Dka regime sarawak handbook 8th

The prototype allows for both indoor and outdoor navigation at and in the vicinity of the experience centre NaturBornholm1 in Denmark u Bluetooth and GPS are used for location-based information and QR-codes are used to convey user preferences En octobredes intéressés de divers pays de l'Afrique de l'Ouest se sont réunis à Accra, au Ghana, afin de discuter de la mise en place d'un centre voué à la promotion de l'intégration régionale, de la bonne gouvernance et de la démocratie.

Read more about Planification de The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm' experience centre in Denmark u MIREC is the acronym for MINT Incineration and Renewable Energy Centre which was established in the year to carry out research and provide services on matters related to incineration technology and renewable energy. Three research contracts with the value of nearly RM 1 million have been signed.

Four laboratory scale burners have been designed and fabricated. Three mathematical models have been developed.

Three programs on enhancement image have been published. Three papers have been published in the international journal. This paper will discuss on the experiences and challenges that could be shared together with MINT staff. Retrospective analysis of paediatric achalasia in India: Single centre experience. Full Text Available Background: Developing countries at tertiary referral centre.

The aim of this study was to share our experience of paediatric achalasia in Indian scenario. Materials and Methods: This was a retrospective analysis of children centrefrom December to December The response rate of parents in follow-up was Mean symptoms duration was Most common symptoms were regurgitation and failure to thrive Des activités de post-réduction sont avérées et certaines opérations de forgeage sont supposées.

The limits inherent in this type of work restrict the interpretation of structures and all spatial approaches to this likely dwelling. The joint study of the different furnishings, in particular ceramics and metal, but also the cob and fauna, attests to its material culture and its interest.

The slag could be amongst the oldest iron metallurgy remains from the Centre region. Some activities of post-forging are proven and certain operations are guessed at. The discovery of this settlement in this sector of the major bed of the Loire, has produced new data concerning the occupation of the land and its evolutionary problems in the valley of Orleans over these periods of transition in the early.

Evolution tectonothermale du massif Hercynien des Rehamna zone centre -mesetienne, Maroc. The rampant success of quantum theory is the result of applications of the 'new' quantum mechanics of Schrodinger and Heisenbergthe Feynman-Schwinger-Tomonaga Quantum Electro-dynamicsthe electro-weak theory of Salaam, Weinberg, and Glashowand Quantum Chromodynamics ; in fact, this success of 'the' quantum theory has depended on a continuous stream of brilliant and quite disparate mathematical formulations.

In this carefully concealed ferment there lie plenty of unresolved difficulties, simply because in churning out fabulously accurate calculational tools there has been no sensible explanation of all that is going on. It is even argued that such an understanding is nothing to do with physics. A long-standing and famous illustration of this is the paradoxical thought- experiment of Einstein, Podolsky and Rosen Fundamental to all quantum theories, and also their paradoxes, is the location of sub-microscopic objects; or, rather, that the specification of such a location is fraught with mathematical inconsistency.

This project encompasses a detailed, critical survey of the tangled history of Position within quantum theories. The first step is to show that, contrary to appearances, canonical quantum mechanics has only a vague notion of locality. After analysing a number of previous attempts at a 'relativistic quantum mechanics', two lines of thought are considered in detail. The first is the work of Wan and students, which is shown to be no real improvement on the iisu.

The second is based on an idea of Dirac's - using backwards-in-time light-cones as the hypersurface in space-time.

Dka regime sarawak handbook 8th

There remain considerable difficulties in the way of producing a consistent scheme here. To keep things nicely stirred up, the author then proposes his own approach - an adaptation of Feynman's QED propagators. This new approach is distinguished from Feynman's since the propagator or Green's function is not obtained.

Birth centre confinement at the Queen Victoria Medical Centre : four years' experience. A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented.

In that time, pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while were transferred to alternative obstetrical care because of antepartum complications and because of intrapartum problems. Therefore, women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

The engineer, sustainable development craftsman at the center of the global energy challenge! By its omnipresence in society, the energy question is at the heart of sustainable development issues. The engineer, as a central actor of human society development, is therefore tightly linked to the energy issue and he must actively contribute to resolve it by integrating to his practices the principles of sustainable development and by applying the solutions that arises.

Part of these elements include as the main ones, listening to the consideration of citizens, becoming aware of the environment importance and reducing costs at all levels. The engineer is a social actor that cannot be ignored in the resolution of these issues. L'ingenieur, etant un acteur central du developpement des societes humaines, est donc inextricablement lie a la question energetique qu'il doit contribuer activement a resoudre en integrant a sa pratique les principes du developpement durable et en appliquant les solutions qui en decoulent.

Parmi ces elements, l'ecoute des considerations citoyennes, la prise de conscience de l'importance de l'environnement et la reduction des couts a tous les niveaux sont des elements centraux. L'ingenieur est un acteur social incontournable pour la resolution de ces enjeux.

Thyroid cancer: experiences at the Regional Cancer CentreTrivandrum. Above thyroid cancers are seen at the Regional Cancer Centre annually. There has been an increase in the number of TC registered over the years. This is at least partly due to improved diagnostic services and availability of I therapy. L'exemple du centre de documentation pédagogique de Damas.

Full Text Available Le secteur éducatif syrien souhaite orienter son action vers les nouvelles technologies de l'information et la sensibilisation du public scolaire aux applications de l'informatique dans le domaine éducatif et en particulier dans le cadre de l'enseignement des langues.

Dans l'enseignement-apprentissage des langues, les apports des TICE sont nombreux, mais là où elles apportent sans doute la plus grande plus-value, c'est lors de la mise en place de projets de classe motivants et valorisants, intégrés à des projets de communication authentique.

Jusqu'alors, les formations ont centr é leurs efforts sur les bases de l'environnement informatique et de la bureautique, avec pour parti pris l'utilisation de logiciels libres. L'année marquera le lancement et l'expérimentation du dispositif de formation continue à distance destiné aux professeurs de français dans le domaine des TICE.

Paediatric percutaneous nephrolithotomy: single- centre year experience. Percutaneous nephrolithotomy PCNL is a standard management option for complex and large renal calculi. In children, there is some concern over potential perioperative complications. We reviewed our 10 years of experience of PCNL in children and present our data. Data for paediatric patients who underwent PCNL at our centre in the last decade were retrieved. PCNL was performed in standard prone position under fluoroscopic guidance.

Patient characteristics, outcomes and complications were reviewed. Complications were graded according to the modified Clavien system. A comparison was also made between supracostal and infracostal accesses. Supracostal puncture was performed in 32 cases. PCNL is a safe and effective procedure in children. It enables excellent stone clearance with minimal number of interventions.

Published by Elsevier Ltd. All rights reserved. Human- centred automation programme: review of experiment related studies. Twenty-three empirical studies concerning automation and performance have been reviewed. Each study was reviewed with regard to twelve study characteristics: domain, type of study, purpose, definition of automation, variables, theoretical basis, models of operator performance, methods applied, experimental design, outcome, stated scope of results, strengths and limitations.

Seven of the studies involved domain experts, the rest used students as participants. The majority of the articles originated from the aviation domain: only the study conducted in HAMMLAB considered process control in power plants.

In ride with gps on iphone experimental studies, the independent variable was level of automation, or reliability of automation, while the most common dependent variables were workload, situation awareness, complacency, trust, and criteria of performance, e. Although the studies highlight important aspects of human-automation interaction, it is still unclear how system performance is affected. Nevertheless, the fact that many factors seem to be involved is taken as support for the system-oriented approach of the HCA programme.

In conclusion, the review provides valuable input both to the design of experiments and to the development of a general theory. Community Centres of social and psychological rehabilitation for the population suffered from Chernobyl catastrophe have been created in Ukraine, Russia and Belarus.

Objectives assigned to the Community Centres for psychosocial rehabilitation on the affected population were as follows: improving mental health of all age and social groups in the community; encouraging interactions within the community; empowering community members to take control over their lives; developing social responsibility; promoting problem-solving skills.

The Community Centres network has developed psychosocial assistance models relevant to post-catastrophe period aggravated by social and economic crisis that might be applied to different types of crises in communities. Full Text Available Fondé eninstallé à Issy-les-Moulineaux, le Centre national des archives de l'Église de France, service de la Conférence des évêques de France, est l'équivalent des Archives nationales pour l'État.

Ses fonds datent majoritairement de la seconde moitié du XXe siècle, à quelques exceptions près. Dépôt central des archives de la Conférence épiscopale, le CNAEF reçoit ses archives et celles des comités qui en dépendent, mais aussi des dons divers archives de mouvements ou de personnalités.

Les documents touchant à l'histoire de l'art se trouvent plus particulièrement dans la section CO, répartis essentiellement dans les fonds du Comité national des constructions d'églises, le Comité national d'art sacré et le Centre national de pastorale liturgique.

Ces fonds ne sont pas classés mais des répertoires sommaires sont consultables sur place, sachant que les délais de communication des documents varient entre 50 et 70 ans. For the Catholic church in France, it is the equivalent of the national archives.

With a few earlier exceptions, most of its holdings date from the second half of the 20th century. It is the central repository for the papers of the Episcopal Conference, and manages the papers of this institution and of the various committees attached to it. It also receives archives and papers by way of gifts from other organisations or personalities. These holdings are not well ordered and certain documents cannot be divulged for 50 or. A health centre and its staff have undertaken a sustainable health approach which aims to reduce the impact of the environment on health.

One of the initiatives focused on the improvement of indoor air quality. A change to practices was possible thanks to a participative approach, the support of the staff and constant communication. Attempt to evaluate the cumulative deposit of strontium 90 in several French centres ; Essai d'evaluation du depot cumulatif de strontium 90 dans plusieurs stations francaises.

In order to be able to interpret results of radioactivity controls of the ambient atmosphere and of the supply chain carried out in several French centresit is necessary to know the prix augmentation mammaire nancy 625 of the cumulative strontium deposit resulting from fall-out. The results show that the method is valid for calculating fall-out prior to in the absence of information and to deduce with sufficient approximation the subsequent cumulative deposits in the French centres under consideration.

L'estimation des retombees locale des annees anterieures a la mise en oeuvre systematique des moyens de surveillance peut etre faite en admettant que la concentration de Sr 90 dans la pluie varie peu d'un endroit a l'autre dans des regions assez rapprochees et que le depot peut etre deduit de celui mesure en une station gr e a des corrections tenant compte de la variation de pluviosite. Cette hypothese est verifiee en appliquant la methode au calcul des retombees de Sr 90 a Ispra, a Mol, et en plusieurs stations francaises: les valeurs calculees sont comparees a celles obtenues par les mesures.

Conscient du fait que les périodes de transformation risquent de provoquer le chaos, mais qu'elles sont également porteuses de rapides progrès sur le plan social et économique, le CRDI est intervenu dans quelque 25 pays ayant amorcé une transition de la guerre à la paix, de la dictature à la démocratie La Commission nationale des signes distinctifs d'origine et de qualité CNSDOQ du Maroc a attribué l'appellation IGP indication géographique protégée à l'huile d'argan, appréciée depuis longtemps pour ses vertus nutritives, cosmétiques et médicinales.

Le roi Mohammed VI a remis au groupe Elle met également en lumière le poids des contraintes inhérentes aux environnements des Etats africains. However, the economical crisis is now facing threats that jeopardize its future and shows the difficulty for African cotton industries to integrate the global market.

It also reveals the inherent constrains to African countries environments. As much factors - exogenous and endogenous — that the actors involved in these industries have to consider in order to promoting a long term improvement of their production.

The stake is to maintain an income for millions of families in these African rural regions. Le statut réplicatif du virus chez la mère séropositive, évalué par la positivité de l'AgHbe et le taux de la charge virale, conditionne le risque de contamination qui est plus important en période péri-natale. Les mères porteuses chroniques du VHB constituent un véritable réservoir de la transmission verticale de cette infection. Ceci relève l'intérêt du dépistage au cours de la grossesse, qui doit se focaliser sur la sensibilisation à la vaccination de femmes séronégatives, et le suivi par biologie moléculaire des mères séropositives dans le but d'instaurer un traitement prophylactique adéquat.

De plus en plus de patients diabétiques sont pris en charge en HDC. Les conséquences sont multiples, notamment les problèmes de pied diabétique qui demeurent mal connus du patient diabétique et des soignants ce qui retentit considérablement sur la qualité de prise en charge. Nous avons réalisé une Etude transversale en Novembre au centre d'hémodialyse de l'hôpital Al Farabi d'Oujda, incluant tous nos patients diabétiques HDC.

Nous avons relevé les données démographiques, clinico-biologiq Efficacité relative des grilles de correction d'un test de jugement situationnel pour la sélection du personnel de centres d'appels. À cet effet, les tests de jugement situationnel TJS sont de plus en plus utilisés pour la sélection du personn It contains a set of clear descriptive posters describing the experimentalong with a video projection showing animations and movies about CMS construction.

Résumant les travaux d'Alan Shihadeh, Rima Afifi, chercheure à l'AUB, rappelle que la fumée des pipes à eau a une forte teneur en goudron et contient en outre de la nicotine et des métaux lourds.

Rima Afifi précise que le fait d'avoir réuni des données probantes sur les dangers du narguilé a ouvert la The limited worldwide opening of the electric power sector: from States pre-eminence to the relative comeback of the Centre ; La mondialisation limitee du secteur electrique: de la preeminence des Etats au retour relatif du Centre.

There are botox pour la transpiration des aisselles least two reasons for undertaking a study of the political economy of India's electrical sector. Given that it is placed under the joint responsibility of the Centre and the States, its evolution reflects the relations between these two levels of the Indian federal system. Besides, the recent implementation of guidelines which have found favour with a large number of foreign countries could camouflage a subtle relationship with globalization which, in the case of India, is determined largely by the power equations within the country.

Indeed, the reform path chosen integrates two elements: the argument that reforms have become necessary on account of the inefficiency of public sector organisations whose modes of functioning are inherited from the Indian bureaucratic system; secondly, there are political and economic forces who demand reforms as an essential element of their political strategy. In particular, contrary to the classical view in India that with liberalization there has been an emancipation of the States with regard to the Centre and the creation of expanding markets for foreign investments, the 'globalization' of the electricity sector, understood here as the opening up to the foreign private sector, could in reality be equated to a relative strengthening of the Centre vis-a-vis the States.

It could also turn out to be to the advantage of some very local components, such as consumers' associations, whether rural or of local communities. Work experiences among attendees of day centres for people with psychiatric disabilities.

It is possible that people with psychiatric disabilities who visit day centres have previous work experiences that may be seen as resources for their current engagement in day centre activities. Research in this respect seems to lack, however.

To investigate work experiences among attendees at day centres for people with psychiatric disabilities and relationships with current type of day centre work-oriented, meeting place-oriented or mixedengagement in day centre activities, motivation and socio-demographic and health-related factors.

Seventy-seven attendees responded to questionnaires. Group I more frequently had college degree and was rated high on GAF functioning. Attending mixed centres was more likely when having a college degree, scoring high on GAF functioning and being highly engaged in activities. Attendees at work-oriented day centres were characterised by being motivated for spending time alone and reporting a diagnosis of psychosis.

The participants had unused working capacity. No clear-cut relationships were found between work experiences and the investigated correlates. Recipient ineligibility after liver transplantation assessment: a single centre experience. Candidacy for liver transplantation is determined through standardized evaluation. There are limited data on the frequency and reasons for denial of transplantation after assessment; analysis may shed light on the short-term utility of the assessment.

We sought to describe the frequency and reasons for ineligibility for liver transplantation among referred adults.

We studied all prospectively followed recipient candidates at a single centre who were deemed unsuitable for liver transplantation after assessment. Inclusion criteria were age 18 years and older and completion of a standard liver transplantation evaluation over a 3-year period.

Patients were excluded if they had a history of prior assessment or liver transplantation within the study period. Demographic and baseline clinical data and reasons for recipient ineligibility were recorded. In all, patients underwent their first liver transplantation evaluation during the study period; The mean age was Ineligibility for transplantation after assessment was common, occurring in nearly half of the cohort.

Most denied candidates could be identified with more discriminate screening before the resource-intensive assessment; however, the assessment likely provides unforeseen positive impacts on patient care. Upper gastrointestinal bleeding: Five-year experience from one centre. Full Text Available Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists.

Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal GI bleeding as well as its relation to age, gender and known risk factors. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the periodthree thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding.

In one quarter of cases, acute gastric erosions were the actual cause of bleeding. In most of the examined cases, bleeding stopped spontaneously, while 7. Duodenal ulcer was detected as a source of bleeding in Consumption of NSAIDs and salicylates was associated more frequently with bleeding from a duodenal ulcer than with erosive gastropathy leading to a conclusion that we must explore other causes of erosive gastropathy more thoroughly.

Bilateral adrenal masses: a single- centre experience. Full Text Available Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism.

The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India — Age at presentation was less in patients with pheochromocytoma 33 years and tuberculosis 41 years compared with PAL 48 years and metastases 61 years P Bilateral adrenal masses: a single- centre experience.

Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Age at presentation was less in patients with pheochromocytoma 33 years and tuberculosis 41 years compared with PAL 48 years and metastases 61 years P Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting.

The aim of this study was to examine the experience of violence in relation to burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Participants were nurses in the emergency medical centre setting of three metropolitan areas in Korea. Measures included a general characteristics form, characteristics related to experiences of violence, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire.

Data were collected from June to February In the prediction model, The greatest influence on burnout was handling violence, followed by verbal abuse.

The greatest influence on job satisfaction was physical threat, followed by handling violence. The study shows that burnout and job satisfaction of Korean nurses in the emergency medical centre setting are related to experiences of violence such as verbal abuse, physical threat and physical violence, as well as handling violence. Co Du Se group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi- centrerandomized, controlled pilot study.

Imbalance leading to falls is common in people with multiple sclerosis PwMS. A multi- centrerandomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late.

A total of 51 participants were initially enrolled; three were lost to follow-up. No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before p balance and reduced perceived walking limitations, compared to no exercise.

The intervention reduced falls and near falls frequency. Kasabach-Merritt phenomenon: a single centre experience. We review the experience of managing KMP in a single institution. RESULTS: All 15 patients had profound thrombocytopenia and hypofibrinogenemia at presentation, half had bleeding symptoms, and three had cardiac failure. All patients received corticosteroids. Ten patients received at least one other therapeutic modality in addition to steroids, including vincristine, interferon, anti-platelet agents and pentoxifylline.

Five patients received vincristine, for a mean of 6 wk, with two patients responding. Eight patients received interferon, for a mean of 4 months, with two patients responding. Ten patients showed a partial response to embolisation, with a mean of 2. Twelve patients remain alive, with relapse in six patients, all treated successfully.

One patient died, and two patients have been lost to follow-up. The therapeutic approach should include a multidisciplinary team and consensus on guidelines. Laparoendoscopic single site surgery in urology: A single centre experience. Full Text Available Objective : To analyze our experience of 87 cases with single port surgery, which is also known as laparoendoscopic single site surgery LESS.

In reconstructive procedures, the functional assessment was performed with a diuretic renogram at 6 months. Mean serum creatinine in recipients at 1 month was 0.

We encountered one instance each of renal artery injury, renal vein injury, large bowel injury, minor cortical laceration at the upper pole and two instances of diaphragmatic injury. There was one instance of large bowel injury during specimen retrieval. LESS ureteroneocystostomy could also be performed successfully without any complications. Conclusion: LESS surgery can be accomplished safely in nephrectomy and reconstructive procedures such as pyeloplasty and ureteroneocystostomy with equivalent outcomes as standard laparoscopy and with added benefits of cosmesis and quicker convalescence.

LESS donor nephrectomy is a technically feasible procedure; current status of procedure needs to be proved with. Analyse de la diversité des systèmes de pratiques en cacaoculture.

Cas du Centre Cameroun. Full Text Available Analysis of the diversity of cocoa cropping systems. Case of the Central Cameroon. Little is known about the cultural practices adopted by cocoa farmers in Central Cameroon. In order to bridge that knowledge gap, 1, farms were surveyed in four divisions of Centre province, which differed through the prevailing type of cocoa cultivation. Farmer typologies were established, based on their cultural practices for cocoa growing.

Three scales of investigation were considered: province, division and village. This study confirmed the diversity of cocoa growing systems existing in Central Cameroon. A multidimensional exploratory analysis revealed that the links between the variables considered varied substantially from one division to another, though the degree of intensification in inputs and labour were the main determinants of cocoa yields.

Four to five categories of farmers, which differed from each other depending on the variables studied, were found for each scale of investigation. In methodological terms, the classification method adopted to establish the typologies confirmed its efficiency. It showed that data analysis on a village scale relativized the results observed on a division scale, by making it possible to identify the cocoa growing system dominating a given village.

This approach therefore enabled a better appreciation of similarities between the study zones, similarities which administrative or geographical zoning tended to hide. It suggested that it is necessary to assist farmers taking into account the diversity of situations. Problems arising from the processing of Arabic language have been progressively settled.

The Tunisian experience in the elimination of transliteration is worth mentioning. A conjoint choice experiment to study attributes related to the selection of stores in shopping centres. This paper first reviews approaches to modeHing consumer choice of shopping destination and argues that models typically have included only few attributes related to the selection or variety of stores in a shopping centre.

Next a conjoint choice experiment is described in which profiles of. Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre. To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers.

The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centresand in Sweden this duty has become increasingly performed by registered nurses.

A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed.

The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes.

The results showed that the decisions to dispatch ambulances were both challenging and difficult.

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Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources.

Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame. Trauma patient discharge and care transition experiences : Identifying opportunities for quality improvement in trauma centres.

Challenges delivering quality care are especially salient during hospital discharge and care transitions. Severely injured patients discharged from a trauma centre will go either home, to rehabilitation or another acute care hospital with complex management needs. This purpose of this study was to explore the experiences of trauma patients and families treated in a regional academic trauma centre to better understand and improve their discharge and care transition experiences. A qualitative study using inductive thematic analysis was conducted between March and October Data collection and analysis were completed inductively and iteratively consistent with a qualitative approach.

Twenty-four interviews included 19 patients and 7 family members. Participants' experiences drew attention to discharge and transfer processes that either 1 Fostered quality discharge or 2 Impeded quality discharge.

Fostering quality discharge was ward staff preparation efforts; establishing effective care continuity; and, adequate emotional support. Impeding discharge quality was perceived pressure to leave the hospital; imposed transfer decisions; and, sub-optimal communication and coordination around discharge.

Patient-provider communication was viewed to be driven by system, rather than patient need. Inter-facility information gaps raised concern about receiving facilities' ability to care for injured patients.

The quality of trauma patient discharge and transition experiences is undermined by system- and ward-level processes that compete, rather than align, in producing high quality patient- centred discharge. Local improvement solutions focused on modifiable factors within the trauma centre include patient-oriented discharge education and patient navigation; however, these approaches alone may be insufficient to enhance patient experiences.

Trauma patients. Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden. The aim of club mincir forum paper is to advocate for the importance of meaningful leisure time for young people repas dietetique cacher a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden.

Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres ' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work.

The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities.

We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

Les outils du CERN. C'est le plus grand centre mondial de recherche en physique des particules. Les outils du Laboratoire, accélérateurs et détecteurs de particules, figurent parmi les instruments scientifiques les plus complexes au monde.

Description of the french graphite reactor and of the experiments performed in ; Presentation du premier reacteur a graphite francais et des experiences effectuees en This paper is an introduction to the experiments performed on the G1 reactor, experiments fully described in the papers following 'B to P'. The main results are given together with some comments. The neutronic parameters of the core, a description of the most important structures, and a few words of the tests leading to normal operation of the reactor under load complete our survey.

Les principaux resultats sont fournis ici et commentes. On trouvera en outre les caracteristiques neutroniques du coeur actif de la pile, une description des principales installations et une mention des essais qui ont conduit au fonctionnement normal du reacteur en puissance.

Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study. Hitzert, M. Objective to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization.

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Design this study is a cross-sectional study using the ReproQ. Objective: to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design: this study is a cross-sectional study using the ReproQ. Woman- centred care during pregnancy and birth in Ireland: thematic analysis of women's and clinicians' experiences.

Recent policy and service provision recommends a woman- centred approach to maternity care.

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In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. Challenges in successfully developing three regional radiotherapy centres. The NCCI experience. Full text: This presentation will provide an overview of the processes, experiencechallenges and success involved in the establishment of the North Coast Cancer Institute NCCI.

NCCI was developed as part of the introduction of radiotherapy into a region previously without access to a local radiotherapy service and as a result with poor radiotherapy utilisation and referral rates. Radiotherapy services commenced with Intensity Modulated Radiotherapy and Image guided radiotherapy as standard of care for some disease sites with remote access to planning systems and electronic workflow process supporting the treatment process.

Forming a small team to simultaneously design, build and establish two new treatment centres to take advantage of the most contemporary treatment modalities while also planning for a third centre was a significant challenge.

The challenges and successful outcomes will be discussed as part of this presentation. The discharge into the Rhone of liquid radio-active waste from the Marcoule Centre necessitates a large number of measurements, in particular chemical and radio-chemical analysis of the waste, itself and of the waters of the Rhone both above arid below the point of discharge.

The results thus obtained during made it possible to evaluate the total amount of active waste discharged and its dilution in the receiving medium. A statistical study of the results of the analysis of the Rhone waters shows that a satisfactory dilution of the waste occurs rapidly; the experimental results obtained with an experimental discharge of rhodamine are thus confirmed.

Au cours de l'anneel'ensemble des resultats ainsi obtenus a permis de dresser un bilan des activites rejetees et de leur dispersion dans le milieu recepteur. Une etude statistique des resultats d'analyses des eaux du Rhone montre qu'une dilution satisfaisante des effluents s'effectue rapidement confirmant ainsi les resultats obtenus lors d'un rejet experimental de rhodamine.

Queer periods: attitudes toward and experiences with menstruation in the masculine of centre and transgender community. Menstruation has long been viewed as an important aspect of women's health. However, scholars and healthcare providers have only recently begun to recognise that transgender men and people with masculine gender identities also menstruate, thus little is known about their attitudes toward and experiences with menstruation.

Participants reported mixed attitudes toward menstruation, but generally positive attitudes toward menstrual suppression. Many participants said that they try to avoid public restrooms during menstruation because of practical and psychological concerns.

Implications of our findings for the transgender health are discussed. User experience in libraries applying ethnography and human- centred design. Modern library services can be incredibly complex. Much more so than their forebears, modern librarians cellulite treatment kitchener waterloo grapple daily with questions of how best to implement innovative new services, while also maintaining and updating the old.

The efforts undertaken are immense, but how best to evaluate their success? In this groundbreaking new book from Routledge, library practitioners, anthropologists, and design experts combine to advocate a new focus on User Experience or UX research methods. Through a combination of theoretical discussion and applied case studies, they argue that this ethnographic and human- centred design approach enables library professionals to gather rich evidence-based insights into what is really going on in their libraries, allowing them to look beyond what library users say they do to what they actually do.

Edited by the team behind the international UX in Libraries conference, "User Experience in Libraries" will ignite new interest in a rapidly emerging and game-changing area of resear Virtual community centre for power wheelchair training: Experience of children and clinicians.

To: 1 characterize the overall experience in using the McGill immersive wheelchair - community centre miWe-CC simulator; and 2 investigate the experience of presence i. A qualitative research design with structured interviews was used. Fifteen clinicians and 11 children were interviewed after driving a power wheelchair PW in the miWe-CC simulator. Data were analyzed using the conventional and directed content analysis approaches. Overall, participants enjoyed using the simulator and experienced a sense of presence in the virtual space.

They felt a sense of being in the virtual environment, involved and focused on driving the virtual PW rather than on the surroundings of the actual room where they were. Participants reported several similarities between the virtual community centre layout and activities of the miWe-CC and the day-to-day reality of paediatric PW users.

The simulator replicated participants' expectations of real-life PW use and promises to have an effect on improving the driving skills of new PW users. Implications for rehabilitation Among young users, the McGill immersive wheelchair miWe simulator provides an experience of presence within the virtual environment. This experience of presence is generated by a sense of being in the virtual scene, a sense of being involved, engaged, and focused on interacting within the virtual environment, and by the perception that the virtual environment is consistent with the real world.

The miWe is a relevant and accessible approach, complementary to real world power wheelchair training for young users. Going private: clinicians' experience of working in UK independent sector treatment centres.

With increased possibility that public healthcare services in the UK will be outsourced to the private sector, this study investigates how clinicians working in Independent Sector Treatment Centres perceive the differences between public and private sectors.

Qualitative interviews with 35 clinicians recruited from two ISTCs. All participants were transferred to the independent sector from the public National Health Service. Interview data were analysed to identify shared experience about the variable organisation and delivery of services.

Clinicians perceived differences between public and independent sectors in the areas of 'environment and facilities', 'management', 'work organisation and care delivery', and 'patient experience '. The independent sector was described as offering a positive alternative to public services in regard to service environment and patient experiencebut there were concerns about management priorities and the reconfiguration of work. Clinicians' experience of moving between sectors reveals mixed experiences.

Although some improvements might legitimise the growing role of the independent sector, there remain doubts about the commercialisation of services, the motives of managers and the impact of clinical roles and capabilities. With policies looking to expand the mixed economy of public healthcare services, the study suggests clinicians will not automatically embrace a move between sectors. Using drawings to understand the child's experience of child- centred care on admission to a paediatric high dependency unit.

This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child- centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child- centred care framework.

Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experienceconsistent with child- centred care, while drawing on the principles of family- centred care.

Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child- centred care and family- centred care principles into practice, theory, research and policy.

Experience with procuring, deploying and maintaining hardware at remote co-location centre. The centre is operated as a remote co-location site providing rack-space, electrical power and cooling for server, storage and networking equipment acquired by CERN. The contract includes a 'remote-hands' services for physical handling of hardware rack mounting, cabling, pushing power buttons, However, only CERN personnel have network and console access to the equipment for system administration.

This report gives an insight to adaptations of hardware architecture, procurement and delivery procedures undertaken enabling remote physical handling of the hardware. We will also describe tools and procedures developed for automating the registration, burn-in testing, acceptance and maintenance of the equipment as well as an independent but important change to the IT assets management ITAM developed in parallel as part of the CERN IT Agile Infrastructure project.

Experiences of Everyday Occupation among People with Psychiatric Disabilities - Relationships to social interaction, the worker role and day centre attendance. The thesis aims to explore subjective experiences of everyday occupation, social interaction and the view of the worker role among people with psychiatric disabilities PDwhile also addressing the importance of day centre attendance.

The thesis consists of one qualitative study, exploring which characteristics in everyday occupation provide meaning to people with PD, and three quantitative studies based on questionnaires to both day centre attendees and non-attendees. Study I showed that fe La confirmation a été faite en réalisant la même technique en double au CTS et au laboratoire de virologie. Experiences and performance of the Harshaw dosimetry system at two major processing centres.

The installations, operating practice, dose algorithms and results and maintenance experience at two major dosimetry processing centres are described.

System selection considerations and a comprehensive quality programme are described in the light of the publication of testing requirements by various dosimetry regulatory organisations.

Reported information from Siemens Dosimetry Services comprises their selection of dosemeters and processing equipment including service history, a description of their dose computation algorithm, and detailed results of their testing against DOELAP standards. Battelle Pacific Northwest Laboratories PNL provides a description of their dosemeters and equipment with service history; in addition, a discussion of their new neural network approach to a dose computation algorithm and test results from that algorithm are presented.

A comparison of labour and birth experiences of women delivering in a birthing centre and at home in the Netherlands. OBJECTIVE: to compare the labour and birth experiences of women who delivered at home without complications with the experiences of women who delivered in a birth centre without complications. DESIGN: a descriptive study using postal questionnaires at months after birth of a consecutive sample.

Midwife-led models of care are seen as one important strategy for enhancing women's choice; a core element of woman- centred care. This study considers women's and clinicians' views, experiences and perspectives of woman- centred maternity care in Ireland.

A descriptive qualitative design. Interviews were face-to-face or over the telephone, one-to-one or focus groups. A thematic analysis of the interview data was performed.

Five major themes representing women's and clinicians' views, experiences and perspectives of women- centred care emerged from the data. Within these major themes, sub-themes emerged that reflect key elements of women- centred care. These were respect, partnership in decision making, information sharing, educational impact, continuity of service, staff continuity and availability, genuine choice, promoting women's autonomy, individualized care, staff competency and practice organization.

Women centred -care, as perceived by participants in this study, is not routinely provided in Ireland and women subscribe to the dominant culture that views safety as paramount. Women- centred care can best be facilitated through continuity of carer and in particular through midwife led models of care; however, there is potential to provide women- centred care within existing labour wards in terms of consistency of care, education of.

Combining these weak form factors with the electromagnetic ones makes possible the extraction of the contribution of strange quarks to the charge and magnetization distribution in the nucleon. Diriger l'élaboration de politiques régissant l'administration de projets du Centre Tenir à jour un aperçu stratégique des activités de projet du Centre afin d'en Gérer le recrutement du personnel de l'administration des subventions dans Injection Experiments in Jutphaas; Injection au Centre de Jutphaas; Ehksperimenty s inzhektsiej v institute fiziki plazmy v yutfaas; Experimentos de Inyeccion en Jutphaas.

De Kluiver, H. Dans une experience type avec un faisceau d'electrons, la moitie du courant injecte est temporairement piege. La courbe du temps de confinement en fonction du champ magnetique concorde avec les resultats de l'analyse des orbites.

Avec des champs electrostatiques externes, on obtient un confinement total, compte non tenu des pertes associees aux collisions avec le gaz residuel.

Pour un champ de 13 kG, un courant d'intensite nette de 35 mA penetre dans le champ a pointes, 15 mA atteignant l'extremite opposee.

Un collecteur place dans le champ annulaire a points de rebroussement permet de mesurer les courants de pertes. L'integration de ces courants sur tout le champ annulaire a points de rebroussement donne une perte de 10 a 20 mA. Une sonde ayant une geometrie particuliere, qui ne recueille que des ions chauds, permet d'obtenir la meme description generale de l'evolution du courant que les sondes ordinaires.

Le sondage radial du plasma accuse une augmentation considerable du courant collecte vers le centre avec une diminution du temps de decroissance. Les mesures donnent a penser que pendant l. Multi- centre experience of implementing image-guided intensity-modulated radiotherapy using the TomoTherapy platform. Dean, J. Use of image guided IG intensity modulated radiotherapy IMRT is increasing, and helical tomotherapy provides an effective, integrated solution.

Practical experience of implementation, shared at a recent UK TomoTherapy Users' meeting, may help centres introducing these techniques using TomoTherapy or other platforms. Seven centres participated, with data shared from 6, varying from - new patients per year. IMRT was also selected for complex target volumes, to avoid field junctions, for technical treatment difficulties, and retreatments.

Across the centresevery patient was imaged every day, with positional correction before treatment. In one centrefor prostate patients including pelvic treatment, the pelvis was also imaged weekly.

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