Specification for face-to-face, centre-to-face, end-to-end and centre-to-end dimensions of flanged and butt-welding end steel valves for the petroleum, petrochemical and allied industries

1974 ◽  
Keyword(s):  
2016 ◽  
Vol 22 (8) ◽  
pp. 499-503 ◽  
Author(s):  
Susan C Jury ◽  
Andrew J Kornberg

The Royal Children’s Hospital, Melbourne, began offering web-based telehealth video consultation in 2011, with the principle being that telehealth should be integrated into ‘business as usual’. In telehealth literature, key differences between telehealth and in-person consultations can make this hard to achieve, so an audit was performed that revealed many small gaps in the process. A total of 125 telehealth appointments were booked during the study period. Of these, 13% ( n = 16) were rescheduled, cancelled or changed to face-to-face appointments, and up to two main issues were identified for the remaining appointments. Some 69% of the remaining 108 appointments ( n = 75) were completed successfully, with 23% ( n = 25) completely seamless end to end. Overall, 39 issues were administrative (40%), 34 technical (35%) and 24 scheduling (25%); nine (8%) required some minor troubleshooting. For long-term sustainability, integrating telehealth into business as usual needs to remain the target. Scheduling and technical glitches were the main barriers to seamless telehealth. Several issues have now been addressed with the introduction of an electronic medical record, and the development of standardised processes and staff training.


1992 ◽  
Vol 1 (2) ◽  
pp. 11-12 ◽  
Author(s):  
James Jerger
Keyword(s):  

2014 ◽  
Vol 23 (3) ◽  
pp. 132-139 ◽  
Author(s):  
Lauren Zubow ◽  
Richard Hurtig

Children with Rett Syndrome (RS) are reported to use multiple modalities to communicate although their intentionality is often questioned (Bartolotta, Zipp, Simpkins, & Glazewski, 2011; Hetzroni & Rubin, 2006; Sigafoos et al., 2000; Sigafoos, Woodyatt, Tuckeer, Roberts-Pennell, & Pittendreigh, 2000). This paper will present results of a study analyzing the unconventional vocalizations of a child with RS. The primary research question addresses the ability of familiar and unfamiliar listeners to interpret unconventional vocalizations as “yes” or “no” responses. This paper will also address the acoustic analysis and perceptual judgments of these vocalizations. Pre-recorded isolated vocalizations of “yes” and “no” were presented to 5 listeners (mother, father, 1 unfamiliar, and 2 familiar clinicians) and the listeners were asked to rate the vocalizations as either “yes” or “no.” The ratings were compared to the original identification made by the child's mother during the face-to-face interaction from which the samples were drawn. Findings of this study suggest, in this case, the child's vocalizations were intentional and could be interpreted by familiar and unfamiliar listeners as either “yes” or “no” without contextual or visual cues. The results suggest that communication partners should be trained to attend to eye-gaze and vocalizations to ensure the child's intended choice is accurately understood.


VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Jan Paweł Skóra ◽  
Jacek Kurcz ◽  
Krzysztof Korta ◽  
Przemysław Szyber ◽  
Tadeusz Andrzej Dorobisz ◽  
...  

Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.


2012 ◽  
Vol 41 (4) ◽  
pp. 249-257 ◽  
Author(s):  
Tana Kröner ◽  
Kathrin Hansen ◽  
Regina Steil

Theoretischer Hintergrund: Chronische Alpträume stellen eine weit verbreitete Schlafstörung dar, welche einen hohen Leidensdruck hervorruft. Als besonders wirksam in der Behandlung gilt die Imagery Rehearsal Therapy (IRT). Selbsthilfeprogramme stellen hierbei eine effektive, ökonomische Behandlungsoption dar. Fragestellung: Die vorliegende Pilotstudie untersucht die Wirksamkeit einer neuen, IRT-basierten, angeleiteten Selbsthilfe. Methode: 10 Patienten mit chronischen Alpträumen wurden im Rahmen von 4 face-to-face-Sitzungen vor Intervention (T1) sowie 4 Wochen (T2) und 3 Monate (T3) danach hinsichtlich Alptraumhäufigkeit sowie verschiedener psychosozialer Parameter untersucht. Ergebnisse: Die Alptraumhäufigkeit reduzierte sich innerhalb von 4 Wochen signifikant (T1-T2; Effektstärke: 1,0). Dieser Effekt blieb über 3 Monate stabil (T1-T3; Effektstärke: 1,26). Zudem reduzierten sich signifikant Depressions-, Angst- und Anspannungsparameter sowie das Stresserleben. Schlussfolgerung: Das deutschsprachige Selbsthilfemanual könnte eine wirksame Behandlungsmöglichkeit zur Reduktion von Alpträumen darstellen.


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