to a self-etch adhesive when applied in self-etch and etch-and-rinse modes over time. Extracted human third molars were used to create 120 enamel specimens. The specimens were ground flat and randomly divided into three groups: two universal adhesives and one self-etch adhesive. Each group was then subdivided, with half the specimens bonded in self-etch mode and half in etch-and-rinse mode. The adhesives were applied as per manufacturers' instructions, and composite was bonded using a standardized mold and cured incrementally. The groups were further divided into two subgroups with 10 specimens each. One subgroup was stored for 24 hours and the second for six months in 37°C distilled water and tested in shear. Failure mode was also determined for each specimen. A three-way analysis of variance (ANOVA) found a significant difference between groups based on bonding agent (p<0.001) and surface treatment (p<0.001) but not on time (p=0.943), with no significant interaction (p>0.05). Clearfil SE in etch-and-rinse and self-etch modes had more mixed fractures than either universal adhesive in either mode. Etching enamel significantly increased the SBS of composite to enamel. Clearfil SE had significantly greater bond strength to enamel than either universal adhesive, which were not significantly different from each other.

Cross-cultural Adaptation and Validation of the Simplified Chinese Version of the Knee Outcome Survey Activities of Daily Living Scale.

PubMed

Jia, Zhen-Yu; Wang, Wei; Nian, Xin-Wen; Zhang, Xiao-Xi; Huang, Zhi-Ping; Cui, Jin; Xu, Wei-Dong

2016-10-01

To perform a cross-cultural adaptation and translation of the original version of the Activities of Daily Living Scale of the Knee Outcome Survey into Simplified Chinese and validate of the Simplified Chinese version. The original version was translated and cross-culturally adapted into Simplified Chinese according to the guidelines and the recommendations of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 213 patients (96 male, 117 female) were selected to participate in our investigation. The inclusion criteria were as follows: 18 years of age and older, able to speak Chinese Mandarin and read Simplified Chinese, and referred to physical therapy for evaluation and treatment for a knee disorder. The exclusion criteria were as follows: patients who had disorders or impairments involving both knees, patients who had other conditions that could affect lower extremity function, patients with physical therapy related to the knee in the previous 1 month, and patients with psychological problems. Each participant was asked to complete the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS), International Knee Documentation Committee Subjective Knee Form, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form 36 forms and to provide baseline demographic data. Each participant completed the KOS-ADLS twice on 2 nonconsecutive days for reliability evaluation. A portion of the participants (n = 161) finished the KOS-ADLS a third time 4 weeks after physical treatment to test responsiveness. The original version of the KOS-ADLS was well adapted and translated into Simplified Chinese. Simplified Chinese of KOS-ADLS was shown to have good internal consistency (Cronbach's alpha = 0.855 to 0.929), great test-retest reliability (intraclass correlation coefficient = 0.935 to 0.961), high construct validity as we hypothesized (significant correlations with Short Form 36 subscales, Western Ontario and McMaster Universities Osteoarthritis Index, and International Knee Documentation Committee Subjective Knee Form), and high responsiveness (standard response means = 0.97 to 1.23, standard effect size = 0.81 to 0.91). Simplified Chinese of KOS-ADLS was shown to have good reliability, validity, and responsiveness for use in patients with knee disorders in China. Level II, testing of previously developed diagnostic criteria in a series of consecutive patients with universally applied gold standard. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Nitrous oxide/oxygen mixture for analgesia in adult cancer patients with breakthrough pain: A randomized, double-blind controlled trial.

PubMed

Liu, Q; Gao, L-L; Dai, Y-L; Li, Y-X; Wang, Y; Bai, C-F; Mu, G-X; Chai, X-M; Han, W-J; Zhou, L-J; Zhang, Y-J; Tang, L; Liu, J; Yu, J-Q

2018-03-01

The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen. The primary endpoint measure was the numerical rating scale (NRS) score measured at baseline, 5 and 15 min after the beginning of treatment, and at 5 min post treatment. In all, analysis of pain score (NRS) at 5 min after the beginning of treatment shown a significant decrease in nitrous oxide/oxygen mixture treated patients with 2.8 ± 1.3 versus 5.5 ± 1.2 in controls (p < 0.01). At 15 min during the intervention, the mean pain score for nitrous oxide/oxygen was 2.0 ± 1.1 compared with 5.6 ± 1.3 for oxygen (p < 0.01). This study shows that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough pain among patients with cancer. The management of breakthrough cancer pain is always a challenge due to its temporal characteristics of rapid onset, moderate to severe in intensity, short duration (median 30-60 min). Our study find that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough cancer pain. © 2017 European Pain Federation - EFIC®.

Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment.

PubMed

Legrand, Matthieu; Gits-Muselli, Maud; Boutin, Louis; Garcia-Hermoso, Dea; Maurel, Véronique; Soussi, Sabri; Benyamina, Mourad; Ferry, Axelle; Chaussard, Maïté; Hamane, Samia; Denis, Blandine; Touratier, Sophie; Guigue, Nicolas; Fréalle, Emilie; Jeanne, Mathieu; Shaal, Jean-Vivien; Soler, Charles; Mimoun, Maurice; Chaouat, Marc; Lafaurie, Matthieu; Mebazaa, Alexandre; Bretagne, Stéphane; Alanio, Alexandre

2016-11-15

 Invasive wound mucormycosis (IWM) is associated with an extremely poor outcome among critically ill burn patients. We describe the detection of circulating Mucorales DNA (cmDNA) for the early diagnosis of IWM in those patients and report the potential value of detecting cmDNA for treatment guidance.  Severely ill burn patients admitted to our tertiary referral center between October 2013 and February 2016 were included. Retrospective plasma samples were tested for the presence of cmDNA by quantitative real-time polymerase chain reaction (qPCR). Patients were then prospectively screened twice a week, and liposomal amphotericin-B therapy initiated based on a positive qPCR. The primary endpoint was the time between cmDNA detection and standard diagnosis. Secondary endpoints were the time from cmDNA detection and treatment initiation and mortality.  Seventy-seven patients (418 samples) were included. The average age was 46 (28-60) years, abbreviated burn severity index was 8 (7-10), and simplified acute physiology score was 33 (23-46). The total body surface area was 33% (22%-52%). cmDNA was detected 11 (4.5-15) days before standard diagnosis. The in-hospital mortality was 62% for patients with IWM and 24% for those without (P = .03). The mortality due to IWM was 80% during period A and 33% during period B (P = .46).  This study suggests that the detection of cmDNA allows earlier diagnosis of IWM in severely ill burn patients and earlier initiation of treatment. Further studies are needed to confirm the impact of earlier treatment initiation on patient outcome. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Impact of the University of Colorado's Advanced Clinical Training and Service (ACTS) Program on dental students' clinical experience and cognitive skills, 1994-2006.

PubMed

Berg, Rob; Call, Richard L; Maguire, Kerry; Berkey, Douglas B; Karshmer, Bernard A; Guyton, Brad; Tawara-Jones, Karen

2010-04-01

The University of Colorado Denver School of Dental Medicine has operated a community-based dental education program for all of its students since 1985. A database of student productivity has been maintained in a standardized format, capable of multiyear compilation, since 1994. This study utilizes twelve years of these data to profile the type and amount of clinical treatment that can be provided by a typical fourth-year dental student during a 100-day community-based training experience. Between 1994 and 2006, the school's 423 graduates provided a mean of 922 treatment procedures per student at a mean of 498 patient visits per student. During a typical four-week clinical affiliation, each student provided a mean of approximately twenty-seven restorations on permanent teeth, sixteen restorations on primary teeth, and twenty-four oral surgery procedures (extractions). Students also gained considerable experience in periodontics, fixed and removable prosthodontics, and endodontics. Self-assessed competency ratings tended to increase after completing the program, as did willingness to treat underserved populations after graduation. About 16 percent of graduates reported planning to practice in the public sector after completing dental school. A community-based experience such as this appears to offer an opportunity to substantially augment dental students' clinical training experiences.

Treatment of Bipolar Disorder in the University Student Population

ERIC Educational Resources Information Center

Federman, Russ

2011-01-01

University counseling centers are faced with the challenge of effectively treating bipolar students while also utilizing brief treatment frameworks and managing high patient volumes. Potential destabilization, particularly within the elevated mood phase, poses significant behavioral management issues for university clinicians and administrators,…

Restorative treatment decisions of Croatian university teachers.

PubMed

Baraba, Anja; Doméjean, Sophie; Jurić, Hrvoje; Espelid, Ivar; Tveit, Anne B; Anić, Ivica

2012-12-01

This study aimed to identify differences in diagnostic criteria and restorative treatment among Croatian university teachers. The questionnaire was distributed to 120 Croatian university teachers in Zagreb and Rijeka. Responses were collected from 59 (49.2%) university teachers. Treatment thresholds for hypothetical approximal and occlusal caries, as well as most favored types of restorative techniques and materials were assessed. The majority (34%) of the respondents would intervene for an approximal caries lesion at the enamel-dentin junction. The leading strategy for occlusal caries was postponing operative treatment until the caries lesion was in the outer third of dentin and removing caries tissue only. Composite resin was the predominant material of choice for restoration of approximal and occlusal caries (70% and 81% respectively). More than half (54%) of Croatian university teachers believed the radiographs underestimated the depth of the caries lesion compared with clinical finding. Findings of this study should be a guideline for Croatian university teachers for a more consistent and modern teaching on the subject of caries management.

The Prevalence of Substance use and Associated Risk Factors Among University Students in the City of Jahrom, Southern Iran

PubMed Central

Heydari, Seyed Taghi; Izedi, Somayeh; Sarikhani, Yaser; Kalani, Navid; Akbary, Ali; Miri, Abolfazl; Mahmoodi, Mojtaba; Akbari, Maryam

2015-01-01

Background: Substance use among college students in Iran is a serious problem. Determining the pattern of substance use among University students is an important issue for implementing prevention and treatment programs. Objectives: The present survey attempts to determine the prevalence of substance usage and associated risk factors among the students of Jahrom University of Medical Sciences and Islamic Azad University of Jahrom, Jahrom, Iran. Patients and Methods: This cross-sectional study was carried out from December 2012 to February 2013 and included 1149 randomly selected students of two Jahrom universities. A standard questionnaire was used for data gathering. Data were analyzed using the SPSS version 15 for Windows. T-test and Chi-square T-test and Chi-square and Logestic regression tests were used for data analysis. Results: Tobacco (28.3%), alcohol (13.0%), and cannabis and marijuana (5.2%) were the most common substances used by the students. The prevalence of substance use among the male students was significantly higher (OR: 1.5, 95%CI: 1.42 - 2.68, P < 0.001). The risk of at least single episode of substance usage was higher among the students which were living alone (OR: 3.03, 95%CI: 1.74 - 5.28, P < 0.001) The most important motivators for beginning substance use were curiosity, in 46.4%, and seeking pleasure, in 28.8%. Conclusions: Substance usage is considered as a risk factor for students’ health among University students in Iran. Design of educational courses addressing the detrimental effects and dire consequences of substance usage could help to improve control programs. Universities could improve their drug abuse control programs by focusing on the high risk groups determined by relevant studies. PMID:26097836

Early cosmology constrained

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

Verde, Licia; Jimenez, Raul; Bellini, Emilio

We investigate our knowledge of early universe cosmology by exploring how much additional energy density can be placed in different components beyond those in the ΛCDM model. To do this we use a method to separate early- and late-universe information enclosed in observational data, thus markedly reducing the model-dependency of the conclusions. We find that the 95% credibility regions for extra energy components of the early universe at recombination are: non-accelerating additional fluid density parameter Ω{sub MR} < 0.006 and extra radiation parameterised as extra effective neutrino species 2.3 < N {sub eff} < 3.2 when imposing flatness. Our constraintsmore » thus show that even when analyzing the data in this largely model-independent way, the possibility of hiding extra energy components beyond ΛCDM in the early universe is seriously constrained by current observations. We also find that the standard ruler, the sound horizon at radiation drag, can be well determined in a way that does not depend on late-time Universe assumptions, but depends strongly on early-time physics and in particular on additional components that behave like radiation. We find that the standard ruler length determined in this way is r {sub s} = 147.4 ± 0.7 Mpc if the radiation and neutrino components are standard, but the uncertainty increases by an order of magnitude when non-standard dark radiation components are allowed, to r {sub s} = 150 ± 5 Mpc.« less

Early cosmology constrained

NASA Astrophysics Data System (ADS)

Verde, Licia; Bellini, Emilio; Pigozzo, Cassio; Heavens, Alan F.; Jimenez, Raul

2017-04-01

We investigate our knowledge of early universe cosmology by exploring how much additional energy density can be placed in different components beyond those in the ΛCDM model. To do this we use a method to separate early- and late-universe information enclosed in observational data, thus markedly reducing the model-dependency of the conclusions. We find that the 95% credibility regions for extra energy components of the early universe at recombination are: non-accelerating additional fluid density parameter ΩMR < 0.006 and extra radiation parameterised as extra effective neutrino species 2.3 < Neff < 3.2 when imposing flatness. Our constraints thus show that even when analyzing the data in this largely model-independent way, the possibility of hiding extra energy components beyond ΛCDM in the early universe is seriously constrained by current observations. We also find that the standard ruler, the sound horizon at radiation drag, can be well determined in a way that does not depend on late-time Universe assumptions, but depends strongly on early-time physics and in particular on additional components that behave like radiation. We find that the standard ruler length determined in this way is rs = 147.4 ± 0.7 Mpc if the radiation and neutrino components are standard, but the uncertainty increases by an order of magnitude when non-standard dark radiation components are allowed, to rs = 150 ± 5 Mpc.

Moving from "Students Can't" to "How Students Can": A Learning Design Anchored in the Standards for Professional Learning Puts the Focus on Equity

ERIC Educational Resources Information Center

Bradley, Janice; Rorrer, Andrea; McKinney, Ashley; Groth, Cori

2017-01-01

What happens when a university-based education policy center uses the Standards for Professional Learning to design purposeful professional learning experiences for teachers, community members, principals, central office administrators, superintendents, and university faculty to re-engage in the meaning and creation of equitable and excellent…

Computer Competencies of the Faculty Members of the College of Education at the United Arab Emirates University

ERIC Educational Resources Information Center

Alghazo, Iman Mohammad

2006-01-01

In its effort to obtain accreditation using NCATE standards, the College of Education at the United Arab Emirates University is integrating ISTE standards into its teacher education programs. The main challenge at this stage is preparing faculty members to integrate technology into their teaching in order to help their students meet ISTE…

Comparing Ethical and Epistemic Standards for Investigative Journalists and Equity-Oriented Collaborative Community-Based Researchers: Why Working for a University Matters

ERIC Educational Resources Information Center

Newman, Anne; Glass, Ronald David

2014-01-01

Criticisms of IRBs are proliferating. In response, we compare the ethical and epistemic standards of two closely related forms of inquiry, investigative journalism and equity-oriented collaborative community-based research (EOCCBR). We argue that a university affiliation justifies formal ethical review of research and suggest how institutionalized…

The Interpretation of "in Context" Verbal Probability Expressions Used in International Accounting Standards: A Comparison of English and Chinese Students Studying at English Speaking Universities

ERIC Educational Resources Information Center

Salleh, Safrul Izani Mohd; Gardner, John C.; Sulong, Zunaidah; McGowan, Carl B., Jr.

2011-01-01

This study examines the differences in the interpretation of ten "in context" verbal probability expressions used in accounting standards between native Chinese speaking and native English speaking accounting students in United Kingdom universities. The study assesses the degree of grouping factors consensus on the numerical…

Continuous Practice-Based Research on the Use of Standardized Patients: Experience from Shanghai Medical College of Fudan University

ERIC Educational Resources Information Center

Zeng, Yong; Wu, Yan; Lai, Yanni; Lu, Yingqing; Zou, Hejian; Feng, Xueshan

2014-01-01

In the past ten years, the objective structured clinical examination (OSCE) project team of the Shanghai Medical College of Fudan University has continuously conducted further study on the development and maintenance of standardized patients and their application in teaching. The team carried out a series of randomized controlled studies on the…

The impact of more visible standard drink labelling on youth alcohol consumption: helping young people drink (ir)responsibly?

PubMed

Jones, Sandra C; Gregory, Parri

2009-05-01

In response to increasing concerns about excessive drinking among young people the Australian alcohol industry announced that it will introduce more visible standard drink labels. This study sought to examine whether young people use this information in a way that decreases, or increases, alcohol-related harms. Six focus groups with students enrolled in an undergraduate university course in a large regional city in New South Wales, recruited by direct approach on the university grounds and via an online message posted on the university bulletin board. The majority of the participants reported that they are aware of the existence of standard drink labelling; notice standard drink labels; and take these into account when choosing what to purchase. However, this was predominantly to help them choose the strongest drinks for the lowest cost. This study provides initial evidence to support the view that standard drink labelling, in isolation of other modifications to product packaging and marketing, is likely to serve to further increase heavy drinking among young people.

Polymerase chain reaction-based denaturing gradient gel electrophoresis in the evaluation of oral microbiota.

PubMed

Li, Y; Saxena, D; Barnes, V M; Trivedi, H M; Ge, Y; Xu, T

2006-10-01

Clinical evaluation of oral microbial reduction after a standard prophylactic treatment has traditionally been based on bacterial cultivation methods. However, not all microbes in saliva or dental plaque can be cultivated. Polymerase chain reaction-based denaturing gradient gel electrophoresis (PCR-DGGE) is a cultivation-independent molecular fingerprinting technique that allows the assessment of the predominant bacterial species present in the oral cavity. This study sought to evaluate the oral microbial changes that occurred after a standard prophylactic treatment with a conventional oral care product using PCR-DGGE. Twelve healthy adults participated in the study. Pooled plaque samples were collected at baseline, 24 h after prophylaxis (T1), and 4 days after toothbrushing with fluoride toothpaste (T4). The total microbial genomic DNA of the plaque was isolated. PCR was performed with a set of universal bacterial 16S rDNA primers. The PCR-amplified 16S rDNA fragments were separated by DGGE. The effects of the treatment and of dental brushing were assessed by comparing the PCR-DGGE fingerprinting profiles. The mean numbers of detected PCR amplicons were 22.3 +/- 6.1 for the baseline group, 13.0 +/- 3.1 for the T1 group, and 13.5 +/- 4.3 for the T4 group; the differences among the three groups were statistically significant (P < 0.01). The study also found a significant difference in the mean similarities of microbial profiles between the baseline and the treatment groups (P < 0.001). PCR-based DGGE has been shown to be an excellent means of rapidly and accurately assessing oral microbial changes in this clinical study.

Primordial alchemy: from the Big Bang to the present universe

NASA Astrophysics Data System (ADS)

Steigman, Gary

Of the light nuclides observed in the universe today, D, 3He, 4He, and 7Li are relics from its early evolution. The primordial abundances of these relics, produced via Big Bang Nucleosynthesis (BBN) during the first half hour of the evolution of the universe provide a unique window on Physics and Cosmology at redshifts ~1010. Comparing the BBN-predicted abundances with those inferred from observational data tests the consistency of the standard cosmological model over ten orders of magnitude in redshift, constrains the baryon and other particle content of the universe, and probes both Physics and Cosmology beyond the current standard models. These lectures are intended to introduce students, both of theory and observation, to those aspects of the evolution of the universe relevant to the production and evolution of the light nuclides from the Big Bang to the present. The current observational data is reviewed and compared with the BBN predictions and the implications for cosmology (e.g., universal baryon density) and particle physics (e.g., relativistic energy density) are discussed. While this comparison reveals the stunning success of the standard model(s), there are currently some challenge which leave open the door for more theoretical and observational work with potential implications for astronomy, cosmology, and particle physics.

Overview of MPEG internet video coding

NASA Astrophysics Data System (ADS)

Wang, R. G.; Li, G.; Park, S.; Kim, J.; Huang, T.; Jang, E. S.; Gao, W.

2015-09-01

MPEG has produced standards that have provided the industry with the best video compression technologies. In order to address the diversified needs of the Internet, MPEG issued the Call for Proposals (CfP) for internet video coding in July, 2011. It is anticipated that any patent declaration associated with the Baseline Profile of this standard will indicate that the patent owner is prepared to grant a free of charge license to an unrestricted number of applicants on a worldwide, non-discriminatory basis and under other reasonable terms and conditions to make, use, and sell implementations of the Baseline Profile of this standard in accordance with the ITU-T/ITU-R/ISO/IEC Common Patent Policy. Three different codecs had responded to the CfP, which are WVC, VCB and IVC. WVC was proposed jointly by Apple, Cisco, Fraunhofer HHI, Magnum Semiconductor, Polycom and RIM etc. it's in fact AVC baseline. VCB was proposed by Google, and it's in fact VP8. IVC was proposed by several Universities (Peking University, Tsinghua University, Zhejiang University, Hanyang University and Korea Aerospace University etc.) and its coding tools was developed from Zero. In this paper, we give an overview of the coding tools in IVC, and evaluate its performance by comparing it with WVC, VCB and AVC High Profile.

[Precision Oncology and "Molecular Tumor Boards" - Concepts, Chances and Challenges].

PubMed

Holch, Julian Walter; Westphalen, Christoph Benedikt; Hiddemann, Wolfgang; Heinemann, Volker; Jung, Andreas; Metzeler, Klaus Hans

2017-11-01

Recent developments in genomics allow a more and more comprehensive genetic analysis of human malignancies, and have sparked hopes that this will contribute to the development of novel targeted, effective and well-tolerated therapies.While targeted therapies have improved the prognosis of many cancer patients with certain tumor types, "precision oncology" also brings along new challenges. Highly personalized treatment strategies require new strategies for clinical trials and translation into routine clinical practice. We review the current technical approaches for "universal genetic testing" in cancer, and potential pitfalls in the interpretation of such data. We then provide an overview of the available evidence supporting treatment strategies based on extended genetic analysis. Based on the available data, we conclude that "precision oncology" approaches that go beyond the current standard of care should be pursued within the framework of an interdisciplinary "molecular tumor board", and preferably within clinical trials. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin in the Era of Value-Based Medicine.

PubMed

Vanounou, Tsafrir; Garfinkle, Richard

2016-08-01

Peritoneal spread from colorectal cancer is second only to the liver as a site for metastasis. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a well-established treatment option for patients with peritoneal carcinomatosis (PC) of colorectal origin. However, due to concerns regarding both its clinical benefit and high cost, its universal adoption as the standard of care for patients with limited peritoneal dissemination has been slow. The purpose of this review was to clarify the clinical utility and cost effectiveness of CRS-HIPEC in the treatment of colorectal PC using the framework of value-based medicine, which attempts to combine both benefit and cost into a single quantifiable metric. Our comprehensive review of the clinical outcomes and cost effectiveness of CRS-HIPEC demonstrate that it is a highly valuable oncologic therapy and a good use of healthcare resources.

Complex absorbing potentials within EOM-CC family of methods: Theory, implementation, and benchmarks

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

Zuev, Dmitry; Jagau, Thomas-C.; Krylov, Anna I.

2014-07-14

A production-level implementation of equation-of-motion coupled-cluster singles and doubles (EOM-CCSD) for electron attachment and excitation energies augmented by a complex absorbing potential (CAP) is presented. The new method enables the treatment of metastable states within the EOM-CC formalism in a similar manner as bound states. The numeric performance of the method and the sensitivity of resonance positions and lifetimes to the CAP parameters and the choice of one-electron basis set are investigated. A protocol for studying molecular shape resonances based on the use of standard basis sets and a universal criterion for choosing the CAP parameters are presented. Our resultsmore » for a variety of π{sup *} shape resonances of small to medium-size molecules demonstrate that CAP-augmented EOM-CCSD is competitive relative to other theoretical approaches for the treatment of resonances and is often able to reproduce experimental results.« less

Esthetics in periodontics and implantology.

PubMed

Zucchelli, Giovanni; Sharma, Praveen; Mounssif, Ilham

2018-06-01

Periodontal plastic surgery comprises an increasing part of clinical periodontology. Clinical trials have traditionally used professionals to judge esthetic outcome, and few studies have addressed patient needs and requests (true end points). Development of universally accepted and validated methods for professional esthetic assessment, together with standardized questionnaires for patient-perceived outcome, may help to provide better insights into the true needs and benefits of periodontal and implant-associated plastic surgery. In this volume of Periodontology 2000, experienced researchers and clinicians from different subdisciplines of periodontology evaluate: treatment of gingival recession with or without papilla elevation; clinical crown lengthening in the natural dentition and in prosthodontic preparative treatment; periodontal regeneration around natural teeth; and soft-tissue augmentation in edentulous areas. Similarly, experts in different areas of implant science address esthetic outcomes with single and multiple implant rehabilitation, alveolar ridge preservation, implant positioning and immediate implant placement in the esthetic zone. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison of two confocal micro-XRF spectrometers with different design aspects

PubMed Central

Smolek, S; Nakazawa, T; Tabe, A; Nakano, K; Tsuji, K; Streli, C; Wobrauschek, P

2014-01-01

Two different confocal micro X-ray fluorescence spectrometers have been developed and installed at Osaka City University and the Vienna University of Technology Atominstitut. The Osaka City University system is a high resolution spectrometer operating in air. The Vienna University of Technology Atominstitut spectrometer has a lower spatial resolution but is optimized for light element detection and operates under vacuum condition. The performance of both spectrometers was compared. In order to characterize the spatial resolution, a set of nine specially prepared single element thin film reference samples (500 nm in thickness, Al, Ti, Cr, Fe Ni, Cu, Zr, Mo, and Au) was used. Lower limits of detection were determined using the National Institute of Standards and Technology standard reference material glass standard 1412. A paint layer sample (cultural heritage application) and paint on automotive steel samples were analyzed with both instruments. The depth profile information was acquired by scanning the sample perpendicular to the surface. © 2013 The Authors. X-Ray Spectrometry published by John Wiley & Sons, Ltd. PMID:26430286

Comparison of two confocal micro-XRF spectrometers with different design aspects.

PubMed

Smolek, S; Nakazawa, T; Tabe, A; Nakano, K; Tsuji, K; Streli, C; Wobrauschek, P

2014-03-01

Two different confocal micro X-ray fluorescence spectrometers have been developed and installed at Osaka City University and the Vienna University of Technology Atominstitut. The Osaka City University system is a high resolution spectrometer operating in air. The Vienna University of Technology Atominstitut spectrometer has a lower spatial resolution but is optimized for light element detection and operates under vacuum condition. The performance of both spectrometers was compared. In order to characterize the spatial resolution, a set of nine specially prepared single element thin film reference samples (500 nm in thickness, Al, Ti, Cr, Fe Ni, Cu, Zr, Mo, and Au) was used. Lower limits of detection were determined using the National Institute of Standards and Technology standard reference material glass standard 1412. A paint layer sample (cultural heritage application) and paint on automotive steel samples were analyzed with both instruments. The depth profile information was acquired by scanning the sample perpendicular to the surface. © 2013 The Authors. X-Ray Spectrometry published by John Wiley & Sons, Ltd.

Diffusion of surgical techniques in early stage breast cancer: variables related to adoption and implementation of sentinel lymph node biopsy.

PubMed

Vanderveen, Kimberly A; Paterniti, Debora A; Kravitz, Richard L; Bold, Richard J

2007-05-01

Understanding how physicians acquire and adopt new technologies for cancer diagnosis and treatment is poorly understood, yet is critical to the dissemination of evidence-based practices. Sentinel lymph node biopsy (SLNB) has recently become a standard technique for axillary staging in early breast cancer and is an ideal platform for studying medical technology diffusion. We sought to describe the timing of SLNB adoption and patterns of surgeon interactions with the following educational sources: local university training program, surgical literature, national meetings/courses, national specialty centers, and other local surgeons. A cross-sectional survey that used semistructured interviews was used to assess timing of adoption, practice patterns, and learning sources for SLNB among surgical oncologists and general surgeons in a single metropolitan area. A total of 44 eligible surgeons were identified; 38 (86%) participated. All surgical oncologists (11 of 11) and most general surgeons (26 of 27) had implemented SLNB. Surgical oncologists were older (mean 51 vs. 48 years, P = .02) and had used SLNB longer (6.1 vs. 3.3 years, P = .01) than general surgeons. By use of social network diagrams, surgical oncologists and the university training program were shown to be key intermediaries between general surgeons and national specialty centers. Surgeons in group practice tended to use more learning sources than solo practitioners. Surgical oncologists and university-based surgeons play key educational roles in disseminating new cancer treatments and therefore have a professional responsibility to educate other community physicians to increase the use of the most current, evidence-based practices.

The European Society for Medical Oncology Magnitude of Clinical Benefit Scale in daily practice: a single institution, real-life experience at the Medical University of Vienna.

PubMed

Kiesewetter, Barbara; Raderer, Markus; Steger, Günther G; Bartsch, Rupert; Pirker, Robert; Zöchbauer-Müller, Sabine; Prager, Gerald; Krainer, Michael; Preusser, Matthias; Schmidinger, Manuela; Zielinski, Christoph C

2016-01-01

The European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS) has been designed to stratify the therapeutic benefit of a certain drug registered for the treatment of cancer. However, though internally validated, this tool has not yet been evaluated for its feasibility in the daily practice of a major center of medical oncology. The practicability of the MCBS for advanced oncological diseases at the Clinical Division of Oncology, Medical University of Vienna, which constitutes one of the largest oncological centres in Europe, was analysed in a three-step approach. First, retrospectively collected data were analysed to gain an overview of treatments in regular use. Second, data were scored by using the MCBS. Third, the ensuing results were evaluated within corresponding programme directorships to assess feasibility in a real-life clinical context. In the majority of tumour entities, the MCBS results reported earlier are consistent with daily clinical practice. Thus, in metastatic breast cancer or advanced lung cancer, there was a high level of clinical benefit for first-line treatment standards, and these results reflected well real-life experience. However, analyses based on the first version of the MCBS are limited if it comes to salvage treatment in tumour entities in which optimal sequencing of potential treatment options is of major importance, as in metastatic colorectal or renal cell cancer. In contrast to this, it is remarkable that certain novel therapies such as nivolumab assessed for heavily pretreated advanced renal cancer reached the highest level of clinical benefit due to prolongation in survival and a favourable toxicity profile. The MCBS clearly underlines the potential benefit of these compounds. The MCBS is an excellent tool for daily clinical practice of a tertiary referral centre. It supports treatment decisions based on the clinical benefit to be expected from a novel approach such as immunotherapy in as yet untested indications.

Incidence and risk factors of antiretroviral treatment failure in treatment-naïve HIV-infected patients at Chiang Mai University Hospital, Thailand

PubMed Central

2011-01-01

Background The use of combination antiretroviral therapy (cART) has become a standard of care for the treatment of HIV infection. However, cost and resistance to cART are major obstacles for access to treatment especially in resource-limited settings. In this study, we aimed to determine the incidence and risk factors of treatment failure in a cohort of treatment-naïve Thai HIV-infected patients. Methods A retrospective cohort study was conducted among HIV-infected patients initiating their first cART at Chiang Mai University Hospital, Thailand. Results From January 2002 to December 2008, 788 patients were enrolled; 365 were male (46.3%), and the mean age was 37.9 ± 8.6 years. The median baseline CD4 count was 57.7 cells/mm3 (IQR 22, 127). GPO-VIR® (a fixed-dose combination of lamivudine, stavudine, and nevirapine) was the most common prescribed cART (657 patients, 83.4%). Seventy-six patients developed virological failure given the cumulative incidence of 9.6%. The incidence of virological failure was 2.79 (95% CI 2.47, 3.14) cases per 100 person years. Poor adherence was the strongest predictor for virological failure. Of 535 immunologically evaluable patients, 179 (33.5%) patients developed immunological failure. A low CD4 cell count at baseline (< 100 cells/mm3) and the increment of CD4 cell count of < 50 cell/mm3 after 6 months of cART were the predictors for immunological failure (p < 0.001). Conclusions This study demonstrated that even in resource-limited settings, the high rate of success could be expected in the cohort with good and sustainable drug adherence. Poor adherence, older age, and low baseline CD4 cell count are the predictors for unfavorable outcome of cART. PMID:22060823

Methotrexate-treated ectopic pregnancy: beta human chorionic gonadotropin serum changes as a success predictor using a mathematical model validation.

PubMed

Kovaleva, Aleksandra; Irishina, Natalia; Pereira, Augusto; Cuesta-Guardiola, Tatiana; Ortiz-Quintana, Luis

2017-03-01

Surgical rescue of methotrexate-treated ectopic pregnancy is necessary when tubal rupture or medical therapy failure is detected during post-therapeutic monitoring. It is known that an increased beta human chorionic gonadotropin (β-hCG) concentration is the most important factor associated with treatment failure. Therefore, we suggested that relative changes in serum β-hCG could predict a successful result of medical treatment, leading to facilitation of the decision to forgo the prospect of possible surgical rescue. A retrospective observational study of 115 patients with an ectopic pregnancy who were treated with a single dosage protocol of 50mg/m 2 of methotrexate injected intramuscularly was performed at Puerta de Hierro University Hospital and Gregorio Marañón University General Hospital. Standard statistical tests were applied in order to evaluate the relative changes in β-hCG concentration between the 1st and the 4th days following methotrexate injection. Methotrexate treatment has a 95% probability to be successful if the relative change of β-hCG from the 1st to the 4th day of monitoring is within the following interval: [-1.02; 0.15]. Moreover, if the values of β-hCG-relative change from 1st to 4th day of monitoring are within [0.54; 1.2], it assures a negative result of treatment with 95% probability. Therefore, the value 0.15 (15%) of β-hCG relative change can be considered a cut-off value for a positive result to treatment. Our data support that negative β-hCG relative changes on the 4th day of treatment likely predict a successful result of methotrexate therapy, with a cut-off point of 0.15. Expectant management should be carried out in these cases if no clinical indications of surgery are presented. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

40 CFR 262.107 - Under what circumstances will a university's participation in this environmental management...

Code of Federal Regulations, 2013 CFR

2013-07-01

... compliance and how it intends to return to compliance. If, upon review of the University's written... University withdraws from this XL project, or receives a notice of termination pursuant to this section, it... university's participation in this environmental management standard pilot be terminated? 262.107 Section 262...

40 CFR 262.107 - Under what circumstances will a university's participation in this environmental management...

Code of Federal Regulations, 2011 CFR

2011-07-01

... compliance and how it intends to return to compliance. If, upon review of the University's written... University withdraws from this XL project, or receives a notice of termination pursuant to this section, it... university's participation in this environmental management standard pilot be terminated? 262.107 Section 262...

40 CFR 262.107 - Under what circumstances will a university's participation in this environmental management...

Code of Federal Regulations, 2012 CFR

2012-07-01

... compliance and how it intends to return to compliance. If, upon review of the University's written... University withdraws from this XL project, or receives a notice of termination pursuant to this section, it... university's participation in this environmental management standard pilot be terminated? 262.107 Section 262...

40 CFR 262.107 - Under what circumstances will a university's participation in this environmental management...

Code of Federal Regulations, 2014 CFR

2014-07-01

... compliance and how it intends to return to compliance. If, upon review of the University's written... University withdraws from this XL project, or receives a notice of termination pursuant to this section, it... university's participation in this environmental management standard pilot be terminated? 262.107 Section 262...

Bedding down the Embedding: IL Reality in a Teacher Education Program

ERIC Educational Resources Information Center

Hobbs, Helen; Aspland, Tania

2003-01-01

Queensland University of Technology (QUT) is one of Australia's largest universities, enrolling 30 000 students. Our Information Literacy Framework and Syllabus was endorsed as university policy in February 2001. QUT Library uses the Australian Information Literacy Standards as the basis and entry point for our syllabus. The university-wide…

Underfunding of Federal University in Nigeria and Perceived Impact on Administration: An Exploratory Case Study

ERIC Educational Resources Information Center

Dimunah, Valentina Obioma

2017-01-01

Universities in Nigeria have historically faced underfunding, and at an operational level, compete for attracting the best pool of students, achieving the highest grades. Adequately funded universities not only ensure a higher standard of University curriculum, but also have the potential to result in competitive advantages over other…

Pediatric selective mutism therapy: a randomized controlled trial.

PubMed

Esposito, Maria; Gimigliano, Francesca; Barillari, Maria R; Precenzano, Francesco; Ruberto, Maria; Sepe, Joseph; Barillari, Umberto; Gimigliano, Raffaele; Militerni, Roberto; Messina, Giovanni; Carotenuto, Marco

2017-10-01

Selective mutism (SM) is a rare disease in children coded by DSM-5 as an anxiety disorder. Despite the disabling nature of the disease, there is still no specific treatment. The aims of this study were to verify the efficacy of six-month standard psychomotor treatment and the positive changes in lifestyle, in a population of children affected by SM. Randomized controlled trial registered in the European Clinical Trials Registry (EuDract 2015-001161-36). University third level Centre (Child and Adolescent Neuropsychiatry Clinic). Study population was composed by 67 children in group A (psychomotricity treatment) (35 M, mean age 7.84±1.15) and 71 children in group B (behavioral and educational counseling) (37 M, mean age 7.75±1.36). Psychomotor treatment was administered by trained child therapists in residential settings three times per week. Each child was treated for the whole period by the same therapist and all the therapists shared the same protocol. The standard psychomotor session length is of 45 minutes. At T0 and after 6 months (T1) of treatments, patients underwent a behavioral and SM severity assessment. To verify the effects of the psychomotor management, the Child Behavior Checklist questionnaire (CBCL) and Selective Mutism Questionnaire (SMQ) were administered to the parents. After 6 months of psychomotor treatment SM children showed a significant reduction among CBCL scores such as in social relations, anxious/depressed, social problems and total problems (P<0.001), Withdrawn (P=0.007) and Internalizing problems (P=0.020). Regarding SM severity according to SMQ assessment, children of group A showed a reduction of SM symptoms in all situations (school, P=0.003; family, P=0.018; and social, P=0.030 situations) and in SMQ total score (P<0.001). Our preliminary results suggest the positive effect of the psychomotor treatment in rehabilitative program for children affected by selective mutism, even if further studies are needed. The present study identifies in psychomotricity a safe and efficacy therapy for pediatric selective mutism.

75 FR 16896 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... Submission: On occasion; recordkeeping. Average time CFR section Respondent universe Total annual per...: Businesses. Frequency of Submission: On occasion. Respondent Universe: 728 railroads. Total Estimated... standard. Form Number(s): N/A. Affected Public: Businesses. Respondent Universe: 728 railroads. Frequency...

[Social phobia - the blind spot: infrequently diagnosed, highly complex, and a predictor for unfavourable therapy outcomes?].

PubMed

Pöhlmann, Karin; Döbbel, Susanne; Löffler, Sabine; Israel, Matthias; Joraschky, Peter

2009-01-01

The objectives of the study were to examine (1) whether patients with social phobia report higher symptom load at the beginning and at the end of treatment and 1 year after treatment; and (2) whether the presence of social phobia is a factor that influences the course of treatment. 613 patients from a university hospital for psychosomatic medicine filled out questionnaires assessing symptom load (SCL 90-R, KOPS), physical symptoms, psychological and social impairment (KOPS), and depression (BDI). Social phobia was diagnosed based on a standardized diagnostic interview. 25%of the patients suffered from social phobia. They had significantly more concurrent mental disorders (4.18 vs. 2.41) and a higher symptom load than patients suffering from other mental disorders. They reported more physical complaints and depression and felt more impaired psychologically as well as socially. Even though both groups of patients profited from the treatment, compared to other patients, social phobia patients still had higher symptom load, impairment, and depression scores at the end of treatment and even at the follow-up 1 year after treatment. Social phobia is a severe disorder in which concurrent disorders frequently cause a high level of distress and impairment. These patients may benefit more from longer courses of treatment and/or disorder-specific treatment elements. Diagnostic and therapy approaches tailored to the generalized type of social anxiety are discussed.

High Voltage Pulsed Radiofrequency for the Treatment of Refractory Neuralgia of the Infraorbital Nerve: A Prospective Double-Blinded Randomized Controlled Study.

PubMed

Luo, Fang; Wang, Tao; Shen, Ying; Meng, Lan; Lu, Jingjing; Ji, Nan

2017-05-01

A recent study showed that 50% of patients who suffered from refractory neuralgia of the infraorbital nerve obtained satisfactory efficacy after pulsed radiofrequency (PRF) treatment. A pilot study showed that increasing the output voltage of PRF significantly improved the efficacy for trigeminal neuralgia; however, whether increasing the output voltage of PRF can improve the treatment outcomes for neuralgia of the infraorbital nerve is unknown. To evaluate the efficacy and safety of high voltage PRF treatment in comparison with standard voltage PRF for neuralgia of the infraorbital nerve. Prospective, single-center, double-blinded, randomized, controlled trial. Beijing Tiantan Hospital, Capital Medical University. A total of 60 patients with refractory neuralgia of the infraorbital nerve were randomly divided into the high voltage PRF group and the standard voltage PRF group to treat their infraorbital nerves. Neither the patients, pain physicians, nor the follow-up evaluators knew the patient group assignments. The primary outcome measure was the one-year response rate. The secondary outcome measures included the time to take effect after PRF, the one-month, 3-month, and 6-month response rates, the relapse rate, and adverse reactions. The intent-to-treat analysis showed that the one-month, 3-month, 6-month, and one-year response rates were all 90% in the high voltage group, which were significantly higher than the rates in the standard voltage group (67% [P < 0.05], 67% [P < 0.05], 63% [P < 0.05], and 60% [P <0.01], respectively). Furthermore, 27% of the patients in the high-voltage group and 13% of the patients in the standard voltage group experienced minor transient (10 - 30 days) numbness in the innervation area after PRF; no other serious adverse reactions were observed in the 2 groups (P > 0.05). We did not investigate the dose-effect relationship between the output voltage and efficacy or the effect of a higher pulse dose on efficacy. This study was a single-center study, and multi-center, randomized, controlled studies are needed to obtain the highest level of empirical evidence. Additionally, the follow-up period lasted only one year in this study; thus, long-term efficacy needs to be further confirmed. The results showed that high voltage PRF was effective and safe for patients with refractory neuralgia of the infraorbital nerve and could become a treatment option in patients who do not respond to conservative treatment.

The Importance and Degree of Implementation of the European Standards and Guidelines for Internal Quality Assurance in Universities: The Views of Portuguese Academics

ERIC Educational Resources Information Center

Manatos, Maria J.; Rosa, Maria J.; Sarrico, Cláudia S.

2015-01-01

This research seeks to explore academics' perceptions of the importance and degree of implementation of the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) for internal quality assurance. It uses empirical evidence from Portugal, gathered via a questionnaire given to all university academics. Results show…

Problems of Technical Standards Teaching in the Context of the Globalization and Euro-Integration in Higher Education System of Ukraine

ERIC Educational Resources Information Center

Kornuta, Olena; Pryhorovska, Tetiana

2015-01-01

Globalization and Ukraine association with EU imply including Ukrainian universities into the world scientific space. The aim of this article is to analyze the problem of drawing standards teaching, based on the experience of Ivano-Frankivsk National Technical University of Oil and Gas (Ukraine) and to summarize the experience of post Soviet…

End-to-End Fault Tolerance Using Transport Layer Multihoming

DTIC Science & Technology

2005-01-01

it meets the academic and professional standard required by the University as a dissertation for the degree of Doctor of Philosophy...dissertation and that in my opinion it meets the academic and professional standard required by the University as a dissertation for the degree of Doctor...grow tired of revising the same text over and over, he always showed enthusiasm for helping me improve its

Comparison of Body Mass Index (BMI) Categories Based on Asian and Universal Standards and Language Spoken at Home among Asian American University Students

ERIC Educational Resources Information Center

Ng, Tiffany; McMahan, Shari; Mouttapa, Michele; Tanjasiri, Sora Park; Beam, William

2009-01-01

Background: The World Health Organization released lower Body Mass Index (BMI) cutoff points for Asian individuals to account for increased body fat percentage (BF%) and risk of obesity-related conditions at a lower body mass index. Purpose: This preliminary study: (1) explores the impact of utilizing Asian BMI standards (compared to universal…

The Impact of the Evaluation of the Standards of Undergraduate Teaching Work on Teaching at Higher Education Institutions: An Investigative Study

ERIC Educational Resources Information Center

Yaoming, Gao; Ping, Zhang; Hui, Chen; Lili, Lan; Guanghui, Zhang

2009-01-01

A questionnaire investigation of academic staff and teaching administrators at Shanghai Normal University and Shanghai Fisheries University shows that the evaluation of the standards of undergraduate teaching work has had positive effects on teaching work and that setting up an evaluation system is an effective measure for assuring the quality of…

Concepts of Information Literacy and Information Literacy Standards among Undergraduate Students in Public and Private Universities in the State of Kuwait

ERIC Educational Resources Information Center

Al-Issa, Reham E.

2013-01-01

The purpose of this qualitative study was to explore the experiences of undergraduate college students attending a public and a private university in the State of Kuwait to understand how they develop their understanding and valuing of information literacy and information literacy standards. Data from student and faculty interviews and student…

Retrospection and Reflection: The Emerging Influence of an Institutional Professional Recognition Scheme on Professional Development and Academic Practice in a UK University

ERIC Educational Resources Information Center

van der Sluis, Hendrik; Burden, Penny; Huet, Isabel

2017-01-01

Raising the quality and profile of teaching and student learning is something universities across the UK are aspiring to achieve in order to maintain reputations. Currently, the UK Professional Standards Framework (UKPSF) provides a standard by which academic staff can gain professional recognition for their academic practice and many UK…

Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial.

PubMed

Wang, Chenchen; Schmid, Christopher H; Iversen, Maura D; Harvey, William F; Fielding, Roger A; Driban, Jeffrey B; Price, Lori Lyn; Wong, John B; Reid, Kieran F; Rones, Ramel; McAlindon, Timothy

2016-07-19

Few remedies effectively treat long-term pain and disability from knee osteoarthritis. Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis. To compare Tai Chi with standard physical therapy for patients with knee osteoarthritis. Randomized, 52-week, single-blind comparative effectiveness trial. (ClinicalTrials.gov: NCT01258985). An urban tertiary care academic hospital. 204 participants with symptomatic knee osteoarthritis (mean age, 60 years; 70% women; 53% white). Tai Chi (2 times per week for 12 weeks) or standard physical therapy (2 times per week for 6 weeks, followed by 6 weeks of monitored home exercise). The primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 12 weeks. Secondary outcomes included physical function, depression, medication use, and quality of life. At 12 weeks, the WOMAC score was substantially reduced in both groups (Tai Chi, 167 points [95% CI, 145 to 190 points]; physical therapy, 143 points [CI, 119 to 167 points]). The between-group difference was not significant (24 points [CI, -10 to 58 points]). Both groups also showed similar clinically significant improvement in most secondary outcomes, and the benefits were maintained up to 52 weeks. Of note, the Tai Chi group had significantly greater improvements in depression and the physical component of quality of life. The benefit of Tai Chi was consistent across instructors. No serious adverse events occurred. Patients were aware of their treatment group assignment, and the generalizability of the findings to other settings remains undetermined. Tai Chi produced beneficial effects similar to those of a standard course of physical therapy in the treatment of knee osteoarthritis. National Center for Complementary and Integrative Health of the National Institutes of Health.

Evaluating an Action Threshold-Based Insecticide Program on Onion Cultivars Varying in Resistance to Onion Thrips (Thysanoptera: Thripidae).

PubMed

Nault, Brian A; Huseth, Anders S

2016-08-01

Onion thrips, Thrips tabaci Lindeman (Thysanoptera: Thripidae), is a highly destructive pest of onion, Allium cepa L., and its management relies on multiple applications of foliar insecticides. Development of insecticide resistance is common in T. tabaci populations, and new strategies are needed to relax existing levels of insecticide use, but still provide protection against T. tabaci without compromising marketable onion yield. An action threshold-based insecticide program combined with or without a thrips-resistant onion cultivar was investigated as an improved approach for managing T. tabaci infestations in commercial onion fields. Regardless of cultivar type, the average number of insecticide applications needed to manage T. tabaci infestations in the action-threshold based program was 4.3, while the average number of sprays in the standard weekly program was 7.2 (a 40% reduction). The mean percent reduction in numbers of applications following the action threshold treatment in the thrips-resistant onion cultivar, 'Advantage', was 46.7% (range 40-50%) compared with the standard program, whereas the percentage reduction in applications in action threshold treatments in the thrips-susceptible onion cultivar, 'Santana', was 34.3% (range 13-50%) compared with the standard program, suggesting a benefit of the thrips-resistant cultivar. Marketable bulb yields for both 'Advantage' and 'Santana' in the action threshold-based program were nearly identical to those in the standard program, indicating that commercially acceptable bulb yields will be generated with fewer insecticide sprays following an action threshold-based program, saving money, time and benefiting the environment. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Surgical versus accommodative treatment for Charcot arthropathy of the midfoot.

PubMed

Pinzur, Michael

2004-08-01

The treatment of Charcot foot arthropathy is one of the most controversial issues facing orthopaedic foot and ankle surgeons. Although current orthopaedic textbooks are in almost universal agreement that treatment should be nonoperative, accommodating the deformity with orthotic methods, most peer-reviewed clinical studies recommend early surgical correction of the deformity. In a university health system orthopaedic foot and ankle clinic with a special interest in diabetic foot disorders, a moderate approach evolved for management of this difficult patient population. Patients with Charcot arthropathy and plantigrade feet were treated with accommodative orthotic methods. Those with nonplantigrade feet were treated with surgical correction of the deformity, followed by long-term management with commercial therapeutic footwear. The desired outcome for both groups was long-term management with standard, commercially available, therapeutic depth-inlay shoes and custom-fabricated accommodative foot orthoses. During a 6-year period, 198 patients (201 feet) were treated for diabetes-associated Charcot foot arthropathy. The location of the deformity was in the midfoot in 147 feet, in the ankle in 50, and in the forefoot in four. At a minimum 1-year follow-up, 87 of the 147 feet with midfoot disease (59.2%) achieved the desired endpoint without surgical intervention. Sixty (40.8%) required surgery. Corrective osteotomy with or without arthrodesis was attempted in 42, while debridement or simple exostectomy was attempted in 18 feet. Three patients had initial amputation (one partial foot amputation, one Syme ankle disarticulation, and one transtibial amputation), and five had amputation (two Syme ankle disarticulations and three transtibial amputations) after attempted salvage failed. Using a simple treatment protocol with the desired endpoint being long-term management with commercially available, therapeutic footwear and custom foot orthoses, more than half of patients with Charcot arthropathy at the midfoot level can be successfully managed without surgery.

Probable or improbable universe? Correlating electroweak vacuum instability with the scale of inflation

DOE PAGES

Hook, Anson; Kearney, John; Shakya, Bibhushan; ...

2015-01-13

Measurements of the Higgs boson and top quark masses indicate that the Standard Model Higgs potential becomes unstable around Λ I ~ 10 11 GeV. This instability is cosmologically relevant since quantum fluctuations during inflation can easily destabilize the electroweak vacuum if the Hubble parameter during inflation is larger than Λ I (as preferred by the recent BICEP 2 measurement). Here, we perform a careful study of the evolution of the Higgs field during inflation, obtaining different results from those currently in the literature. We consider both tunneling via a Coleman-de Luccia or Hawking-Moss instanton, valid when the scale ofmore » inflation is below the instability scale, as well as a statistical treatment via the Fokker-Planck equation appropriate in the opposite regime. We show that a better understanding of the post-inflation evolution of the unstable AdS vacuum regions is crucial for determining the eventual fate of the universe. If these AdS regions devour all of space, a universe like ours is indeed extremely unlikely without new physics to stabilize the Higgs potential; however, if these regions crunch, our universe survives, but inflation must last a few e-folds longer to compensate for the lost AdS regions. Lastly, we examine the effects of generic Planck-suppressed corrections to the Higgs potential, which can be sufficient to stabilize the electroweak vacuum during inflation.« less

Assessment of the calibration of periodontal diagnosis and treatment planning among dental students at three dental schools.

PubMed

Lane, Brittany A; Luepke, Paul; Chaves, Eros; Maupome, Gerardo; Eckert, George J; Blanchard, Steven; John, Vanchit

2015-01-01

Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.

Cost Accounting Standards: An Overview of Compliance with These Complex Standards.

ERIC Educational Resources Information Center

Bruce, Janet D.

1993-01-01

A discussion of federal cost accounting standards (CAS) chronicles briefly the history of CAS, notes other pertinent regulations applicable to higher education, summarizes the initial standards drafted for colleges and universities, and examines disclosure statement requirements and implications of noncompliance. (MSE)

Universal Design: Process, Principles, and Applications

ERIC Educational Resources Information Center

Burgstahler, Sheryl

2009-01-01

Designing any product or environment involves the consideration of many factors, including aesthetics, engineering options, environmental issues, safety concerns, industry standards, and cost. Typically, designers focus their attention on the average user. In contrast, universal design (UD), according to the Center for Universal Design," is…

40 CFR 262.101 - What is in this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... definitions that apply to the University laboratories. It contains specific requirements for how to handle... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project... framework for a new management system for wastes that are generated in University laboratories. This...

40 CFR 262.101 - What is in this subpart?

Code of Federal Regulations, 2013 CFR

2013-07-01

... definitions that apply to the University laboratories. It contains specific requirements for how to handle... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project... framework for a new management system for wastes that are generated in University laboratories. This...

40 CFR 262.101 - What is in this subpart?

Code of Federal Regulations, 2012 CFR

2012-07-01

... definitions that apply to the University laboratories. It contains specific requirements for how to handle... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project... framework for a new management system for wastes that are generated in University laboratories. This...

40 CFR 262.101 - What is in this subpart?

Code of Federal Regulations, 2014 CFR

2014-07-01

... definitions that apply to the University laboratories. It contains specific requirements for how to handle... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project... framework for a new management system for wastes that are generated in University laboratories. This...

International Universities: Misunderstandings and Emerging Models?

ERIC Educational Resources Information Center

Knight, Jane

2015-01-01

Internationalization has transformed higher education institutions and systems but there is much confusion as to what an international, binational, transnational, cosmopolitan, multinational, or global university actually means. There is no standardized model for an international university, nor should there be, but a deeper understanding of…

Efficacy of enteral nutrition for the treatment of pancreatitis using standard enteral formula.

PubMed

Makola, Diklar; Krenitsky, Joe; Parrish, Carol; Dunston, Emily; Shaffer, Hubert A; Yeaton, Paul; Kahaleh, Michel

2006-10-01

Elemental formula delivered distal to the ligament of Treitz has demonstrated efficacy in patients with pancreatitis, presumably by decreasing pancreatic stimulation. Few data exist on the use of standard enteral formula in such patients. This study describes the outcomes of pancreatitis patients managed with long-term standard enteral nutrition (EN). One hundred twenty-six patients managed at the University of Virginia Health System with pancreatitis requiring nutritional support between August 2000 and June 2004 received a standard formula delivered distal to the ligament of Treitz and were followed prospectively to resolution of their disease process. Predictors of improvement in CT Severity Index, duration of EN, and length of hospital stay were identified. Changes in body weight and serum albumin were determined. Mean age was 50.8 +/- 15.2 yr (male, 83). Etiology included alcohol (46), gallstones (49), idiopathic (15), post-ERCP (7), drug (5), hyperlipidemia (3), and pancreas divisum (1). EN lasted a median of 18.9 (2.4 to 111.7) wk. Median CT Severity Index decreased from 4 to 2 (p < 0.001). Underweight patients gained 9.8 lbs; overweight and obese patients lost 7.2 and 28.8 lbs, respectively. Albumin concentration increased from 3 to 3.8 g/dL (p < 0.001). Standard enteral formula is effective in the management of patients with complicated pancreatitis.

Water as consumed and its impact on the consumer--do we understand the variables?

PubMed

Bates, A J

2000-01-01

Water is the most important natural resource in the world, without it life cannot exist. In 1854 a cholera outbreak in London caused 10, 000 deaths and positively linked enteric disease with bacterial contamination of drinking water by sewage pollution. Since then, adequate water hygiene standards and sewage purification have played the most significant role in disease eradication and public health improvements everywhere. Standards for drinking water have become an extensive range of microbiological and chemical parametric values. Which has not increased consumer, if the media is to be believed. Customers rightly expect that the water they drink is safe and wholesome. Standard setting is perceived as a precise science and meaningful to health. Is this justified and do scientists and regulators who derive and set the standards understand the uncertainties in the system? Water is the universal solvent, therefore it will never be pure; it will contain impurities prior to and after treatment. Knowledge of its potential to become contaminated is necessary to understand the epidemiology associated with waterborne contaminants and their effects. Water use patterns vary considerably and affect assumptions based on toxicology derived from laboratory studies under tightly controlled conditions. Consideration must be given to the model systems used to assess toxicity and translate results from the laboratory to the real world, if sensible scientifically-based water quality standards are to be set and achieved cost effectively.

Functionally Equivalent Variants in a Non-standard Variety and Their Implications for Universal Grammar: A Spontaneous Speech Corpus.

PubMed

Leivada, Evelina; Papadopoulou, Elena; Pavlou, Natalia

2017-01-01

Findings from the field of experimental linguistics have shown that a native speaker may judge a variant that is part of her grammar as unacceptable, but still use it productively in spontaneous speech. The process of eliciting acceptability judgments from speakers of non-standard languages is sometimes clouded by factors akin to prescriptive notions of grammatical correctness. It has been argued that standardization enhances the ability to make clear-cut judgments, while non-standardization may result to grammatical hybridity, often manifested in the form of functionally equivalent variants in the repertoire of a single speaker. Recognizing the importance of working with corpora of spontaneous speech, this work investigates patterns of variation in the spontaneous production of five neurotypical, adult speakers of a non-standard variety in terms of three variants, each targeting one level of linguistic analysis: syntax, morphology, and phonology. The results reveal the existence of functionally equivalent variants across speakers and levels of analysis. We first discuss these findings in relation to the notions of competing, mixed, and fused grammars, and then we flesh out the implications that different values of the same variant carry for parametric approaches to Universal Grammar. We observe that intraspeaker realizations of different values of the same variant within the same syntactic environment are incompatible with the 'triggering-a-single-value' approach of parametric models, but we argue that they are compatible with the concept of Universal Grammar itself. Since the analysis of these variants is ultimately a way of investigating the status of Universal Grammar primitives, we conclude that claims about the alleged unfalsifiability of (the contents of) Universal Grammar are unfounded.

Functionally Equivalent Variants in a Non-standard Variety and Their Implications for Universal Grammar: A Spontaneous Speech Corpus

PubMed Central

Leivada, Evelina; Papadopoulou, Elena; Pavlou, Natalia

2017-01-01

Findings from the field of experimental linguistics have shown that a native speaker may judge a variant that is part of her grammar as unacceptable, but still use it productively in spontaneous speech. The process of eliciting acceptability judgments from speakers of non-standard languages is sometimes clouded by factors akin to prescriptive notions of grammatical correctness. It has been argued that standardization enhances the ability to make clear-cut judgments, while non-standardization may result to grammatical hybridity, often manifested in the form of functionally equivalent variants in the repertoire of a single speaker. Recognizing the importance of working with corpora of spontaneous speech, this work investigates patterns of variation in the spontaneous production of five neurotypical, adult speakers of a non-standard variety in terms of three variants, each targeting one level of linguistic analysis: syntax, morphology, and phonology. The results reveal the existence of functionally equivalent variants across speakers and levels of analysis. We first discuss these findings in relation to the notions of competing, mixed, and fused grammars, and then we flesh out the implications that different values of the same variant carry for parametric approaches to Universal Grammar. We observe that intraspeaker realizations of different values of the same variant within the same syntactic environment are incompatible with the ‘triggering-a-single-value’ approach of parametric models, but we argue that they are compatible with the concept of Universal Grammar itself. Since the analysis of these variants is ultimately a way of investigating the status of Universal Grammar primitives, we conclude that claims about the alleged unfalsifiability of (the contents of) Universal Grammar are unfounded. PMID:28790953

A New Understanding of the Heat Treatment of Nb-Sn Superconducting Wires

NASA Astrophysics Data System (ADS)

Sanabria, Charlie

Enhancing the beam energy of particle accelerators like the Large Hadron Collider (LHC), at CERN, can increase our probability of finding new fundamental particles of matter beyond those predicted by the standard model. Such discoveries could improve our understanding of the birth of universe, the universe itself, and/or many other mysteries of matter--that have been unresolved for decades--such as dark matter and dark energy. This is obviously a very exciting field of research, and therefore a worldwide collaboration (of universities, laboratories, and the industry) is attempting to increase the beam energy in the LHC. One of the most challenging requirements for an energy increase is the production of a magnetic field homogeneous enough and strong enough to bend the high energy particle beam to keep it inside the accelerating ring. In the current LHC design, these beam bending magnets are made of Nb Ti superconductors, reaching peak fields of 8 T. However, in order to move to higher fields, future magnets will have to use different and more advanced superconducting materials. Among the most viable superconductor wire technologies for future particle accelerator magnets is Nb3Sn, a technology that has been used in high field magnets for many decades. However, Nb3Sn magnet fabrication has an important challenge: the fact the wire fabrication and the coil assembly itself must be done using ductile metallic components (Nb, Sn, and Cu) before the superconducting compound (Nb3 Sn) is activated inside the wires through a heat treatment. The studies presented in this thesis work have found that the heat treatment schedule used on the most advanced Nb3Sn wire technology (the Restacked Rod Process wires, RRPRTM) can still undergo significant improvements. These improvements have already led to an increase of the figure of merit of these wires (critical current density) by 28%.

Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria.

PubMed

Oli, Angus N; Akabueze, Vivian B; Ezeudu, Chijioke E; Eleje, George U; Ejiofor, Obiora S; Ezebialu, Ifeanyichukwu U; Oguejiofor, Charlotte B; Ekejindu, Ifeoma M; Emechebe, George O; Okeke, Kenneth N

2017-01-01

Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment. This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria. Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days' antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby-bauer disc diffusion method. Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients' location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85). E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

Science, Medicine, and Intercessory Prayer

PubMed Central

Sloan, Richard P.; Ramakrishnan, Rajasekhar

2012-01-01

Among the many recent attempts to demonstrate the medical benefits of religious activity, the methodologically strongest seem to be studies of the effects of distant intercessory prayer (IP). In these studies, patients are randomly assigned to receive standard care or standard care plus the prayers or “healing intentions” of distant intercessors. Most of the scientific community has dismissed such research, but cavalier rejection of studies of IP is unwise, because IP studies appear to conform to the standards of randomized controlled trials (RCTs) and, as such, would have a significant advantage over observational investigations of associations between religious variables and health outcomes. As we demonstrate, however, studies of IP fail to meet the standards of RCTs in several critical respects. They fail to adequately measure and control exposure to prayer from others, which is likely to exceed IP and to vary widely from subject to subject, and whose magnitude is unknown. This supplemental prayer so greatly attenuates the differences between the treatment and control groups that sample sizes are too large to justify studies of IP. Further, IP studies generally do not specify the outcome variables, raising problems of multiple comparisons and Type 1 errors. Finally, these studies claim findings incompatible with current views of the physical universe and consciousness. Unless these problems are solved, studies of IP should not be conducted. PMID:17146135

"UNICERT," or: Towards the Development of a Unified Language Certificate for German Universities.

ERIC Educational Resources Information Center

Voss, Bernd

The standardization of second language proficiency levels for university students in Germany is discussed. Problems with the current system, in which each university has developed its own program of study and proficiency certification, are examined and a framework for development of a unified language certificate for all universities is outlined.…

From Humanity to Utility: Melbourne University and Public Examinations 1856-1964.

ERIC Educational Resources Information Center

Musgrave, P. W.

The interaction of a university and the society is described in a case study of the system of public examinations of Melbourne University in Victoria (Australia). The initial desire to guarantee the academic standards of college entrants grew into a system that also provided school leaving certificates for those not entering the university. Over a…

High-Level Primary Clarithromycin Resistance of Helicobacter pylori in Algiers, Algeria: A Prospective Multicenter Molecular Study.

PubMed

Djennane-Hadibi, Fazia; Bachtarzi, Mohamed; Layaida, Karim; Ali Arous, Nassima; Nakmouche, Mhamed; Saadi, Berkane; Tazir, Mohamed; Ramdani-Bouguessa, Nadjia; Burucoa, Christophe

2016-04-01

Knowledge of local antibiotic resistance is crucial to adaptation for the choice of the optimal first-line treatment for Helicobacter pylori infection. Clarithromycin is a key component of the standard triple therapy largely used worldwide and, more particularly, in Algeria. Clarithromycin resistance is the main risk factor for treatment failure. The aim of this study was to evaluate, for the first time in Algeria, the prevalence of the primary resistance of H. pylori to clarithromycin. We conducted a prospective study (2008-2014) that included 195 Algerian patients referred for gastroduodenal endoscopy to two University Hospitals, one General Hospital, and several private gastroenterologists in Algiers (Algeria). One gastric biopsy was collected for the molecular detection of H. pylori and the mutations in 23S rRNA genes that confer resistance to clarithromycin with a quadruplex real-time PCR using Scorpion primers. The Scorpion PCR detected H. pylori DNA in 91 biopsies (47%). A mutation conferring resistance to clarithromycin was detected in 32 of the 91 positive patients (35%) and in 29 of the 88 positive patients never previously treated for an H. pylori infection (33%). The prevalence of primary resistance of H. pylori to clarithromycin was 33% in the Algerian population being studied. The high level of primary clarithromycin resistance in the H. pylori strains infecting the Algerian population that we report leads us to recommend the abandonment of the standard clarithromycin-based triple therapy as a first-line treatment in Algeria.

An accurate method for measuring triploidy of larval fish spawns

USGS Publications Warehouse

Jenkins, Jill A.; Draugelis-Dale, Rassa O.; Glennon, Robert; Kelly, Anita; Brown, Bonnie L.; Morrison, John

2017-01-01

A standard flow cytometric protocol was developed for estimating triploid induction in batches of larval fish. Polyploid induction treatments are not guaranteed to be 100% efficient, thus the ability to quantify the proportion of triploid larvae generated by a particular treatment helps managers to stock high-percentage spawns and researchers to select treatments for efficient triploid induction. At 3 d posthatch, individual Grass Carp Ctenopharyngodon idella were mechanically dissociated into single-cell suspensions; nuclear DNA was stained with propidium iodide then analyzed by flow cytometry. Following ploidy identification of individuals, aliquots of diploid and triploid cell suspensions were mixed to generate 15 levels (0–100%) of known triploidy (n = 10). Using either 20 or 50 larvae per level, the observed triploid percentages were lower than the known, actual values. Using nonlinear regression analyses, quadratic equations solved for triploid proportions in mixed samples and corresponding estimation reference plots allowed for predicting triploidy. Thus, an accurate prediction of the proportion of triploids in a spawn can be made by following a standard larval processing and analysis protocol with either 20 or 50 larvae from a single spawn, coupled with applying the quadratic equations or reference plots to observed flow cytometry results. Due to the universality of triploid DNA content being 1.5 times the diploid level and because triploid fish consist of fewer cells than diploids, this method should be applicable to other produced triploid fish species, and it may be adapted for use with bivalves or other species where batch analysis is appropriate.

A comparative study of the use of the Istanbul Protocol amongst civil society organizations in low-income countries.

PubMed

Kelly, Toby; Jensen, Steffen; Koch Andersen, Morten; Christiansen, Catrine; Sharma, Jeevan Raj

2016-01-01

The Istanbul Protocol (IP) is one of the great success stories of the global anti-torture movement, setting out universal guidelines for the production of rigorous, objective and reliable evidence about allegations of torture and ill-treatment. The IP is explicitly designed to outline 'minimum standards for States'. However, it is all too often left to civil society organizations to investigate allegations of torture and ill-treatment. In this context, important questions remain as to how and where the IP can be used best by such organizations. These questions are particularly acute in situations where human rights groups may have limited institutional capacity. This paper explores the practical challenges faced by civil society in using the IP in Low-Income Countries. It is based on qualitative research in three case studies: Nepal, Kenya and Bangladesh. This research involved over 80 interviews with human rights practitioners. The conclusions of the paper are that the Istanbul Protocol provides a useful framework for documentation, but more comprehensive forms of documentation will often be limited to a very small - albeit important - number of legal cases. In many cases, the creation of precise and standardized forms of evidence is not necessarily the most effective form of documentation for redress or accountability. In the absence of legal systems willing and able to respond effectively to allegations of torture and ill-treatment, there are severe limitations on the practical effectiveness of detailed and technical forms of documentation.

Are magnetic resonance imaging or radiographic findings correlated with clinical prognosis in spinal cord neuropathy?

PubMed Central

Neshat Halati, Fatemeh; Vajhi, Alireza; Molazem, Mohammad; Dehghan, Mohammad Mehdi; Ansari, Fereshteh

2016-01-01

Dogs presented to the Small Animal Hospital of Veterinary Medicine, University of Tehran were included in the present study if spinal or intervertebral disc involvement was suspected. Clinical signs were recorded as well as general information of the patient such as age, breed and sex. Sixty dogs were examined radiographically and two standard orthogonal lateral and ventrodorsal projections were taken from the suspected region. Then magnetic resonance imaging (MRI) was performed for all patients. Agreement between MRI and radiographic findings, comparison of sex and breed with diagnostic imaging grades, comparison between diagnostic imaging grades and mean age, recovery rate after surgery or medical treatment, effects of diagnostic imaging severity grades on surgical or medical referrals were evaluated statistically. There were no significant association between age, sex and breed and frequency of the intervertebral disk disease. Intervertebral disc involvements between L2-L3 and T13-L1 were estimated as the most frequent sites of involvements. Sensitivity and specificity of radiography were evaluated 90.0% and 46.0%, respectively, by considering the MRI as a gold standard modality. There was a significant association between severity of disease in the MRI with referral to surgery and medical treatment. The recovery rate after surgery was significantly higher than medical treatment. These results can be used as a foundation for other studies with more focuses on details of injury and larger group of patients. PMID:27872724

Standardized metrics for accessibility : establishing a federal policy-relevant knowledge base : USDOT Region V Regional University Transportation Center final report.

DOT National Transportation Integrated Search

2016-12-01

This report seeks opportunities for standardization of these data and explains findings on three principal tasks. First, it assesses the current state of standardized transportation data. By studying documentation of other programs of standardized da...

A Comparison of Internships among Louisiana University Principal Preparation Programs

ERIC Educational Resources Information Center

Campbell, Kathleen Taylor; Parker, Randy

2016-01-01

After widespread accusations that universities were not adequately preparing school leadership candidates with real world experiences, the movement to reform U.S. university principal preparation began. The National Policy Board for Educational Administration approved the Educational Leadership Constituent Council (ELCC) standards as guidelines…

Quality Assurance for University Teaching.

ERIC Educational Resources Information Center

Ellis, Roger, Ed.

This book, written from a British perspective, presents 17 papers on quality assurance in teaching at the university level. The first eight papers address issues of assuring quality and include: (1) "Quality Assurance for University Teaching; Issues and Approaches" (Roger Ellis); (2) "A British Standard for University…

Analysis of 2014 Post UTME Score of Candidates in the University of Ibadan with Two Methods of Standard Setting to Set Cut Off Points

ERIC Educational Resources Information Center

Oladele, Babatunde

2017-01-01

The aim of the current study is to analyse the 2014 Post UTME scores of candidates in the university of Ibadan towards the establishment of cut off using two methods of standard settings. Prospective candidates who seek admission to higher institution are often denied admission through the Post UTME exercise. There is no single recommended…

Fully in Silico Calibration of Empirical Predictive Models for Environmental Fate Properties of Novel Munitions Compounds

DTIC Science & Technology

2016-04-01

57) ASTM Standard E 2552 (2008) Standard guide for assessing the environmental and human health impacts of new energetic compounds; ASTM...Project ER-1735 APRIL 2016 Paul G. Tratnyek Alexandra J. Salter-Blanc Oregon Health & Science University Eric J. Bylaska Kurt R...order NEB Nudged Elastic Band NMR Nuclear Magnetic Resonance NOM Natural Organic Matter OHSU Oregon Health & Science University PCM Polarizable

The Degree of Employment of Faculty Members for Assessment Standards Defined by the American Educational Organizations in Assessing Student Learning at the University of Najran

ERIC Educational Resources Information Center

Kabil, Raafat; Abduh, Yahya Bani

2017-01-01

This study investigates the faculty members' employment of assessment standards defined by the American educational organizations (NCME, AFT and NEA) to assessing student learning at the University of Najran from the students' point of view. To achieve the objective of the study, the questionnaire which consisted of 38 items distributed to seven…

CROI 2018: Highlights of Viral Hepatitis.

PubMed

Luetkemeyer, Anne F; Wyles, David L

2018-05-01

At the 2018 Conference on Retroviruses and Opportunistic Infections (CROI), there was a major focus on hepatitis C virus (HCV) elimination and improving each component of the hepatitis C care cascade. Several countries and cohorts have demonstrated the remarkable impact that universal HCV testing and unrestricted access to hepatitis C treatment can have on markedly reducing incident HCV infections and HCV infection prevalence, including in people who inject drugs and HIV/HCV-coinfected populations. However, in many settings, substantial barriers to widespread HCV treatment remain, including undiagnosed HCV infection, particularly in populations outside the standard "baby boomer" birth cohort (ie, born 1945-1965); restricted access to hepatitis C treatment in those with known HCV infection; reinfection with HCV; and migration of HCV-infected populations. Many innovative programs have successfully implemented HCV testing and treatment outside of traditional care settings, expanding access for harder-to-reach populations, which will be crucial to successful elimination efforts. Outbreaks of hepatitis A virus (HAV) infection continue to occur in among men who have sex with men and homeless populations in the United States, Europe, and Southeast Asia, highlighting the need for improved HAV vaccination programs for populations at risk.

Ethnic Rhinoplasty in Female Patients: The Neoclassical Canons Revisited.

PubMed

Saad, Ahmad; Hewett, Sierra; Nolte, Megan; Delaunay, Flore; Saad, Mariam; Cohen, Steven R

2018-04-01

Despite the substantial amount of research devoted to objectively defining facial attractiveness, the canons have remained a paradigm of aesthetic facial analysis, yet their omnipresence in clinical assessments revealed their limitations outside of a subset of North American Caucasians, leading to criticism about their validity as a standard of facial beauty. In an effort to introduce more objective treatment planning into ethnic rhinoplasty, we compared neoclassical canons and other current standards pertaining to nasal proportions to anatomic proportions of attractive individuals from seven different ethnic backgrounds. Beauty pageant winners (Miss Universe and Miss World nominees) between 2005 and 2015 were selected and assigned to one of seven regionally defined ethnic groups. Anteroposterior and lateral images were obtained through Google, Wikipedia, Miss Universe, and Miss World Web sites. Anthropometry of facial features was performed via Adobe Photoshop TM. Individual facial measurements were then standardized to proportions and compared to the neoclassical canons. Our data reflected an ethnic-dependent preference for the multiple fitness model. Wide-set eyes, larger mouth widths, and smaller noses were significantly relevant in Eastern Mediterranean and European ethnic groups. Exceptions lied within East African and Asian groups. As in the attractive face, the concept of the ideal nasal anatomy varies between different ethnicities. Using objective criteria and proportions of beauty to plan and execute rhinoplasty in different ethnicities can help the surgeon plan and deliver results that are in harmony with patients' individual background and facial anatomy. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Establishment of a Universal Size Standard Strain for Use with the PulseNet Standardized Pulsed-Field Gel Electrophoresis Protocols: Converting the National Databases to the New Size Standard

PubMed Central

Hunter, Susan B.; Vauterin, Paul; Lambert-Fair, Mary Ann; Van Duyne, M. Susan; Kubota, Kristy; Graves, Lewis; Wrigley, Donna; Barrett, Timothy; Ribot, Efrain

2005-01-01

The PulseNet National Database, established by the Centers for Disease Control and Prevention in 1996, consists of pulsed-field gel electrophoresis (PFGE) patterns obtained from isolates of food-borne pathogens (currently Escherichia coli O157:H7, Salmonella, Shigella, and Listeria) and textual information about the isolates. Electronic images and accompanying text are submitted from over 60 U.S. public health and food regulatory agency laboratories. The PFGE patterns are generated according to highly standardized PFGE protocols. Normalization and accurate comparison of gel images require the use of a well-characterized size standard in at least three lanes of each gel. Originally, a well-characterized strain of each organism was chosen as the reference standard for that particular database. The increasing number of databases, difficulty in identifying an organism-specific standard for each database, the increased range of band sizes generated by the use of additional restriction endonucleases, and the maintenance of many different organism-specific strains encouraged us to search for a more versatile and universal DNA size marker. A Salmonella serotype Braenderup strain (H9812) was chosen as the universal size standard. This strain was subjected to rigorous testing in our laboratories to ensure that it met the desired criteria, including coverage of a wide range of DNA fragment sizes, even distribution of bands, and stability of the PFGE pattern. The strategy used to convert and compare data generated by the new and old reference standards is described. PMID:15750058

The application of polymerized porcine hemoglobin (pPolyHb) in the rat small bowel preservation.

PubMed

Huang, He; Ma, Jun; Zhu, Wenjin; Sun, Jinghui; Yan, Kunping; Song, Bo; Xue, Yuejin; Xin, Jianguo; Pan, Wencan; Zhu, Hongli; Chen, Chao

2014-10-01

Small bowel transplantation (SBTx) has become a standard clinical treatment for short bowel syndrome or irreversible intestinal function failure. Optimum preservation of the organ is essential for the success of transplantation. In this study, pPolyHb was used as an additive to hypertonic citrate adenine solution (HCA) to provide oxygen for rat small bowel transplant. Rat small bowels were preserved in HCA, HCA with pPolyHb, and University of Wisconsin solution (UW) for 12, 24, and 36 h, respectively. The results suggested that the preservation effect of HCA with pPolyHb was comparable with the UW solution, and more effective than the HCA solution.

Surface Dielectric Barrier Discharge Jet for Skin Disinfection

NASA Astrophysics Data System (ADS)

Creyghton, Yves; Meijer, Rogier; Verweij, Paul; van der Zanden, Frank; Leenders, Paul

A consortium consisting of the research institute TNO, the medical ­university and hospital St Radboud and two industrial enterprises is working on a non-thermal plasma treatment method for hand disinfection. The group is seeking for cooperation, in particular in the field of validation methods and potential ­standardization for plasma based disinfection procedures. The present paper describes technical progress in plasma source development together with initial microbiological data. Particular properties of the sheet shaped plasma volume are the possibility of treating large irregular surfaces in a short period of time, effective plasma produced species transfer to the surface together with high controllability of the nature of plasma species by means of temperature conditioning.

Gliomatosis cerebri: A consensus summary report from the First International Gliomatosis cerebri Group Meeting, March 26-27, 2015, Paris, France.

PubMed

Greenfield, Jeffrey P; Castañeda Heredia, Alicia; George, Emilie; Kieran, Mark W; Morales La Madrid, Andres

2016-12-01

Gliomatosis cerebri (GC) is a universally fatal extensive and diffuse infiltration of brain parenchyma by a glial tumor. Many aspects of this phenomenon remain unknown. The First International Gliomatosis cerebri Group Meeting had the following goals: refine the clinical and radiologic diagnostic criteria for GC, suggest appropriate diagnostic procedures, standardize tissue manipulation for histologic and molecular characterization, and prioritize relevant preclinical projects. Also, general treatment recommendations were outlined for the pediatric population. Importantly, this meeting was the starting point for meaningful collaborative international research projects. This review is a consensus summary of discussions shared and conclusions derived from this meeting. © 2016 Wiley Periodicals, Inc.

Education Technology Standards Self-Efficacy (ETSSE) Scale: A Validity and Reliability Study

ERIC Educational Resources Information Center

Simsek, Omer; Yazar, Taha

2016-01-01

Problem Statement: The educational technology standards for teachers set by the International Society for Technology in Education (the ISTE Standards-T) represent an important framework for using technology effectively in teaching and learning processes. These standards are widely used by universities, educational institutions, and schools. The…

Technology and Technique Standards for Camera-Acquired Digital Dermatologic Images: A Systematic Review.

PubMed

Quigley, Elizabeth A; Tokay, Barbara A; Jewell, Sarah T; Marchetti, Michael A; Halpern, Allan C

2015-08-01

Photographs are invaluable dermatologic diagnostic, management, research, teaching, and documentation tools. Digital Imaging and Communications in Medicine (DICOM) standards exist for many types of digital medical images, but there are no DICOM standards for camera-acquired dermatologic images to date. To identify and describe existing or proposed technology and technique standards for camera-acquired dermatologic images in the scientific literature. Systematic searches of the PubMed, EMBASE, and Cochrane databases were performed in January 2013 using photography and digital imaging, standardization, and medical specialty and medical illustration search terms and augmented by a gray literature search of 14 websites using Google. Two reviewers independently screened titles of 7371 unique publications, followed by 3 sequential full-text reviews, leading to the selection of 49 publications with the most recent (1985-2013) or detailed description of technology or technique standards related to the acquisition or use of images of skin disease (or related conditions). No universally accepted existing technology or technique standards for camera-based digital images in dermatology were identified. Recommendations are summarized for technology imaging standards, including spatial resolution, color resolution, reproduction (magnification) ratios, postacquisition image processing, color calibration, compression, output, archiving and storage, and security during storage and transmission. Recommendations are also summarized for technique imaging standards, including environmental conditions (lighting, background, and camera position), patient pose and standard view sets, and patient consent, privacy, and confidentiality. Proposed standards for specific-use cases in total body photography, teledermatology, and dermoscopy are described. The literature is replete with descriptions of obtaining photographs of skin disease, but universal imaging standards have not been developed, validated, and adopted to date. Dermatologic imaging is evolving without defined standards for camera-acquired images, leading to variable image quality and limited exchangeability. The development and adoption of universal technology and technique standards may first emerge in scenarios when image use is most associated with a defined clinical benefit.

Does Extended Pre Quit Bupropion Aid in Extinguishing Smoking Behavior?

PubMed

Hawk, Larry W; Ashare, Rebecca L; Rhodes, Jessica D; Oliver, Jason A; Cummings, Kenneth Michael; Mahoney, Martin C

2015-11-01

Understanding the mechanisms by which bupropion promotes smoking cessation may lead to more effective treatment. To the extent that reduced smoking reinforcement is one such mechanism, a longer duration of pre quit bupropion treatment should promote extinction of smoking behavior. We evaluated whether 4 weeks of pre quit bupropion (extended run-in) results in greater pre quit reductions in smoking rate and cotinine and, secondarily, greater short-term abstinence, than standard 1 week of pre quit bupropion (standard run-in). Adult smokers (n = 95; 48 females) were randomized to a standard run-in group (n = 48; 3-week placebo, then 1-week bupropion pre quit) or an extended run-in group (4-week pre quit bupropion; n = 47). Both groups received group behavioral counseling and 7 weeks of post quit bupropion. Smoking rate (and craving, withdrawal, and subjective effects) was collected daily during the pre quit period; biochemical data (cotinine and carbon monoxide) were collected at study visits. During the pre quit period, the extended run-in group exhibited a greater decrease in smoking rate, compared to the standard run-in group, interaction p = .03. Cigarette craving and salivary cotinine followed a similar pattern, though the latter was evident only among women. Biochemically verified 4-week continuous abstinence rates were higher in the extended run-in group (53%) than the standard run-in group (31%), p = .033. The extended use of bupropion prior to a quit attempt reduces smoking behavior during the pre quit period and improved short-term abstinence rates. The data are consistent with an extinction-of-reinforcement model and support further investigation of extended run-in bupropion therapy for smoking cessation. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Universal Design in Postsecondary Education: Process, Principles, and Applications

ERIC Educational Resources Information Center

Burgstahler, Sheryl

2009-01-01

Designing any product or environment involves the consideration of many factors, including aesthetics, engineering options, environmental issues, safety concerns, industry standards, and cost. Typically, designers focus their attention on the average user. In contrast, universal design (UD), according to the Center for Universal Design, "is…

40 CFR 262.100 - To what organizations does this subpart apply?

Code of Federal Regulations, 2012 CFR

2012-07-01

...: (a) It is one of the three following academic institutions: The University of Massachusetts Boston in... Burlington, Vermont (“Universities”); and (b) It is a laboratory at one of the Universities (identified... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University...

40 CFR 262.100 - To what organizations does this subpart apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

...: (a) It is one of the three following academic institutions: The University of Massachusetts Boston in... Burlington, Vermont (“Universities”); and (b) It is a laboratory at one of the Universities (identified... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University...

40 CFR 262.100 - To what organizations does this subpart apply?

Code of Federal Regulations, 2014 CFR

2014-07-01

...: (a) It is one of the three following academic institutions: The University of Massachusetts Boston in... Burlington, Vermont (“Universities”); and (b) It is a laboratory at one of the Universities (identified... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University...

40 CFR 262.106 - When must a hazardous waste determination be made?

Code of Federal Regulations, 2013 CFR

2013-07-01

... this point each University must determine whether the laboratory waste will be reused or whether it... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University... accumulation area, each University must evaluate the laboratory wastes to determine whether they are solid...

40 CFR 262.102 - What special definitions are included in this subpart?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University... particularly hazardous substances as designated in a University's Chemical Hygiene Plan under OSHA, or... Management Plan (EMP) means a written program developed and implemented by the university which sets forth...

40 CFR 262.100 - To what organizations does this subpart apply?

Code of Federal Regulations, 2011 CFR

2011-07-01

...: (a) It is one of the three following academic institutions: The University of Massachusetts Boston in... Burlington, Vermont (“Universities”); and (b) It is a laboratory at one of the Universities (identified... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University...

40 CFR 262.106 - When must a hazardous waste determination be made?

Code of Federal Regulations, 2014 CFR

2014-07-01

... this point each University must determine whether the laboratory waste will be reused or whether it... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University... accumulation area, each University must evaluate the laboratory wastes to determine whether they are solid...

40 CFR 262.100 - To what organizations does this subpart apply?

Code of Federal Regulations, 2013 CFR

2013-07-01

...: (a) It is one of the three following academic institutions: The University of Massachusetts Boston in... Burlington, Vermont (“Universities”); and (b) It is a laboratory at one of the Universities (identified... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University...

40 CFR 262.106 - When must a hazardous waste determination be made?

Code of Federal Regulations, 2012 CFR

2012-07-01

... this point each University must determine whether the laboratory waste will be reused or whether it... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University... accumulation area, each University must evaluate the laboratory wastes to determine whether they are solid...

40 CFR 262.106 - When must a hazardous waste determination be made?

Code of Federal Regulations, 2011 CFR

2011-07-01

... this point each University must determine whether the laboratory waste will be reused or whether it... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University... accumulation area, each University must evaluate the laboratory wastes to determine whether they are solid...

40 CFR 262.106 - When must a hazardous waste determination be made?

Code of Federal Regulations, 2010 CFR

2010-07-01

... this point each University must determine whether the laboratory waste will be reused or whether it... (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University... accumulation area, each University must evaluate the laboratory wastes to determine whether they are solid...

40 CFR 262.104 - What are the minimum performance criteria?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories... criteria? The Minimum Performance Criteria that each University must meet in managing its Laboratory Waste are: (a) Each University must label all laboratory waste with the general hazard class and either the...

40 CFR 262.104 - What are the minimum performance criteria?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories... criteria? The Minimum Performance Criteria that each University must meet in managing its Laboratory Waste are: (a) Each University must label all laboratory waste with the general hazard class and either the...

40 CFR 262.104 - What are the minimum performance criteria?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories... criteria? The Minimum Performance Criteria that each University must meet in managing its Laboratory Waste are: (a) Each University must label all laboratory waste with the general hazard class and either the...

A Case Study on Undergraduate Entrepreneurial Constructivist Learning in Morocco

ERIC Educational Resources Information Center

Benamar, Said

2016-01-01

Jobs are available for university graduates with entrepreneurship skills, but unemployment in Morocco persists because of the dissociation between university entrepreneurship graduate skills and professional market demand. While university graduates have achieved academic standards, they have lacked the entrepreneurial attributes to be employable.…

An Interdisciplinary University-Based Initiative for Graduate Training in Evidence-Based Treatments for Children's Mental Health

ERIC Educational Resources Information Center

Kerns, Suzanne E. U.; Cevasco, Molly; Comtois, Katherine A.; Dorsey, Shannon; King, Kevin; McMahon, Robert; Sedlar, Georganna; Lee, Terry G.; Mazza, James J.; Lengua, Liliana; Davis, Carol; Evans-Campbell, Tessa; Trupin, Eric W.

2016-01-01

States and jurisdictions are under increased pressure to demonstrate the use of evidence-based treatments (EBTs) for children's mental health, increasing the demand for a workforce trained in these practices. Universities are a critical pipeline for this workforce. This article describes the genesis and evolution of a university-based initiative…

Surgical Management of Supratentorial Intracerebral Hemorrhages: Endoscopic Versus Open Surgery.

PubMed

Eroglu, Umit; Kahilogullari, Gokmen; Dogan, Ihsan; Yakar, Fatih; Al-Beyati, Eyyub S M; Ozgural, Onur; Cohen-Gadol, Aaron A; Ugur, Hasan Caglar

2018-06-01

Intracerebral hemorrhage continues to be a major global problem. No standard treatment or surgical procedure has been identified for intracerebral hemorrhages. High morbidity and mortality rates caused by conventional approaches and the disease itself have necessitated more-invasive treatment methods. The endoscopic approach is a more minimally invasive method than craniotomy, which is another alternative surgical treatment. We compared intracerebral hematoma drainage in 2 groups of 17 patients each, treated with minimally invasive endoscopic method versus craniotomy. All the patients were treated for supratentorial spontaneous hemorrhage between December 2013 and February 2017 at the Neurosurgery Clinic of Ankara University Faculty of Medicine. We retrospectively evaluated 34 patients surgically treated between December 2013 and February 2017. All patients underwent surgery within the first 24 hours. Patients in the early surgery group had better surgical outcomes. In the neuroendoscopic group, Glasgow Coma Scale increased from 6 to 11 at 1 week postoperatively compared with 5 to 9 in the craniotomy group. Minimally invasive endoscopic hematoma evacuation may be a good alternative surgical method for treating supratentorial spontaneous cerebral hematomas. Copyright © 2018 Elsevier Inc. All rights reserved.

Modeling microenvironmental regulation of glioblastoma stem cells: a biomaterials perspective

NASA Astrophysics Data System (ADS)

Heffernan, John M.; Sirianni, Rachael W.

2018-02-01

Following diagnosis of a glioblastoma (GBM) brain tumor, surgical resection, chemotherapy and radiation together yield a median patient survival of only 15 months. Importantly, standard treatments fail to address the dynamic regulation of the brain tumor microenvironment that actively supports tumor progression and treatment resistance. It is becoming increasingly recognized that specialized niches within the tumor microenvironment maintain a population of highly malignant glioblastoma stem-like cells (GSCs). GSCs are resistant to traditional chemotherapy and radiation therapy, suggesting that they may be responsible for the near universal rates of tumor recurrence and associated morbidity in GBM. Thus, disrupting microenvironmental support for GSCs could be critical to developing more effective GBM therapies. Three-dimensional (3D) culture models of the tumor microenvironment are powerful tools for identifying key biochemical and biophysical inputs that impact malignant behaviors. Such systems have been used effectively to identify conditions that regulate GSC proliferation, invasion, stem-specific phenotypes, and treatment resistance. Considering the significant role that GSC microenvironments play in regulating this tumorigenic sub-population, these models may be essential for uncovering mechanisms that limit GSCs malignancy.

Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

PubMed Central

López-Liria, Remedios; Padilla-Góngora, David; Catalan-Matamoros, Daniel; Rocamora-Pérez, Patricia; Pérez-de la Cruz, Sagrario; Fernández-Sánchez, Manuel

2015-01-01

Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients' functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The groups did not significantly differ in the leg side (right/left) or clinical characteristics (P > 0.05). After the intervention, both groups showed significant improvements (P < 0.001) from the baseline values in the level of pain (visual analogue scale), the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices), balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective. PMID:25961017

[Diagnostics and treatment decisions in acute compartment syndrome. Results of a survey in German hospitals].

PubMed

Sellei, R M; Andruszkow, H; Weber, C; Damen, T O; Pape, H-C; Hildebrand, F

2016-02-01

The presented survey was intended to evaluate whether a standardization of diagnostics and therapy for acute compartment syndrome has been achieved. University hospitals, academic teaching hospitals, and county hospitals in Germany were included. A total of 38% (n=120) of all contacted hospitals participated in this study with questions mainly answered by consulting physicians (68%). In general the importance of the clinical examination was considered as being more important than other diagnostic measures. In cases where further diagnostics were necessary, the intramuscular pressure measurement was used most frequently. Of the participants 50% performed surgical fasciotomy based on the clinical examination in combination with the intramuscular pressure measurement; however, there were considerable differences between the participating hospitals with respect to the anatomical position of intramuscular measurements, the limiting value of the intramuscular pressure and the surgical technique for performing fasciotomy. According to the presented analysis the diagnosis and indications for surgical treatment in patients developing an acute compartment syndrome do not seem to be sufficiently clarified. The establishment of unified treatment guidelines could help to reduce the number of delayed diagnoses of compartment syndrome.

Evaluation of an outpatient protocol in the treatment of canine parvoviral enteritis.

PubMed

Venn, Emilee C; Preisner, Karolina; Boscan, Pedro L; Twedt, David C; Sullivan, Lauren A

2017-01-01

To compare 2 treatment protocols (standard in-hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. Prospective, randomized study. University teaching hospital. Client-owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission. Following stabilization, basic inpatient interventions included administration of IV fluids, administration of cefoxitin (22 mg/kg IV q 8 h), and maropitant (1 mg/kg IV q 24 h). Basic outpatient interventions (provided in-hospital) included administration of subcutaneous (SC) fluid (30 mL/kg q 6 h), administration of maropitant (1 mg/kg SC q 24 h) and cefovecin (8 mg/kg SC once). Using daily electrolyte and glucose evaluations, dextrose and potassium supplementation was provided intravenously (inpatients) or orally (outpatients) as indicated. Rescue criteria were used in both groups for analgesia and nausea. All dogs were syringe fed a commercial canine convalescence diet (1 mL/kg PO q 6 h) until voluntary appetite returned. Protocol success, defined as survival to hospital discharge, was 90% (18/20) for the inpatient group compared to 80% (16/20) for the outpatient group (P = 0.66). There was no difference detected in duration of hospitalization for inpatient dogs (4.6 ± 2 days) versus outpatient dogs (3.8 ± 1.8 days, P = 0.20). Metabolic disturbances were frequent in the outpatient group, with 50% of dogs requiring dextrose supplementation and 60% of dogs requiring potassium supplementation. An outpatient protocol may be a reasonable alternative for dogs that cannot receive standard in-hospital treatment for parvoviral enteritis. Diligent supportive care and monitoring are still required to optimize treatment of dogs with parvoviral enteritis in an outpatient setting. © Veterinary Emergency and Critical Care Society 2016.

Origins and Missions of Two Early Land-Grant Colleges: Georgetown University and George Washington University. ASHE Annual Meeting 1980 Paper.

ERIC Educational Resources Information Center

Quigley, Martin S.

The founding and missions of Georgetown University and George Washington University, two early land-grant colleges, are considered. The account is based partially on standard histories of the colleges, and other information comes from Congressional Records. Some understanding of why Congress took an interest in the founding and survival of…

Are Residents Losing Their Edge in Public University Admissions? The Case at the University of Washington. Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Blume, Grant; Roza, Marguerite

2012-01-01

This case study examines admissions data at the University of Washington (UW) in order to quantify the effect on admissions standards for residents versus nonresidents. Like many other state flagship universities, the UW has suffered from constrained state revenues during the recent recessionary years. The findings suggest that Washington…

Dark Energy and Dark Matter Hidden in the Geometry of Space?

NASA Astrophysics Data System (ADS)

Buchert, Thomas

A spatially flat and infinite Universe in the form of a "concordant" standard model of cosmology rules present-day thinking of cosmologists. The price to pay is an unknown physical origin of Dark Energy and Dark Matter that are supposed to exist and even appear to rule the dynamics of our Universe. A growing number of cosmologists question the existence of dark constituents: the standard model of cosmology may be just too simple, since it neglects the influence of structure in the Universe on its global expansion history. The key-issue appears to be the curvature of space: the formation of structure interacts with the geometry of space, changing our global picture of the Universe. This chapter explains the underlying mechanism that works in the right direction to uncover the dark faces of the standard model of cosmology. If successful, this novel approach furnishes a new paradigm of modern cosmology. Hundreds of researchers have recently embarked into studies of this new subject. We understand much at present, but there are many open questions.

Satisfaction of undergraduate students at University of Jordan after root canal treatment of posterior teeth using rotary or hand preparation.

PubMed

Abu-Tahun, Ibrahim; El-Ma'aita, Ahmad; Khraisat, Ameen

2016-08-01

The aim of this study was to report the satisfaction of fifth year undergraduate students on the clinical use of rotary endodontic preparation compared with stainless steel standard technique and to evaluate the impact of rotary nickel-titanium instruments on undergraduate teaching. This study was carried out by the fifth year undergraduate students attending peer review sessions as a part of their training program using a questionnaire to assess their satisfaction with these two techniques. The overall results indicated a statistically significant satisfaction of the undergraduate students with the use of the nickel-titanium system (P < 0.001) compared to stainless steel standard technique. Under the conditions of this study, the results showed a positive acceptance and consensus among novice dental students regarding the use of ProTaper rotary files and the need for undergraduate teaching of rotary nickel-titanium systems in Jordan. © 2015 Australian Society of Endodontology Inc.

Screening and syndromic approaches to identify gonorrhea and chlamydial infection among women.

PubMed

Sloan, N L; Winikoff, B; Haberland, N; Coggins, C; Elias, C

2000-03-01

The standard diagnostic tools to identify sexually transmitted infections are often expensive and have laboratory and infrastructure requirements that make them unavailable to family planning and primary health-care clinics in developing countries. Therefore, inexpensive, accessible tools that rely on symptoms, signs, and/or risk factors have been developed to identify and treat reproductive tract infections without the need for laboratory diagnostics. Studies were reviewed that used standard diagnostic tests to identify gonorrhea and cervical chlamydial infection among women and that provided adequate information about the usefulness of the tools for screening. Aggregation of the studies' results suggest that risk factors, algorithms, and risk scoring for syndromic management are poor indicators of gonorrhea and chlamydial infection in samples of both low and high prevalence and, consequently, are not effective mechanisms with which to identify or manage these conditions. The development and evaluation of other approaches to identify gonorrhea and chlamydial infections, including inexpensive and simple laboratory screening tools, periodic universal treatment, and other alternatives must be given priority.

Multi-level Monte Carlo Methods for Efficient Simulation of Coulomb Collisions

NASA Astrophysics Data System (ADS)

Ricketson, Lee

2013-10-01

We discuss the use of multi-level Monte Carlo (MLMC) schemes--originally introduced by Giles for financial applications--for the efficient simulation of Coulomb collisions in the Fokker-Planck limit. The scheme is based on a Langevin treatment of collisions, and reduces the computational cost of achieving a RMS error scaling as ɛ from O (ɛ-3) --for standard Langevin methods and binary collision algorithms--to the theoretically optimal scaling O (ɛ-2) for the Milstein discretization, and to O (ɛ-2 (logɛ)2) with the simpler Euler-Maruyama discretization. In practice, this speeds up simulation by factors up to 100. We summarize standard MLMC schemes, describe some tricks for achieving the optimal scaling, present results from a test problem, and discuss the method's range of applicability. This work was performed under the auspices of the U.S. DOE by the University of California, Los Angeles, under grant DE-FG02-05ER25710, and by LLNL under contract DE-AC52-07NA27344.

Colposcopy audit for improving quality of service in areas with a high incidence of cervical cancer.

PubMed

Manopunya, Manatsawee; Suprasert, Prapaporn; Srisomboon, Jatupol; Kietpeerakool, Chumnan

2010-01-01

To audit routine colposcopy performance using 8 standard requirements of the National Health Service Cervical Screening Programme (NHSCSP). Records of women who underwent colposcopy for abnormal cervical cytology between January and December 2008 at Chiang Mai University Hospital, Thailand, were reviewed. The standard requirements were not achieved in 2 practices: (1) the proportion of women who had recordings of visibility of the transformation zone (96.6%) did not achieve the NHSCSP requirement of 100%; and (2) the rate of excisional biopsy (87.8%) was lower than the 95% minimum required. Colposcopic performance at Chiang Mai University Hospital was generally favorable. However, re-audit is necessary to ensure that unmet standards of performance are improved and achieved standards are maintained.

Developing Partnerships in the Provision of Youth Mental Health Services and Clinical Education: A School-Based Cognitive Behavioral Intervention Targeting Anxiety Symptoms in Children.

PubMed

Waters, Allison M; Groth, Trisha A; Sanders, Mary; O'Brien, Rosanne; Zimmer-Gembeck, Melanie J

2015-11-01

Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5 children's anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate students. Children in the active condition (N=74) completed the CBI during regular class time, while children in the control condition (N=77) received the standard classroom curriculum. Children's anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12 months after the CBI (n=76), symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education. Copyright © 2015. Published by Elsevier Ltd.

Impact of fumaric acid esters on cardiovascular risk factors and depression in psoriasis: a prospective pilot study.

PubMed

Schmieder, Astrid; Poppe, Manuel; Hametner, Christian; Meyer-Schraml, Hanna; Schaarschmidt, Marthe-Lisa; Findeisen, Peter; Benoit, Sandrine; Bauer, Boris; Schmid, Sybille; Goebeler, Matthias; Goerdt, Sergij; Ludwig-Peitsch, Wiebke K

2015-07-01

Patients with psoriasis have an increased risk of cardiovascular disease that is partly attributable to chronic systemic inflammation. The aim of our prospective pilot study was to investigate the impact of fumaric acid esters (FAE), a first-line systemic antipsoriatic treatment in Germany, on cardiovascular risk parameters. Participants with moderate-to-severe psoriasis from the University Medical Center Mannheim and the University Hospital Würzburg were treated with FAE for 16 weeks according to standard dosage recommendations. Disease severity, life quality and depression scores as well as biomarkers of inflammation, lipid and glucose metabolism were assessed prior to initiation of FAE and after 16 weeks. Out of 39 participants recruited, 27 completed the study. 44% of all participants and 63% of those completing the 16-week treatment achieved PASI 50 response and 27 or 37% PASI 75 response. Clinical improvement was paralleled by significant improvement in quality of life, high treatment satisfaction and significant reduction of depressive symptoms. Adverse events, most frequently mild gastrointestinal complaints, flush and lymphocytopenia occurred in 89%. FAE did not modify glucose metabolism or inflammatory parameters substantially. However, a highly significant increase in serum levels of the atheroprotective cytokine adiponectin was noted after 16 weeks (median 4.7 vs. 8.9 µg/ml; p = 0.0002). Our study demonstrates a significant beneficial impact of FAE on adiponectin, indicating a potential cardioprotective effect. It will be interesting to verify this finding in larger cohorts and to assess the long-term influence of FAE on cardiovascular risk and disease.

[Management of eyelid carcinomas: Retrospective bicentric study of 64 cases and review of the literature].

PubMed

Echchaoui, A; Benyachou, M; Houssa, A; Kajout, M; Oufkir, A A; Hajji, C; Daoudi, R; Hafidi, J; El Mazouz, S; Gharib, N; Abbassi, A

2016-02-01

To study the epidemiologic, clinical and histological aspects of eyelid carcinomas in our context, and to evaluate our surgical management on an oncological, functional and aesthetic level. This work is a retrospective bicentric study extended over a 5-year period between January 2009 and December 2013, including 64 patients with eyelid carcinoma undergoing surgery in the Plastic and Reconstructive Surgery Department at the Avicenne University Hospital of Rabat and in the ENT/Head and Neck Surgery Department at the Hassan II University Hospital of Fez. The study included 25 men and 39 women with a mean age of 60.6 ± 15.33 years. Advanced age and chronic sun exposure were the most important risk factors. The most commonly involved site was the lower eyelid (53%). Histological examination emphasized the very high prevalence of basal cell carcinoma (90.62%). Surgical treatment was performed in all our patients followed by an extemporaneous and/or standard histological examination of the surgical specimen. Exenteration was performed in one patient with adjuvant radiation therapy. Reconstruction incorporated a variety of techniques, of which total skin graft and Mustardé flap were the most common in our series. Aside from a few complications, the postoperative results were satisfactory for the majority of our patients. Malignant tumors of the eyelids, of which basal cell carcinoma is the most common, pose a therapeutic problem where surgery remains the most utilized treatment option. The best treatment is prevention and diagnosis of early lesions to improve prognosis and to avoid worse outcomes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Cold plasma treatment in wound care: efficacy and risk assessment

NASA Astrophysics Data System (ADS)

Stoffels, Eva

2007-10-01

Cold atmospheric plasma is an ideal medium for non-destructive modification of vulnerable surfaces. One of the most promising medical applications of cold plasma treatment is wound healing. Potential advantages in wound healing have been demonstrated in vitro: the plasma does not necrotize the cells and does not affect the extracellular matrix [1], has clear bactericidal or bacteriostatic effects [2], and stimulates fibroblast cells towards faster attachment and proliferation [3]. However, safety issues, such as the potential cytotoxicity of the plasma must be clarified prior to clinical implementation. This work comprises the recent facts on sub-lethal plasma effects on mammalian cells, as well as studies on apoptosis induction and quantitative assessment of DNA damage. Fibroblast, smooth muscle and endothelial cells were treated using the standard cold plasma needle [1,2]; intra- and extracellular oxidant levels as well as the influence of the plasma on intracellular antioxidant balance were monitored using appropriate fluorescent markers [1]. We have studied long-term cellular damage was monitored using flow cytometry to determine the DNA profiles in treated cells. Dose-response curves were obtained: increased proliferation as well as apoptosis were visualized under different treatment conditions. The results from the in vitro studies are satisfying. [1] I.E. Kieft, ``Plasma needle: exploring biomedical applications of non-thermal plasmas'', PhD Thesis, Eindhoven University of Technology (2005). [2] R.E.J. Sladek, ``Plasma needle: non-thermal atmospheric plasmas in dentistry'' PhD Thesis, Eindhoven University of Technology (2006). [3] I.E. Kieft, D. Darios, A.J.M. Roks, E. Stoffels, IEEE Trans. Plasma Sci. 34(4), 2006, pp. 1331-1336.

Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study.

PubMed

Millar, Kathryn R; McCutcheon, Jennifer; Coakley, Eugenie H; Brieger, William; Ibrahim, Mohammed A; Mohammed, Zainab; Bassi, Amos; Sambisa, William

2014-11-21

Despite recent improvements in malaria prevention strategies, malaria case management remains a weakness in Northern Nigeria, which is underserved and suffers the country's highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria's National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity. A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment. Overall, 76.7% of children were brought to treatment-45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7-59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months. Northern Nigeria's coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.

Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders.

PubMed

Evrensel, Alper; Ceylan, Mehmet Emin

2016-08-31

Fecal microbiota transplantation has a 1700-year history. This forgotten treatment method has been put into use again during the last 50 years. The interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. New evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. There is a large number of experimental and clinical researches in the field of gut-brain axis. There is limited information on fecal microbiota transplantation. Despite this, initial results are promising. It is commonly used in the treatment of gastrointestinal diseases such as Clostridium difficile infection, Crohn's disease, ulcerative colitis. It is also experimentally used in the treatment of metabolic and autoimmune diseases. There are case reports that it is effective in the treatment of autism, Parkinson's disease, multiple sclerosis, chronic fatigue syndrome and irritable bowel syndrome. Its implementation is easy, and it is a cheap and reliable treatment method. However, the long-term risks are unknown. Additionally, standard application protocols have not yet been established. There are a lot of questions to be answered. A university in Turkey has got official permission this year, and started to apply fecal microbiota transplantation. In this review, neuropsychiatric areas of use of fecal microbiota transplantation have been discussed in the light of the current information.

Transrectal Ultra Sonography based evidence of Ksharasutra therapy for Fistula-in-ano - A case series.

PubMed

Nema, Aditya; Gupta, Sanjay Kumar; Dudhamal, Tukaram S; Mahanta, Vyasadeva

Ksharasutra (parasurgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara, (fistula in ano), and generally difficult to treat. In this case series, standard Ksharasutra was prepared as per the Ayurvedic Pharmacopeia of India and used to treat the different cases of Bhagandara. In this case series total 6 patients of Bhagandara were treated with Ksharasutra and partial fistulectomy. The average Unit Cutting Time and healing (UCTH) was observed 7.86 days/cm. During treatment Panchawalkala Kwatha (decoction of five medicinal plant's bark), Shatdhautaghrita, Jatyaditaila and Erandabhrishtaharitaki Churna were used as adjuvant drugs. To generate quality evidence Transrectal Ultra Sonography (TRUS) was used in pre as well as post-treatment and showed remarkable tool to assess effect of treatment. Substantial clinical result was observed at the end of treatment and all the patients were free of fistula. No recurrence was observed in any case during the 12 follow up of 12 months. The treatment was reported safe and well tolerated in all the patients. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

Chemoradiotherapy for esophageal squamous cell cancer.

PubMed

Sasaki, Yusuke; Kato, Ken

2016-09-01

Chemoradiotherapy has been clinically indicated for patients with resectable esophageal squamous cell carcinoma who refuse surgical resection and in locally advanced unresectable esophageal squamous cell carcinoma patients. Concurrent chemoradiotherapy prolongs survival than radiation therapy alone when given as definitive treatment. Therefore, chemoradiotherapy is recognized as the standard non-invasive treatment for patients with localized esophageal cancer who opt for non-surgical treatment. JCOG9906 showed promising outcomes for stage II/III ESCC patients. But there are some problems about chemoradiotherapy for esophageal squamous cell carcinoma. Late toxicities are sometimes lethal for patients who achieved complete response even after years. Salvage treatment for residual or recurrent disease is unestablished. Modified Radiation Therapy Oncology Group regimen at the dose of 50.4 Gy reduced late toxicities without reducing efficacy. Optimal timings and procedure of salvage surgery and endoscopic therapy is evaluated in JCOG0909. Strategy including salvage therapy after chemoradiotherapy should be considered at the time of starting the treatment. Targeted therapy has not shown adding effect for chemoradiotherapy for esophageal squamous cell carcinoma yet. New agents, such as immune checkpoint inhibitors, are expected to show synergistic effect with chemoradiotherapy for esophageal squamous cell carcinoma. Further investigation is needed. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

40 CFR 268.46 - Alternative treatment standards based on HTMR.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Alternative treatment standards based on HTMR. 268.46 Section 268.46 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Treatment Standards § 268.46 Alternative treatment...

The occurrence of benign brain tumours in transgender individuals during cross-sex hormone treatment.

PubMed

Nota, Nienke M; Wiepjes, Chantal M; de Blok, Christel J M; Gooren, Louis J G; Peerdeman, Saskia M; Kreukels, Baudewijntje P C; den Heijer, Martin

2018-04-23

Benign brain tumours may be hormone sensitive. To induce physical characteristics of the desired gender, transgender individuals often receive cross-sex hormone treatment, sometimes in higher doses than hypogonadal individuals. To date, long-term (side) effects of cross-sex hormone treatment are largely unknown. In the present retrospective chart study we aimed to compare the incidence of common benign brain tumours: meningiomas, pituitary adenomas (non-secretive and secretive), and vestibular schwannomas in transgender individuals receiving cross-sex hormone treatment, with those reported in general Dutch or European populations. This study was performed at the VU University Medical Centre in the Netherlands and consisted of 2555 transwomen (median age at start of cross-sex hormone treatment: 31 years, interquartile range 23-41) and 1373 transmen (median age 23 years, interquartile range 18-31) who were followed for 23 935 and 11 212 person-years, respectively. For each separate brain tumour, standardized incidence ratios with 95% confidence intervals were calculated. In transwomen (male sex assigned at birth, female gender identity), eight meningiomas, one non-secretive pituitary adenoma, nine prolactinomas, and two vestibular schwannomas occurred. The incidence of meningiomas was higher in transwomen than in a general European female population (standardized incidence ratio 4.1, 95% confidence interval 1.9-7.7) and male population (11.9, 5.5-22.7). Similar to meningiomas, prolactinomas occurred more often in transwomen compared to general Dutch females (4.3, 2.1-7.9) and males (26.5, 12.9-48.6). Noteworthy, most transwomen had received orchiectomy but still used the progestogenic anti-androgen cyproterone acetate at time of diagnosis. In transmen (female sex assigned at birth, male gender identity), two cases of somatotrophinomas were observed, which was higher than expected based on the reported incidence rate in a general European population (incidence rate females = incidence rate males; standardized incidence ratio 22.2, 3.7-73.4). Based on our results we conclude that cross-sex hormone treatment is associated with a higher risk of meningiomas and prolactinomas in transwomen, which may be linked to cyproterone acetate usage, and somatotrophinomas in transmen. Because these conditions are quite rare, performing regular screenings for such tumours (e.g. regular prolactin measurements for identifying prolactinomas) seems not necessary.

[Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital].

PubMed

Knobe, M; Böttcher, B; Coburn, M; Friess, T; Bollheimer, L C; Heppner, H J; Werner, C J; Bach, J-P; Wollgarten, M; Poßelt, S; Bliemel, C; Bücking, B

2018-04-19

Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU). A comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model). In the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035). There was a clear tendency to a better overall result in patients receiving multidisciplinary orthogeriatric treatment using a ward visit model of orthogeriatric comanagement, with lower rates of cardiorespiratory complications and mortality. While special care pathways could reduce the rate of myocardial infarction in hip fracture patients, costs and revenues showed no difference between all care models evaluated. However, patients with hip fracture or periprosthetic fracture represent cohorts at clinical and economic risk as well.

The Human Microbiome Project (HMP) and the Data Analysis and Coordination Center (DAAC) Portal to the HMP (GSC8 Meeting)

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

Weinstock, George; Wortman, Jennifer

The Genomic Standards Consortium was formed in September 2005. It is an international, open-membership working body which promotes standardization in the description of genomes and the exchange and integration of genomic data. The 2009 meeting was an activity of a five-year funding Research Coordination Network from the National Science Foundation and was organized held at the DOE Joint Genome Institute with organizational support provided by the JGI and by the University of California - San Diego. George Weinstock from Washington University School of Medicine talks about the Human Microbiome Project (HMP) followed briefly by Jennifer Wortman from the University ofmore » Maryland School of Medicine on the Data Analysis and Coordination Center (DACC) portal to the HMP at the Genomic Standards Consortium's 8th meeting at the DOE JGI in Walnut Creek, CA on Sept. 9, 2009.« less

The Human Microbiome Project (HMP) and the Data Analysis and Coordination Center (DAAC) Portal to the HMP (GSC8 Meeting)

ScienceCinema

Weinstock, George; Wortman, Jennifer

2018-01-22

The Genomic Standards Consortium was formed in September 2005. It is an international, open-membership working body which promotes standardization in the description of genomes and the exchange and integration of genomic data. The 2009 meeting was an activity of a five-year funding Research Coordination Network from the National Science Foundation and was organized held at the DOE Joint Genome Institute with organizational support provided by the JGI and by the University of California - San Diego. George Weinstock from Washington University School of Medicine talks about the Human Microbiome Project (HMP) followed briefly by Jennifer Wortman from the University of Maryland School of Medicine on the Data Analysis and Coordination Center (DACC) portal to the HMP at the Genomic Standards Consortium's 8th meeting at the DOE JGI in Walnut Creek, CA on Sept. 9, 2009.

Performativity Double Standards and the Sexual Orientation Climate at a Southern Liberal Arts University.

PubMed

Byron, Reginald A; Lowe, Maria R; Billingsley, Brianna; Tuttle, Nathan

2017-01-01

This study employs quantitative and qualitative methods to examine how heterosexual, bisexual, and gay students rate and describe a Southern, religiously affiliated university's sexual orientation climate. Using qualitative data, queer theory, and the concept tyranny of sexualized spaces, we explain why non-heterosexual students have more negative perceptions of the university climate than heterosexual male students, in both bivariate and multivariate analyses. Although heterosexual students see few problems with the campus sexual orientation climate, bisexual men and women describe being challenged on the authenticity of their orientation, and lesbian and, to a greater extent, gay male students report harassment and exclusion in a number of settings. These distinct processes are influenced by broader heteronormative standards. We also shed much-needed light on how gendered sexual performativity double standards within an important campus microclimate (fraternity parties) contribute to creating a tyrannical sexualized space and negatively affect overall campus climate perceptions.

50 years of CP violation — What have we learned?

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

McKellar, Bruce H. J.

Early after the discovery of CP violation, the explanation of how the Standard Model of particle physics could allow CP violation was quickly given, but it took many years for the original observation to be unequivocally explained on that basis. It was also proposed that this observation opened up the possibility that we could now explain the fact that the universe is made of matter. Remarkably, 50 years later we have no evidence in particle physics that there is any CP violation except that of the Kobayashi Maskawa mechanism of the standard model. Yet we fail completely to explain themore » baryon asymmetry of the Universe through that mechanism. After reviewing the main points in the history I describe the present experimental attempts to find CP violation beyond the standard model, and explain the theoretical attempts to explain the matter in the Universe.« less

Evaluation of diabetes care management in primary clinics based on the guidelines of American Diabetes Association.

PubMed

Albarrak, Ahmed Ismail; Mohammed, Rafiuddin; Assery, Bushra; Allam, Dalya; Morit, Sarah Al; Saleh, Reem Al; Zare'a, Reem

2018-01-01

There is a rapid increase in the incidence of diabetes mellitus in Saudi Arabia. Diabetes management is an essential constituent to prevent prognosis of diabetes complications. The main objective of this study was to assess diabetes care in primary clinics based on the guidelines of American Diabetes Association (ADA). A retrospective study at King Khaled University Hospitals, Riyadh, Saudi Arabia. A total of 200 patients were randomly selected from the databases of primary care clinics. An evaluation checklist was created based on the ADA treatment guidelines such as medical history, physical examination, laboratory evaluation, and referrals. The result showed that elements achieving the ADA targets for overall care were medical history (44.9%), physical examination (59.6%), laboratory evaluation (36.3%), and referrals (19.3%). The other subelement indicators such as referral to diabetes self-management education clinics (10%), dental examination (2%), HbA1c regular monitoring (33.5%), and blood pressure determination (100%) were documented with adherence to ADA standards. Diabetes management standards are an essential element in the success of the management plan. Most of the elements examined are not in full compliance with the ADA standard. Continues monitoring and self-review are recommended.

An Exploratory Study of Thai University Students' Understanding of World Englishes

ERIC Educational Resources Information Center

Saengboon, Saksit

2015-01-01

This exploratory study investigated the perceptions of Thai university students towards World Englishes (WEs). One hundred and ninety-eight students from three universities in Bangkok were administered a questionnaire inquiring about definitions of WEs, the Kachruvian concentric circles, the concepts of standard and ownership of English, Thai…

The Effect of Relational Database Technology on Administrative Computing at Carnegie Mellon University.

ERIC Educational Resources Information Center

Golden, Cynthia; Eisenberger, Dorit

1990-01-01

Carnegie Mellon University's decision to standardize its administrative system development efforts on relational database technology and structured query language is discussed and its impact is examined in one of its larger, more widely used applications, the university information system. Advantages, new responsibilities, and challenges of the…

Global Corporations "R" Us? The Impacts of Globalisation on Australian Universities.

ERIC Educational Resources Information Center

Pratt, Graham; Poole, David

2000-01-01

Discusses the rise of entrepreneurialism in Australian universities as one response to globalization. Examines its positive and negative effects upon educational standards, academic morale, and structure of academic work. Highlights areas of fundamental change in the sector, including changes in university missions and culture and the uneven…

The Price of Power-Universities in America and New Zealand

ERIC Educational Resources Information Center

Flynn, James R.

1973-01-01

Explains some of the ills affecting universities in America and New Zealand, student alienation and unrest, the loss of morale on the part of staff, and the collapse of standards, by focusing on the social roles of the university and its interaction with the larger society. (Author)

`Universal' FitzGerald contractions

NASA Astrophysics Data System (ADS)

Gogberashvili, Merab

2009-09-01

The model of a universe with a preferred frame, which nevertheless shares the main properties with traditional special and general relativity theories, is considered. We adopt Mach’s interpretation of inertia and show that the energy balance equation, which includes the Machian energy of gravitational interactions with the universe, can imitate standard relativistic formulas.

Public University Responses to Academic Dishonesty: Disciplinary or Academic.

ERIC Educational Resources Information Center

Roberts, Robert N.

1986-01-01

Reviews court decisions in cases involving suspension or dismissal of public university students for academic dishonesty. The courts have required universities defending such suits to meet the procedural and due process standards for nonacademic disciplinary proceedings. Discusses the constitutional due process problems raised by the suspension or…

The Relative Merits of PBL (Problem-Based Learning) in University Education

ERIC Educational Resources Information Center

Benson, Steve

2012-01-01

In Australia, academic workloads are increasing, and university funding is decreasing. Academics and university managers are engaging in risk adverse behavior and tending to focus on customer satisfaction and student retention, potentially at the expense of academic standards. Conventional approaches to pedagogy minimize adverse student feedback,…

El Espanol como Idioma Universal (Spanish as a Universal Language)

ERIC Educational Resources Information Center

Mijares, Jose

1977-01-01

A proposal to transform Spanish into a universal language because it possesses the prerequisites: it is a living language, spoken in several countries; it is a natural language; and it uses the ordinary alphabet. Details on simplification and standardization are given. (Text is in Spanish.) (AMH)

Tutors for a University.

ERIC Educational Resources Information Center

Styler, W. E.

The pamphlet describes the system developed at Hull University for providing tutors for adult education, and analyzes the use of full-time and part-time tutors. These tutors are responsible for teaching courses, generally shorter in duration than a standard academic course, and geared for adults not in school rather than for university students.…

Wake Forest U. Joins Ranks of Test-Optional Colleges

ERIC Educational Resources Information Center

Hoover, Eric; Supiano, Beckie

2008-01-01

Wake Forest University will no longer require applicants to submit standardized test scores, the university announced last week. The move makes Wake Forest, in Winston-Salem, North Carolina, one of the most prominent institutions with a "test optional" admissions policy. The university's decision reveals the increasing complexity of the…

The Total Quality Initiative at South Bank University.

ERIC Educational Resources Information Center

Geddes, Tommy

1993-01-01

Application of the Total Quality Management approach to one aspect of the administration of South Bank University (England), the relationship between student as customer and university as supplier, is described. The technique includes development of service quality standards and agreements for each service, support, and academic department. (MSE)

Naturalness in the Standard Model and beyond

NASA Astrophysics Data System (ADS)

Papaioannou, Anastasios Yiannaki

After an introduction to the Standard Model of particle physics and the unresolved question of naturalness posed by its treatment of electroweak symmetry breaking, we consider several different theoretical approaches that attempt to answer this question. First, we present work in which we consider the possibility that the Higgs boson, the long-sought hypothetical particle intimately associated with electroweak symmetry breaking, has a much larger mass than is usually assumed. Absent direct experimental evidence for a light Higgs boson (m ˜ O (100 GeV)), and precision electroweak data consistent with a light Higgs notwithstanding, we propose a heavier (m ˜ O (500 GeV)), thus more natural, Higgs boson. This heavy Higgs can be made consistent with the precision electroweak data if we also extend the Standard Model via the inclusion of new fermionic states near the weak energy scale. These new states, in addition to bringing the heavy Higgs boson in line with the precision data, also serve as a candidate for the elusive dark matter that pervades the universe. From there we go on to consider the problem of naturalness from the perspective of supersymmetry, one of the most popular candidates for physics beyond the Standard Model. In particular, the theory of the Next-to-Minimal Supersymmetric Standard Model (NMSSM) has found favor in its ability to solve the problem of naturalness posed by the Standard Model, in its hints at unification of the strong, weak, and electromagnetic interactions at high energies, and in its ability to provide supersymmetric particles as dark matter candidates. The NMSSM, however, requires rather large superpartner masses in order to accommodate a Higgs boson heavier than current experimental bounds while still maintaining gauge unification at high energies. We explore the possibility of new supersymmetric states at intermediate energies between the weak scale and the unification scale, which preserve gauge unification and allow a heavier Higgs, with only moderately heavy superpartners. Finally, we explore the possibility that previous attempts to resolve the naturalness problem may be too limited in scope. Perhaps the anthropic principle can instead provide a new way to answer such questions. We consider the intriguing scenario in which our observed universe is but one region of a much larger multi-verse, and the "constants" of nature are not constant after all, but take on a range of values. The anthropic principle's unique answer to the problem of naturalness is that only those regions of the multiverse with unnatural or "fine-tuned" parameters can give rise to the physical processes and structures that are necessary for our very existence; those regions with more natural values are dead universes where life is impossible. In particular, we examine an implementation of a unified physical theory, the Minimal Supersymmetric Standard Model (MSSM), within this multi-verse framework, and its consequences for the naturalness of electroweak symmetry breaking.

Partial Treatment Requests and Underlying Motives of Applicants for Gender Affirming Interventions.

PubMed

Beek, Titia F; Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T; Steensma, Thomas D

2015-11-01

Historically, only individuals with a cross-gender identity who wanted to receive a full treatment, were eligible for "complete sex reassignment" consisting of feminizing/masculinizing hormone treatment and several surgical interventions including genital surgery (full treatment). Currently, it is unclear what motives underlie a request for hormones only or surgery only or a combination of hormones and surgery (e.g., a mastectomy), but no genital surgery (partial treatment). The aims of this study were (i) to describe treatment requests of applicants at a specialized gender identity clinic in the Netherlands; and (ii) to explore the motives underlying a partial treatment request, including the role of (non-binary) gender identity. Information was collected on all 386 adults who applied for treatment at the Center of Expertise on Gender Dysphoria of the VU University Medical Center in Amsterdam, the Netherlands, in the year 2013. Treatment requests were available for 360 individuals: 233 natal men (64.7%) and 127 natal women (35.3%). Treatment requests were systematically collected during assessment. Individuals were classified as either desiring a full or partial treatment. The motives behind a partial treatment request were collected and categorized as well. The majority of applicants at our gender identity clinic requested full treatment. Among those who requested partial treatment, the most reported underlying motive was surgical risks/outcomes. Only a small number of applicants requested partial treatment to bring their body into alignment with their non-binary gender identity. It becomes clear that partial treatment is requested by a substantial number of applicants. This emphasizes the need for gender identity clinics to provide information about the medical possibilities and limitations, and careful introduction and evaluation of non-standard treatment options. © 2015 International Society for Sexual Medicine.

Cytomegalovirus reactivation in patients with refractory checkpoint inhibitor-induced colitis.

PubMed

Franklin, Cindy; Rooms, Isabelle; Fiedler, Melanie; Reis, Henning; Milsch, Laura; Herz, Saskia; Livingstone, Elisabeth; Zimmer, Lisa; Schmid, Kurt Werner; Dittmer, Ulf; Schadendorf, Dirk; Schilling, Bastian

2017-11-01

Immune checkpoint inhibitors can cause severe immune-related adverse events, with immune-related diarrhea and colitis (irColitis) being among the most frequent ones. While the majority of patients with irColitis respond well to corticosteroid treatment ± other immunomodulatory drugs such as infliximab, some patients do not show resolution of their symptoms. In the present study, we analysed the frequency of therapy-refractory irColitis, the underlying cause, and useful diagnostic approaches. Between 2006 and 2016, 370 patients with metastatic malignant melanoma were treated with checkpoint inhibitors at the Department of Dermatology at the University Hospital Essen. All patients were identified for whom diarrhea and/or colitis was documented in the digital patient records. Patients who did not respond to standard immunosuppressive therapy within 2 weeks were classified as refractory. Demographic and clinical data of all patients were collected. We identified 41 patients with irColitis, the majority occurring during treatment with ipilimumab. Amongst these, 5 (12.2%) were refractory to standard immunomodulatory treatment with corticosteroids and infliximab. Therapy-refractory cases tended to show more severe inflammation in colonic biopsies (p = 0.04). In all therapy-refractory cases cytomegalovirus (CMV) was detectable. CMV-DNA in colonic biopsies and in plasma was significantly more often detectable in therapy-refractory cases (in colonic biopsies p = 0.005, in plasma: p = 0.002). Presence of serum CMV IgM and positive immunohistochemical stainings of colon biopsies for CMV were also associated with refractory colitis (p=0.021; p = 0.053). This report on CMV reactivation during management of checkpoint inhibitor-induced colitis emphasises the need for repetitive diagnostic measures in treatment-refractory irColitis. Copyright © 2017 Elsevier Ltd. All rights reserved.

A space standards application to university-class microsatellites: The UNISAT experience

NASA Astrophysics Data System (ADS)

Graziani, Filippo; Piergentili, Fabrizio; Santoni, Fabio

2010-05-01

Hands-on education is recognized as an invaluable tool to improve students' skills, to stimulate their enthusiasm and to educate them to teamwork. University class satellite programs should be developed keeping in mind that education is the main goal and that university satellites are a unique opportunity to make involved students familiar with all the phases of space missions. Moreover university budgets for education programs are much lower than for industrial satellites programs. Therefore two main constraints must be respected: a time schedule fitting with the student course duration and a low economic budget. These have an impact on the standard which can be followed in university class satellite programs. In this paper university-class satellite standardization is discussed on the basis of UNISAT program experience, reporting successful project achievements and lessons learned through unsuccessful experiences. The UNISAT program was established at the Scuola di Ingegneria Aerospaziale by the Group of Astrodynamics of the University of Rome "La Sapienza" (GAUSS) as a research and education program in which Ph.D. and graduate students have the opportunity to gain hands-on experience on small space missions. Four university satellites (UNISAT, UNISAT-2, UNISAT-3, UNISAT-4), weighing about 10 kg, have been designed, manufactured, tested and launched every two years since 2000 in the framework of this program In the paper, after a brief overview of new GAUSS programs, an analysis of the UNISAT satellites ground test campaign is carried out, identifying the most critical procedures and requirements to be fulfilled. Moreover a device for low earth orbit low-cost satellite end-of-life disposal is presented; this system (SIRDARIA) complies with the international guidelines on space debris.

42 CFR 8.14 - Suspension or revocation of certification.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.14 Suspension... certification; (2) Has failed to comply with the Federal opioid treatment standards in any respect; (3) Has... certification or continued compliance with the Federal opioid treatment standards; or (4) Has refused a...

42 CFR 8.14 - Suspension or revocation of certification.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.14 Suspension... certification; (2) Has failed to comply with the Federal opioid treatment standards in any respect; (3) Has... certification or continued compliance with the Federal opioid treatment standards; or (4) Has refused a...

42 CFR 8.14 - Suspension or revocation of certification.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.14 Suspension... certification; (2) Has failed to comply with the Federal opioid treatment standards in any respect; (3) Has... certification or continued compliance with the Federal opioid treatment standards; or (4) Has refused a...

42 CFR 8.14 - Suspension or revocation of certification.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.14 Suspension... certification; (2) Has failed to comply with the Federal opioid treatment standards in any respect; (3) Has... certification or continued compliance with the Federal opioid treatment standards; or (4) Has refused a...

42 CFR 8.14 - Suspension or revocation of certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROVISIONS CERTIFICATION OF OPIOID TREATMENT PROGRAMS Certification and Treatment Standards § 8.14 Suspension... certification; (2) Has failed to comply with the Federal opioid treatment standards in any respect; (3) Has... certification or continued compliance with the Federal opioid treatment standards; or (4) Has refused a...

Combination of somatostatin analog, dexamethasone, and standard androgen ablation therapy in stage D3 prostate cancer patients with bone metastases.

PubMed

Koutsilieris, Michael; Mitsiades, Constantine S; Bogdanos, John; Dimopoulos, Theodoros; Karamanolakis, Dimitrios; Milathianakis, Constantine; Tsintavis, Athanassios

2004-07-01

Androgen ablation-refractory prostate cancer patients (stage D3) develop painful bone metastases and limited responsiveness to conventional therapies, hence the lack of universally accepted "gold standard" treatment for this poor prognosis clinical setting. We tested the safety and efficacy in stage D3 patients of the combination hormonal therapy, which combines administration of somatostatin analog and dexamethasone with standard androgen ablation monotherapy (luteinizing-hormone releasing-hormone analog or orchiectomy). Thirty eight patients with stage D3 prostate cancer (mean age 71.8 +/- 5.9 years) continued receiving androgen ablation therapy in combination with oral dexamethasone (4 mg daily for the 1st month of treatment, tapered down to 1 mg daily by the 4th month, with 1 mg daily maintenance dose thereafter) and somatostatin analog (20 mg octreotide i.m. injections every 28 days). Twenty-three of 38 patients (60.5%) receiving this combination regimen had partial responses [PR, >/=50% prostate-specific antigen (PSA) decline], 9 (21.1%) had stable disease, and 7 (18.4%) had progressive disease. In 47.7% (18 of 38) of patients, their serum PSA levels decreased with treatment but did not return to their respective baselines until the end of follow-up (or death from non-prostate cancer-related causes). The median time-to-return to baseline PSA was 12 months (95% CI, 7-17 months), median progression-free survival was 7 months (95% CI, 4.5-9.5 months), median overall survival was 14 months (95% CI, 10.7-17.4 months), and median prostate cancer-specific overall survival (defined as time from onset of combination therapy until prostate cancer-related death) was 16.0 months (95% CI, 11.9-20.1 months). All patients reported significant and durable improvement of bone pain and performance status (for a median duration of 14 months; 95% CI, 9-19 months), without major treatment-related side effects. We observed a statistically significant (P < 0.01) reduction in serum insulin-like growth factor-1 levels at response to the combination therapy. T levels remained suppressed within castration levels at baseline and throughout therapy, including relapse. The combination therapy of dexamethasone plus somatostatin analog and standard androgen ablation manipulation produces objective clinical responses and symptomatic improvement in androgen ablation-refractory refractory prostate cancer patients.

Patterns of care analysis for head & neck cancer of unknown primary site: a survey inside the German society of radiation oncology (DEGRO).

PubMed

Müller von der Grün, Jens; Bon, Dimitra; Rödel, Claus; Balermpas, Panagiotis

2018-05-14

Due to the absence of randomized trials, the optimal management for squamous cell cancer of unknown primary in the head and neck region (SCCHN CUP) remains controversial. Current strategies are based on retrospective studies, clinical experience, and institutional policies. An anonymous questionnaire with a total of 24 questions was created and distributed by the use of an online version (Google Forms®, Google, Mountain View, CA, USA) as well as a printout version as equivalent option. An email with a link to the survey and the questionnaire as attachment was sent to 361 DEGRO(German Society of Radiation Oncology)-associated departments. Frequency distributions of responses for each question were calculated. The data were also analyzed by type of practice. Representativity of the sample size for the DEGRO was also evaluated. 66 responses were received including answers from 20 (30%) university departments, 16 (24%) non-university institutions, and 30 (46%) radiation oncology practices. 95% of the participants routinely present these cases in an interdisciplinary tumor board and use intensity modulated radiotherapy (IMRT) techniques for SCCHN CUP treatment. Surgery includes neck dissection in 83% and tonsillectomy in 73% of the cases. Human papilloma virus (HPV) status is routinely determined in 82% of the departments. Statistically significant differences between universities and institutions and clinics and practices could be found with respect to positron emission tomography-computed tomography (PET-CT) utilization, indications for chemotherapy, radiotherapy volumes, and cumulative doses. Diagnostics and treatment for SCCHN CUP within the DEGRO remain heterogeneous. A prospective register trial with standard operation procedures is warranted to homogenize and possibly improve management.

Can persons with a history of multiple addiction treatment episodes benefit from technology delivered behavior therapy? A moderating role of treatment history at baseline

PubMed Central

Kim, Sunny Jung; Marsch, Lisa A.; Acosta, Michelle C.; Guarino, Honoria; Aponte-Melendez, Yesenia

2015-01-01

A growing line of research has shown positive treatment outcomes from technology-based therapy for substance use disorders (SUDs). However, little is known about the effectiveness of technology-based SUD interventions for persons who already had numerous prior SUD treatments. We conducted a secondary analysis on a 12-month trial with patients (N = 160) entering methadone maintenance treatment (MMT). Patients were randomly assigned to either standard MMT treatment or a model in which half of standard counseling sessions were replaced with a computer-based intervention, called Therapeutic Education System (standard + TES). Four treatment history factors at baseline, the number of lifetime SUD treatment episodes, detoxification episodes, and inpatient/outpatient treatment episodes were categorized into three levels based on their tertile points, and analyzed as moderators. Dependent variables were urine toxicology results for opioid and cocaine abstinence for 52-weeks. The standard + TES condition produced significantly better opioid abstinence than standard treatment for participants with 1) a moderate or high frequency of lifetime SUD treatment episodes, and 2) those with all three levels (low, moderate and high) of detoxification and inpatient/outpatient treatment episodes, ps < .01. The standard + TES condition enhanced cocaine abstinence compared to standard treatment among people with 1) a moderate or high frequency of lifetime SUD treatment episodes, 2) a high level of detoxification episodes, and 3) a moderate or high level of inpatient treatment history, ps < .01. We found that including technology-based behavioral therapy as part of treatment can be more effective than MMT alone, even among patients with a history of multiple addiction treatment episodes. PMID:26657820

Can persons with a history of multiple addiction treatment episodes benefit from technology delivered behavior therapy? A moderating role of treatment history at baseline.

PubMed

Kim, Sunny Jung; Marsch, Lisa A; Acosta, Michelle C; Guarino, Honoria; Aponte-Melendez, Yesenia

2016-03-01

A growing line of research has shown positive treatment outcomes from technology-based therapy for substance use disorders (SUDs). However, little is known about the effectiveness of technology-based SUD interventions for persons who already had numerous prior SUD treatments. We conducted a secondary analysis on a 12-month trial with patients (N=160) entering methadone maintenance treatment (MMT). Patients were randomly assigned to either standard MMT treatment or a model in which half of standard counseling sessions were replaced with a computer-based intervention, called Therapeutic Education System (standard+TES). Four treatment history factors at baseline, the number of lifetime SUD treatment episodes, detoxification episodes, and inpatient/outpatient treatment episodes were categorized into three levels based on their tertile points, and analyzed as moderators. Dependent variables were urine toxicology results for opioid and cocaine abstinence for 52-weeks. The standard+TES condition produced significantly better opioid abstinence than standard treatment for participants with 1) a moderate or high frequency of lifetime SUD treatment episodes, and 2) those with all three levels (low, moderate and high) of detoxification and inpatient/outpatient treatment episodes, ps<.01. The standard+TES condition enhanced cocaine abstinence compared to standard treatment among people with 1) a moderate or high frequency of lifetime SUD treatment episodes, 2) a high level of detoxification episodes, and 3) a moderate or high level of inpatient treatment history, ps<.01. We found that including technology-based behavioral therapy as part of treatment can be more effective than MMT alone, even among patients with a history of multiple addiction treatment episodes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychiatric patients turnaround times in the emergency department

PubMed Central

2005-01-01

Background To analyze the turnaround times of psychiatric patients within the Emergency Department (ED) from registration to discharge or hospitalization in a University Hospital in 2002. Methods Data from a one-year period of psychiatric admissions to the emergency service at a University Hospital were monitored and analyzed focused on turnaround times within the ED. Information on patients variables such as age, sex, diagnosis, consultations and diagnostic procedures were extracted from the patients' charts. Results From 34.058 patients seen in the ED in 2002, 2632 patients were examined by psychiatrists on duty. Mean turnaround time in the ED was 123 (SD 97) minutes (median 95). Patients to be hospitalized on a psychiatric ward stayed shorter within the ED, patients who later were admitted to another faculty, were treated longer in the ED. Patients with cognitive or substance related disorders stayed longer in the ED than patients with other psychiatric diagnoses. The number of diagnostic procedures and consultations increased the treatment time significantly. Conclusion As the number of patients within the examined ED increases every year, the relevant variables responsible for longer or complicated treatments were assessed in order to appropriately change routine procedures without loss of medical standards. Using this basic data, comparisons with the following years and other hospitals will help to define where the benchmark of turnaround times for psychiatric emergency services might be. PMID:16351721

Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review.

PubMed

Chiang, Chun-Ju; You, San-Lin; Chen, Chien-Jen; Yang, Ya-Wen; Lo, Wei-Cheng; Lai, Mei-Shu

2015-03-01

Cancer registration provides core information for cancer surveillance and control. The population-based Taiwan Cancer Registry was implemented in 1979. After the Cancer Control Act was promulgated in 2003, the completeness (97%) and data quality of cancer registry database has achieved at an excellent level. Hospitals with 50 or more beds, which provide outpatient and hospitalized cancer care, are recruited to report 20 items of information on all newly diagnosed cancers to the central registry office (called short-form database). The Taiwan Cancer Registry is organized and funded by the Ministry of Health and Welfare. The National Taiwan University has been contracted to operate the registry and organized an advisory board to standardize definitions of terminology, coding and procedures of the registry's reporting system since 1996. To monitor the cancer care patterns and evaluate the cancer treatment outcomes, central cancer registry has been reformed since 2002 to include detail items of the stage at diagnosis and the first course of treatment (called long-form database). There are 80 hospitals, which count for >90% of total cancer cases, involved in the long-form registration. The Taiwan Cancer Registry has run smoothly for >30 years, which provides essential foundation for academic research and cancer control policy in Taiwan. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Standards-Based Grading and Reporting Tool for Faculty: Design and Implications

ERIC Educational Resources Information Center

Sadik, Alaa M.

2011-01-01

The use of standard-based assessment, grading and reporting tools is essential to ensure that assessment meets acceptable levels of quality and standardization. This study reports the design, development and evaluation of a standards-based assessment tool for the instructors at Sultan Qaboos University, Sultanate of Oman. The Rapid Applications…

Reflections on International Bibliographic Standards.

ERIC Educational Resources Information Center

Roberts, W.

This paper raises questions about many bibliographic standards developed over the past 20 years, and challenges librarians to consider how standards might evolve. A brief overview is given of the aims of Universal Bibliographic Control (UBC) and to some assumptions common to much standardization work in recent years inspired by the concept of UBC.…

Standard Setting: A Systematic Approach to Interpreting Student Learning.

ERIC Educational Resources Information Center

DeMars, Christine E.; Sundre, Donna L.; Wise, Steven L.

2002-01-01

Describes workshops designed to set standards for freshman technological literacy at James Madison University (Virginia). Results indicated that about 30% of incoming freshmen could meet the standards set initially; by the end of the year, an additional 50-60% could meet them. Provides recommendations for standard setting in a general education…

46 CFR 160.077-5 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (NBS) “The Universal Color Language” and “The Color Names Dictionary” in Color: Universal Language and Dictionary of Names, National Bureau of Standards Special Publication 440. Underwriters Laboratories (UL) UL...

46 CFR 160.024-1 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) “The Universal Color Language” and “The Color Names Dictionary” in Color: Universal Language and Dictionary of Names, National Bureau of Standards Special Publication 440, Dictionary 1976. (b) NBS Special...

The Standardization of Time: A Sociohistorical Perspective.

ERIC Educational Resources Information Center

Zerubavel, Eviatar

1982-01-01

Explores the social process of establishing a standard time-reckoning framework. The paper examines the introduction of Greenwich Mean Time in Britain, the establishment of the American railway time-zone system, and the almost universal enforcement of the international standard time-zone system. (AM)

A fixed inhaled nitrous oxide/oxygen mixture as an analgesic for adult cancer patients with breakthrough pain: study protocol for a randomized controlled trial.

PubMed

Liu, Qiang; Wang, Yu; Luo, Xiang-Jiang; Wang, Ning-Ju; Chen, Ping; Jin, Xin; Mu, Guo-Xia; Chai, Xiao-Min; Zhang, Yue-Juan; Li, Yu-Xiang; Yu, Jian-Qiang

2017-01-11

The management of breakthrough pain in cancer patients is always a challenge for medical professions. Occurring in 80% of cancer patients with advanced disease, breakthrough pain significantly decreases both patient's and caregiver's quality of life. The aim of this study is to assess the analgesic efficacy of a fixed inhaled nitrous oxide/oxygen mixture for adult cancer patients with breakthrough pain. This is a randomized, placebo-controlled, double-blind study; it will be conducted in the General Hospital of Ningxia Medical University. The target study subjects are at least 18 years old, and are hospitalized cancer patients who are receiving routine opioids to control cancer-related pain but still experience breakthrough pain. A total of 240 patients will be recruited and randomly allocated between three treatment groups (A, B, C) and a control group (group D) in a ratio of 3:1. All treatment groups (A, B, C) will receive standard pain treatment (oral immediate-release morphine) plus a pre-prepared nitrous oxide/oxygen mixture, and the control group (D) will receive the standard pain treatment plus oxygen. Patients, doctors, nurses, and data collectors are all blind to the experiment. Assessments will be taken before treatment (T0), at 5 min (T1) and 15 min (T2) during treatment, and at 5 min after treatment (T3). The primary endpoint measures will be the percentage of patients whose pain is relieved at T1, T2, and T3. Secondary outcome measures will include the safety of treatment, adverse events, and satisfaction from both health professionals and patients. This study aims to provide an effective and practical intervention for a fast breakthrough pain relief and to improve cancer patients' quality of life significantly. The Evidence-Based Medicine Working Group claim that a randomized, double-blind, placebo-controlled experimental intervention is the most appropriate design to demonstrate its efficacy, so this study could give a new approach to controlling breakthrough pain episodes. ChiCTR-INC-16008075 . Registered on 8 March 2016.

The Biocurator Society (GSC8 Meeting)

ScienceCinema

Gaudet, Pascal

2018-01-10

The Genomic Standards Consortium was formed in September 2005. It is an international, open-membership working body which promotes standardization in the description of genomes and the exchange and integration of genomic data. The 2009 meeting was an activity of a five-year funding "Research Coordination Network" from the National Science Foundation and was organized held at the DOE Joint Genome Institute with organizational support provided by the JGI and by the University of California - San Diego. Pascal Gaudet of Northwestern University talks about "The Biocurator Society" at the Genomic Standards Consortium's 8th meeting at the DOE JGI in Walnut Creek, CA on Sept. 11, 2009.

Photometric calibration of T40 telescope system at Ankara University Kreiken Observatory (AUKR)

NASA Astrophysics Data System (ADS)

Karakuş, O.; Ekmekçi, F.

2017-07-01

We aim to present the photometric calibration of T40 telescope system at Ankara University Kreiken Observatory(AUKR) in the Johnson BVRI bands system through CCD observations of selected Landolt stars on the clearest 11 nights. Ten more stars with a magnitude of V< 11 were also observed in order to check up on standard transformation coefficients. Using these coefficients, we present standard brightness and color magnitudes for these 10 selected stars. These standard brightness values of these 10 stars are also compared with the previously published ones. It is clearly seen that the calibration results are sufficiently reliable.

Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.

PubMed

Shiranibidabadi, Shahrzad; Mehryar, Amirhooshang

2015-09-15

Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4 ± 1.9 vs standard treatment only: 15.1 ± 1.7, p < 0.001, effect size = 56.7%). For subtypes, significant between-group differences were identified for checking (p = 0.004), and slowness (p = 0.019), but not for washing or responsibility. Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy + standard treatment: 16.9 ± 7.4 vs standard treatment only: 22.9 ± 4.6, p < 0.001, effect size = 47.0%), and depressive symptoms (post-intervention score: music therapy + standard treatment: 10.8 ± 3.8 vs standard treatment: 17.1 ± 3.7, p < 0.001, effect size = 47.0%). Inclusion of a small sample size, lack of blinding due to the nature of the intervention, short duration of follow-up. In patients with OCD, music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms. Copyright © 2015. Published by Elsevier B.V.

Physical therapy vs. internet-based exercise training (PATH-IN) for patients with knee osteoarthritis: study protocol of a randomized controlled trial.

PubMed

Williams, Quinn I; Gunn, Alexander H; Beaulieu, John E; Benas, Bernadette C; Buley, Bruce; Callahan, Leigh F; Cantrell, John; Genova, Andrew P; Golightly, Yvonne M; Goode, Adam P; Gridley, Christopher I; Gross, Michael T; Heiderscheit, Bryan C; Hill, Carla H; Huffman, Kim M; Kline, Aaron; Schwartz, Todd A; Allen, Kelli D

2015-09-28

Physical activity improves pain and function among individuals with knee osteoarthritis (OA), but most people with this condition are inactive. Physical therapists play a key role in helping people with knee OA to increase appropriate physical activity. However, health care access issues, financial constraints, and other factors impede some patients from receiving physical therapy (PT) for knee OA. A need exists to develop and evaluate other methods to provide physical activity instruction and support to people with knee OA. This study is examining the effectiveness of an internet-based exercise training (IBET) program designed for knee OA, designed by physical therapists and other clinicians. This is a randomized controlled trial of 350 participants with symptomatic knee OA, allocated to three groups: IBET, standard PT, and a wait list (WL) control group (in a 2:2:1 ratio, respectively). The study was funded by the Patient Centered Outcomes Research Institute, which conducted a peer review of the proposal. The IBET program provides patients with a tailored exercise program (based on functional level, symptoms, and current activity), video demonstrations of exercises, and guidance for appropriate exercise progression. The PT group receives up to 8 individual visits with a physical therapist, mirroring standard practice for knee OA and with an emphasis on a home exercise program. Outcomes are assessed at baseline, 4 months (primary time point) and 12 months (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include objective physical function, satisfaction with physical function, physical activity, depressive symptoms and global assessment of change. Linear mixed models will be used to compare both the IBET and standard PT groups to the WL control group, examine whether IBET is non-inferior to PT (a treatment that has an established evidence base for knee OA), and explore whether participant characteristics are associated with differential effects of IBET and/or standard PT. This research is in compliance with the Helsinki Declaration and was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill. The IBET program could be disseminated widely at relatively low cost and could be an important resource for helping patients with knee OA to adopt and maintain appropriate physical activity. This trial will provide an important evaluation of the effectiveness of this IBET program for knee OA. NCT02312713.

Benznidazole treatment safety: the Médecins Sans Frontières experience in a large cohort of Bolivian patients with Chagas' disease.

PubMed

Sperandio da Silva, Gilberto Marcelo; Mediano, M F F; Hasslocher-Moreno, Alejandro Marcel; Holanda, Marcelo Teixeira de; Silvestre de Sousa, Andrea; Sangenis, Luiz Henrique Conde; Brasil, Pedro Emmanuel Alvarenga Americano do; Mejía, Roger Arteaga; Fux, Carina Perotti; Cubides, Juan-Carlos; Saraiva, Roberto Magalhães; Brum-Soares, Lucia Maria

2017-09-01

Up to half of patients with Chagas' disease under benznidazole treatment present adverse drug reactions (ADRs) and up to one-third do not complete standard treatment. To verify the incidence and possible factors associated with the suspension of benznidazole treatment in a large cohort of patients. We included 2075 patients treated with benznidazole during the projects managed by the medical humanitarian organization Doctors Without Borders (Médecins Sans Frontières) in Bolivia from 2009 to 2013. Benznidazole treatment was provided two or three times per day for ∼60 days at 5-7.5 mg/kg/day. A multiple logistic regression model was developed to evaluate the factors associated with permanent suspension of benznidazole treatment. Permanent benznidazole treatment suspension occurred in 211 patients (10.2%) and the average time until permanent treatment suspension was 23 days. Multifactorial analysis revealed that female sex (adjusted OR = 1.70), moderate ADRs (adjusted OR = 10.57), mild ADRs (adjusted OR = 1.69) and skin disorders (adjusted OR = 4.18) were significantly associated with the permanent suspension of benznidazole treatment. Women with mild or moderate skin ADRs presented a probability of treatment interruption of 18.6% and 59.0%, respectively. Benznidazole treatment was safe and a large proportion of patients were able to complete a full course of benznidazole treatment under close treatment surveillance. Female sex, skin disorders and mild and moderate ADRs were independently associated with the permanent suspension of benznidazole treatment. In particular, women with moderate skin ADRs had the highest risk of benznidazole treatment interruption. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

40 CFR 437.16 - Pretreatment standards for new sources (PSNS).

Code of Federal Regulations, 2010 CFR

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS THE CENTRALIZED WASTE TREATMENT POINT SOURCE CATEGORY Metals Treatment... standards: Standards for antimony, arsenic, cadmium, chromium, cobalt, copper, lead, mercury, nickel, silver...

MMV in partnership: the Eurartesim® experience

PubMed Central

2013-01-01

Background This case study describes how a public-private partnership between Medicines for Malaria Venture (MMV) and Sigma-Tau Industrie Farmaceutiche Riunite SpA achieved international regulatory approval for use of the fixed-dose artemisinin-based combination therapy dihydroartemisinin-piperaquine (Eurartesim®) for the treatment of malaria, enabling more widespread access to the medicine in malaria-endemic countries. Case description The combination of dihydroartemisinin and piperaquine demonstrated success in clinical trials for the treatment of malaria in Asia and Africa in the 2000s. However, as it had not been developed to international regulatory standards it was out of the reach of the majority of patients in disease-endemic countries, particularly those reliant on public healthcare systems supported by international donor funding. To overcome this, as of 2004 MMV worked in partnership with Sigma-Tau, Holleykin, Oxford University, the Institute of Tropical Medicine Antwerp, and the National Institute of Malaria Research India to develop the dihydroartemisinin-piperaquine combination to international standards. In 2011, the European Commission granted full marketing authorization to Sigma-Tau for Eurartesim. Discussion and evaluation The partnership between MMV, Sigma-Tau, and numerous other academic and industrial partners across the world, led to the successful development to EMA regulatory standards of a high-quality and highly efficacious anti-malarial treatment that otherwise would not have been possible. The dossier has also been submitted to the WHO for prequalification, and a safety statement to guide correct use of Eurartesim has been produced. In July 2012, the first delivery to a disease-endemic country was made to Cambodia, where the medicine is being used to treat patients and help counter the emergence of artemisinin resistance in the area. A paediatric dispersible formulation of Eurartesim is being developed, with the objective to submit the dossier to the EMA by the end of 2014. Conclusions The development of Eurartesim to international regulatory standards exemplifies the strengths of the product development partnership model in utilising the individual skills and expertise of partners with differing objectives to achieve a common goal. Successful uptake of Eurartesim by public health systems in malaria-endemic countries poses new challenges, which may require additional partnerships as we move forward. PMID:23782869

Standardizing Naming Conventions in Radiation Oncology

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

Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa

2012-07-15

Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creatingmore » this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were satisfactorily identified using this nomenclature. Conclusions: Use of standardized naming conventions is important to facilitate comparison of dosimetry across patient datasets. The guidelines presented here will facilitate international acceptance across a wide range of efforts, including groups organizing clinical trials, Radiation Oncology Institute, Dutch Radiation Oncology Society, Integrating the Healthcare Enterprise, Radiation Oncology domain (IHE-RO), and Digital Imaging and Communication in Medicine (DICOM).« less

Reporting standards for angioplasty and stent-assisted angioplasty for intracranial atherosclerosis.

PubMed

Schumacher, H Christian; Meyers, Philip M; Higashida, Randall T; Derdeyn, Colin P; Lavine, Sean D; Nesbit, Gary M; Sacks, David; Rasmussen, Peter; Wechsler, Lawrence R

2010-12-01

Intracranial cerebral atherosclerosis causes ischemic stroke in a significant number of patients. Technological advances over the past 10 years have enabled endovascular treatment of intracranial atherosclerotic stenosis. The number of patients treated with angioplasty or stent-assisted angioplasty for this condition is increasing. Given the lack of universally accepted definitions, the goal of this document is to provide consensus recommendations for reporting standards, terminology, and written definitions when reporting clinical and radiological evaluation, technique, and outcome of endovascular treatment using angioplasty or stent-assisted angioplasty for stenotic and occlusive intracranial atherosclerosis. This article was written under the auspices of Joint Writing Group of the Technology Assessment Committee, Society of Neurolnterventional Surgery, Society of Interventional Radiology; Joint Section on Cerebro-vascular Neurosurgery of the American Association of Neurological Surgeons and Congress of Neurological Surgeons; and the Section of Stroke and Interventional Neurology of the American Academy of Neurology. A computerized search of the National Library of Medicine database of literature (PubMed) from January 1997 to December 2007 was conducted with the goal to identify published endovascular cerebrovascular interventional data in stenotic intracranial atherosclerosis that could be used as benchmarks for quality assessment. We sought to identify those risk adjustment variables that affect the likelihood of success and complications. This document offers the rationale for different clinical and technical considerations that may be important during the design of clinical trials for endovascular treatment of intracranial stenotic and occlusive atherosclerosis. Included in this guidance document are suggestions for uniform reporting standards for such trials. These definitions and standards are primarily intended for research purposes; however, they should also be helpful in clinical practice and applicable to all publications. In summary, the definitions proposed represent recommendations for constructing useful research data sets. The intent is to facilitate production of scientifically rigorous results capable of reliable comparisons between and among similar studies. In some cases, the definitions contained here are recommended by consensus of a panel of experts in this writing group for consistency in reporting and publication. These definitions should allow different groups to publish results that are directly comparable.

Bevacizumab, Carboplatin and Paclitaxel Combination Treatment in Advanced Stage Ovarian Cancer: The First Experience in Thammasat University Hospital, Thailand: A Case Report.

PubMed

Suwannarurk, Komsun; Thaweekul, Yudthadej; Mairaing, Karicha; Poomtavorn, Yenrudee; Tangtiang, Kaan; Piyawang, Wichet; Bhamarapravatana, Kornkarn

2015-04-01

Bevacizumab, a humanized monoclonal antibody targeting vascular endothelial growthfactor (VEGF), has been approvedfor concurrent treatment with first line chemotherapy in advanced epithelial ovarian cancer. A case of an advanced stage epithelial ovarian cancer (EOC) receiving a combination of bevacizumab, carboplatin andpaclitaxel chemotherapy was reported. A 44-year-old woman was presented with abdominal discomfort and distention for 4 months. Bilateral 12 cm diameter ovarian tumors were diagnosed as FIGO stage IIIc after surgical staging operation. Histopathology report showed the mixed type of serous and endometriod adenocarcinoma. The patient was then started on carboplatin/paclitaxel combination chemotherapy for 6 cycles after surgery every 3 weeks. Bevacizumab (7.5 mg/ m2) was concurrently administered with chemotherapy every 3 weeks startingfrom the 2nd cycle. A complete remission was achieved after the end of the chemotherapy treatment. Bevacizumab was continued for one year after the completion of the standard chemotherapy. Bone marrow suppression, hypertension and proteinuria were not found during Bevacizumab treatment. At bevacizumab treatment completion, a platinum-sensitive recurrent ovarian cancer was diagnosed at the two weeks postprogram routine check-up. The patient was counseled to start second line chemotherapy treatment and has yet to come back with her decision. Combination of bevacizumab, carboplatin and paclitaxelfor first line chemotherapy in advanced EOC in this case had no serious side effects and need further study.

The Effect of Using Some Professional Development Strategies on Improving the Teaching Performance of English Language Student Teacher at the Faculty of Education, Helwan University in the Light of Pre-Service Teacher Standards

ERIC Educational Resources Information Center

Halim, Safaa Mahmoud Abdel

2008-01-01

The main aim of this thesis was to determine the effect of using a training program based on three professional development strategies; namely: action learning, peer coaching and study groups, on improving teaching performance of Faculty of Education, Helwan University EFL student teachers in the light of standards for teachers of English at…

Grand Valley State University Checks Out Energy Savings at New Mary Idema Pew Library

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

none,

Grand Valley State University (GVSU) partnered with the Department of Energy (DOE) to develop and implement solutions to build new, low-energy buildings that are at least 50% below Standard 90.1-2007 of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), the American National Standards Institute (ANSI), and the Illuminating Engineering Society of North America (IESNA) as part of DOE’s Commercial Building Partnerships (CBP) Program.

Patient Core Data Set. Standard for a longitudinal health/medical record.

PubMed

Renner, A L; Swart, J C

1997-01-01

Blue Chip Computers Company, in collaboration with Wright State University-Miami Valley College of Nursing and Health, with support from the Agency for Health Care Policy and Research, Public Health Service, completed Small Business innovative Research research to design a comprehensive integrated Patient information System. The Wright State University consultants undertook the development of a Patient Core Data Set (PCDS) in response to the lack of uniform standards of minimum data sets, and lack of standards in data transfer for continuity of care. The purpose of the Patient Core Data Set is to develop a longitudinal patient health record and medical history using a common set of standard data elements with uniform definitions and coding consistent with Health Level 7 (HL7) protocol and the American Society for Testing and Materials (ASTM) standards. The PCDS, intended for transfer across all patient-care settings, is essential information for clinicians, administrators, researchers, and health policy makers.

Inflation in the standard cosmological model

NASA Astrophysics Data System (ADS)

Uzan, Jean-Philippe

2015-12-01

The inflationary paradigm is now part of the standard cosmological model as a description of its primordial phase. While its original motivation was to solve the standard problems of the hot big bang model, it was soon understood that it offers a natural theory for the origin of the large-scale structure of the universe. Most models rely on a slow-rolling scalar field and enjoy very generic predictions. Besides, all the matter of the universe is produced by the decay of the inflaton field at the end of inflation during a phase of reheating. These predictions can be (and are) tested from their imprint of the large-scale structure and in particular the cosmic microwave background. Inflation stands as a window in physics where both general relativity and quantum field theory are at work and which can be observationally studied. It connects cosmology with high-energy physics. Today most models are constructed within extensions of the standard model, such as supersymmetry or string theory. Inflation also disrupts our vision of the universe, in particular with the ideas of chaotic inflation and eternal inflation that tend to promote the image of a very inhomogeneous universe with fractal structure on a large scale. This idea is also at the heart of further speculations, such as the multiverse. This introduction summarizes the connections between inflation and the hot big bang model and details the basics of its dynamics and predictions. xml:lang="fr"

An Exploratory Study of Universal Design for Teaching Chemistry to Students with and without Disabilities

ERIC Educational Resources Information Center

King-Sears, Margaret E.; Johnson, Todd M.; Berkeley, Sheri; Weiss, Margaret P.; Peters-Burton, Erin E.; Evmenova, Anya S.; Menditto, Anna; Hursh, Jennifer C.

2015-01-01

In this exploratory study, students in four co-taught high school chemistry classes were randomly assigned to a Universal Design for Learning (UDL) treatment or a comparison condition. Each co-teaching team taught one comparison and treatment class. UDL principles were operationalized for treatment: (a) a self-management strategy (using a…

Preliminary Evidence on the Effectiveness of Psychological Treatments Delivered at a University Counseling Center

ERIC Educational Resources Information Center

Minami, Takuya; Davies, D. Robert; Tierney, Sandra Callen; Bettmann, Joanna E.; McAward, Scott M.; Averill, Lynnette A.; Huebner, Lois A.; Weitzman, Lauren M.; Benbrook, Amy R.; Serlin, Ronald C.; Wampold, Bruce E.

2009-01-01

Treatment data from a university counseling center (UCC) that utilized the Outcome Questionnaire-45.2 (OQ-45; M. J. Lambert et al., 2004), a self-report general clinical symptom measure, was compared against treatment efficacy benchmarks from clinical trials of adult major depression that utilized similar measures. Statistical analyses suggested…

Effectively Managing Copyright Clearance: Electronic Reserves in a Large Distance Education University

ERIC Educational Resources Information Center

Wang, Yu-Hsiu; Baker, Megan

2013-01-01

This paper describes the automated copyright clearance process for electronic reserves materials by the electronic reserves staff at the Information and Library Services (ILS), at the University of Maryland University College (UMUC). Besides the standard practice to handle and post required course readings in digital format for UMUC's distance…

The Ivory Tower in Violent America: An Historical Perspective.

ERIC Educational Resources Information Center

Frankhouser, Willis M.

The history of violence on university campuses mirrors that of the surrounding culture--students bring their values and standards of conduct with them to the university. This paper traces historical events which associate violence with university settings to give a sense of today's situation. The focus is on four periods representing important…

Testing Program Reveals Deficient Mathematics for Health Science Students Commencing University

ERIC Educational Resources Information Center

McNaught, Keith; Hoyne, Gerard

2013-01-01

In response to staff concerns about literacy and numeracy standards of commencing students, the School of Health Sciences at the University of Notre Dame Australia (UNDA) Fremantle campus worked with academic support staff from the University's Academic Enabling and Support Centre (AESC) to develop a Post Entrance Numeracy Assessment (PENA). The…

University Research Funding: The United States Is Behind and Falling

ERIC Educational Resources Information Center

Atkinson, Robert D.; Stewart, Luke A.

2011-01-01

Research and development drives innovation and innovation drives long-run economic growth, creating jobs and improving living standards in the process. University-based research is of particular importance to innovation, as the early-stage research that is typically performed at universities serves to expand the knowledge pool from which the…

40 CFR 273.40 - Exports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Exports. 273.40 Section 273.40... UNIVERSAL WASTE MANAGEMENT Standards for Large Quantity Handlers of Universal Waste § 273.40 Exports. A... exporter in 40 CFR 262.53, 262.56(a)(1) through (4), (6), and (b) and 262.57; (b) Export such universal...

40 CFR 273.20 - Exports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Exports. 273.20 Section 273.20... UNIVERSAL WASTE MANAGEMENT Standards for Small Quantity Handlers of Universal Waste § 273.20 Exports. A... exporter in 40 CFR 262.53, 262.56(a) (1) through (4), (6), and (b) and 262.57; (b) Export such universal...

Model of Collaboration between Two Universities: Meeting the Challenge.

ERIC Educational Resources Information Center

Easterbrooks, Susan R.; Laughton, Joan M.

This paper describes a collaborative program of Georgia State University and the University of Georgia to train prospective teachers of the deaf in accordance with recent standards developed by the Council on Education of the Deaf (CED). The program involves: (1) a shared advisory committee; (2) foundation coursework taken separately at the two…

Using an Electronic Bulletin Board in Science Teacher Education: Issues and Trade-Offs

ERIC Educational Resources Information Center

Burkett, Ruth S.; Leard, Cynthia; Spector, Barbara S.

2004-01-01

University professors increasingly are expected to infuse computer technology in teaching. Many universities are aggressively promoting the delivery of entire courses and programs using computers and the Internet as vehicles for instruction. There is also a movement to align university teaching with the national standards for K-12 teaching.…

Quality Assurance in University Guidance Services

ERIC Educational Resources Information Center

Simon, Alexandra

2014-01-01

In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

Quality Assurance Challenges and Opportunities Faced by Private Universities in Zimbabwe

ERIC Educational Resources Information Center

Garwe, Evelyn Chiyevo

2014-01-01

The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

(Un)Desirable Effects of Output Funding for Flemish Universities

ERIC Educational Resources Information Center

Cantillon, B.; De Ridder, A.; Vanhaecht, E.; Verbist, G.

2011-01-01

Governments introducing output parameters (e.g. graduation numbers) in the funding rule of universities believe that it will induce universities to raise their teaching efforts while educational standards will remain unaffected. In this article we first show on theoretical grounds that this desire can only be fulfilled if there exist positive…

40 CFR 262.108 - When will this subpart expire?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE University Laboratories XL Project-Laboratory Environmental Management Standard § 262.108 When will this subpart expire? This subpart will...

EDITORIAL: Deeper, broader, higher, better?

NASA Astrophysics Data System (ADS)

Dobson, Ken

1998-07-01

Honorary Editor The standard of educational achievement in England and Wales is frequently criticized, and it seems to be an axiom of government that schools and teachers need to be shaken up, kept on a tight rein, copiously inspected, shamed and blamed as required: in general, subjected to the good old approach of: ' Find out what Johnny is doing and tell him to stop.' About the only exception to this somewhat severe attitude is at A-level, where the standard is simply golden. Often, comparisons are made between the performance of, say, English children and that of their coevals in other countries, with different customs, systems, aims and languages. But there has been a recent comparison of standards at A-level with a non-A-level system of pre-university education, in an English-speaking country that both sends students to English universities and accepts theirs into its own, and is, indeed, represented in the UK government at well above the level expected from its ethnical weighting in the population. This semi-foreign country is Scotland. The conclusions of the study are interesting. Scotland has had its own educational system, with `traditional breadth', and managed to escape much of the centralized authoritarianism that we have been through south of the border. It is interesting to note that, while for the past dozen years or so the trend in A-level Physics entries has been downwards, there has been an increase in the take-up of Scottish `Highers'. Highers is a one-year course. Is its popularity due to its being easier than A-level? Scottish students keen enough to do more can move on to the Certificate of Sixth Year Studies, and will shortly be able to upgrade a Higher Level into an Advanced Higher Level. A comparability study [ Comparability Study of Scottish Qualifications and GCE Advanced Levels: Report on Physics January 1998 (free from SQA)] was carried out by the Scottish Qualifications Authority (SQA) with the aim (amongst others) of helping universities make a fair comparison between grades attained in A-Levels and Highers, CSYS and Advanced Highers. It was a fairly limited exercise, but a careful one, carried out by examiners and teachers rather than statisticians. They compared syllabuses, questions and candidates' answers. I quote: '... the two years of study for A-level perhaps means that there is a secure, consolidated grasp of the basics; more than the Higher candidate after one year. But there is no evidence of this from candidates' scripts.' Comparing syllabuses, the report noted a greater mathematical demand in Scotland: 'The rigour or depth of treatment is generally lower in the Syllabus Y [an A-level syllabus.] than in CSYS or Advanced Higher because many topics have a qualitative treatment rather than the mathematical treatment of CSYS and AH.' Adding a certain sting to its tail, the report concludes: `Many of the CSYS candidates will have achieved excellent grades at Higher... in four or five subjects before proceeding to CSYS. Scottish candidates tend to have qualifications in a broader range of subjects.' Perhaps this is why they get to be in charge everywhere.