General practitioner, specialist providers case conferences in palliative care: Lessons learned from 56 case conferences

OBJECTIVE: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care. METHOD: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff. RESULTS: For most GPs, case conferences by teleconference were a time effective and immediate means of information transfer. The best instances for a conference were at time of patient referral, time of discharge to the community, or where the case was complex. General practitioners appreciated access to multiple professionals simultaneously. Workload pressures were a drawback of participation for both GPs and specialists. Palliative care team members thought case conferences gave GPs an appreciation of a team approach, and reduced professional isolation. The usefulness of the case conferences depended on the willingness of the GP to participate. General practitioners would participate again provided they did not have to organise the case conference. Specialist staff were concerned by the financial cost of organising case conferences. DISCUSSION: Case conferences provide useful information exchange between GPs and specialist staff, and are acceptable to both parties. Much depends on the individual GPs attitude toward participation, as well as the timing of the conferences in the course of the patient's illness. Organisation needs to be a task of the specialist units, who would need administrative support to organise them. (author abstract)

Highly demanding resistive vibration exercise program is tolerated during 56 days of strict bed-rest

Several studies have tried to find countermeasures against musculoskeletal de-conditioning during bed-rest, but none of them yielded decisive results. We hypothesised that resistive vibration exercise (RVE) might be a suitable training modality. We have therefore carried out a bed-rest study to evaluate its feasibility and efficacy during 56 days of bed-rest. Twenty healthy male volunteers aged 24 to 43 years were recruited and, after medical check-ups, randomised to a non-exercising control (Ctrl) group or a group that performed RVE 11 times per week. Strict bed-rest was controlled by video surveillance. The diet was controlled. RVE was performed in supine position, with a static force component of about twice the body weight and a smaller dynamic force component. RVE comprised four different units (squats, heel raises, toe raises, kicks), each of which lasted 60 - 100 seconds. Pre and post exercise levels of lactate were measured once weekly. Body weight was measured daily on a bed scale. Pain questionnaires were obtained in regular intervals during and after the bed-rest. Vibration frequency was set to 19 Hz at the beginning and progressed to 25.9 Hz (SD 1.9) at the end of the study, suggesting that the dynamic force component increased by 90%. The maximum sustainable exercise time for squat exercise increased from 86 s (SD 21) on day 11 of the BR to 176 s (SD 73) on day 53 (p = 0.006). On the same days, post-exercise lactate levels increased from 6.9 mmol/l (SD2.3) to 9.2 mmol/l (SD 3.5, p = 0.01). On average, body weight was unchanged in both groups during bed-rest, but single individuals in both groups depicted significant weight changes ranging from -10% to + d10% (p < 0.001). Lower limb pain was more frequent during bed-rest in the RVE subjects than in Ctrl (p = 0.035). During early recovery, subjects of both groups suffered from muscle pain to a comparable extent, but foot pain was more common in Ctrl than in RVE (p = 0.013 for plantar pain, p = 0.074 for dorsal foot pain). Our results indicate that RVE is feasible twice daily during bed-rest in young healthy males, provided that one afternoon and one entire day per week are free. Exercise progression, mainly by progression of vibration frequency, yielded increases in maximum sustainable exercise time and blood lactate. In conclusion, RVE as performed in this study, appears to be safe.

Recognition times of different views of 56 depth-rotated objects: a note concerning Verfaillie and Boutsen (1995)

The present study examines the effect of the goodness of view on the minimal exposure time required to recognize depth-rotated objects. In a previous study, Verfaillie and Boutsen (1995) derived scales of goodness of view, using a new corpus of images of depth-rotated objects. In the present experiment, a subset of this corpus (five views of 56 objects) is used to determine the recognition exposure time for each view, by increasing exposure time across successive presentations until the object is recognized. The results indicate that, for two thirds of the objects, good views are recognized more frequently and have lower recognition exposure times than bad views.

THOMAS NIEHR AND KARIN BÖKE (eds), Einwanderungsdiskurse. Vergleichende diskurslinguistische Studien. [Immigration Discourses: Comparative Discourse Studies.] Opladen: Westdeutscher Verlag, 2000. 241 pp. DM 56.00 (pbk). ISBN 3–5311–3307–1

Book review

Medical School Donor Recognition Reception Photo 56

http://digitalcommons.fiu.edu/com_images/1061/thumbnail.jpg

56 Gb/s multi-band CAP for data center interconnects up to an 80 km SMF

We present the first (to the best of our knowledge) experimental demonstration of a 56 Gb/s multi-band carrierless amplitude and phase modulation (CAP) signal transmission over an 80-km single-mode fiber link with zero overhead pre-FEC signal recovery and enhanced timing jitter tolerance for optical data center interconnects.

(Table 1) Lithology, mineralogy, and physical properties of Cretaceous cherts and porcellanites at DSDP Hole 56-436

Cretaceous chert and porcellanite recovered at Site 436, east of northern Honshu, Japan, are texturally and mineralogically similar to siliceous rocks of comparable age at Sites 303, 304, and 307 in the northwest Pacific. These rocks probably were formed by impregnation of the associated pelagic clay with locally derived silica from biogenic and perhaps some volcanic debris. Fine horizontal laminations are the only primary sedimentary structures, suggesting minimal reworking and transport. Collapse breccias and incipient chert nodules are diagenetic features related to silicification and compaction of the original sediment. Disordered opal-CT (d[101] = 4.09 Å) and microgranular quartz (crystallinity index < 1.0) are the two common silica minerals present. Some samples show quartz replacing this poorly ordered opal- CT, supporting the notion that opal-CT does not become completely ordered (i.e., d[101] = 4.04 Å) in some cases before being converted to quartz. The present temperature calculated for the depth of the shallowest chert and porcellanite at this site is 30 °C; this may represent the temperature of conversion of opal-CT to quartz. High reflection coefficients (0.29-0.65) calculated for the boundary between chert-porcellanite and clay-claystone support the common observation that chert is a strong seismic reflector in deep-sea sedimentary sections.

Peter Gansen: Metaphorisches Denken von Kindern, Theoretische und empirische Studien zu einer Pädagogischen Metaphorologie, (Erziehung – Schule – Gesellschaft, Bd. 56) Würzburg: Ergon 2010 [Rezension]

Rezension von: Peter Gansen: Metaphorisches Denken von Kindern, Theoretische und empirische Studien zu einer Pädagogischen Metaphorologie, (Erziehung – Schule – Gesellschaft, Bd. 56), Würzburg: Ergon 2010 (540 S.; ISBN 978-3-89913-742-2)

¿Y qué misterio tendrá el número siete ? hoy a las 12:34: 56 del 7/8/90, la secuencia perfecta : cábalas para el presidente Gaviria

Fondo Margaritainés Restrepo

Resolución 56 del 20 de mayo de 2009: ¿Que efectos jurídicos produce el acto de inscripción del nombramiento de un liquidador durante el tiempo en que adquiere su firmeza y no ha sido objeto de impugnación? ¿Es susceptible de inscripción en el registro mercantil un acto producido por un liquidados cuya inscripción de nombramiento aun no esta en firme?

Servicios registrales

Seventy-Eighth Annual Report of the Public Service Commission of South Carolina 1955-56

Each year the South Carolina Public Service Commission reports to the Office of State Budget that includes the agency's mission, goals and objectives to accomplish the mission, and performance measures regarding the goals and objectives.