Chief Medical Officer's Report - Evidential Base and Clinical Practice Aspects of Congenital Cardiac Services (August 2013) (PDF 77KB)

Report on Evidential Base and Clinical Practice Aspects of Congenital Cardiac Services The principle drivers that should determine the optimal arrangements for the provision of congenital cardiac services, including  paediatric and adult cardiac surgery, for the population of Northern Ireland is how best those services can be configured to ensure the safest possible care that is of the highest quality possible in order to optimise outcomes and experience for patients and carers. Of necessity, this requires consideration of all requisite supporting services and arrangements to ensure access across the continuum of care. Such a configuration should support safe, high quality service provision on an on-going basis i.e. ensure sustainability as far as can be determined. In addressing this issue, consideration to the changing profile of population need and the evolving nature specialist services is required.  

Report on the Iowa Office of the Chief Information Officer for the year ended June 30, 2015

Report on the Iowa Office of the Chief Information Officer for the year ended June 30, 2015

Chief British poets of the fourteenth and fifteenth centuries; selected poems,

"Biographical and bibliographical notes": p. [425]-436.

Alternative media for public pedagogy: "Chief" concerns and human agency

To demonstrate how the growing influence of alternative media in civil society correlates with the rise of social movements and their influence on contemporary manifestations of resistance, this research uses critical ethnographic methodologies to document the narratives of alternative media producers in the pro-Indigenous and anti-“Chief” campaigns at the University of Illinois at Urbana-Champaign during the 2006-2007 school year. These narratives demonstrate not only the ways alternative media help transmit dissent by distributing information to diverse populations, but also the manner they facilitate contexts that influence identity formations and strengthen counter-cultural communal practices. Particular lineages of critical social theory are used to situate knowledge construction and social relationships within specific socio-historic contexts to approach issues of subjectivity, human agency, and resistance. These include the Frankfurt School for Social Research, the Birmingham Centre for Contemporary Cultural Studies, and the Brazilian education philosopher Paulo Freire, who emphasize criticality based on the engagement of ideological analysis, as well as developing capacities to critique and resist oppressive social and political relationships. Thus, this study argues for expanding traditional notions of literacy to include the ability to decode and produce media as a critical element of meaningful democratic participation.

Map of Nassau Heights in the village of Newtown, Queens County, L.I. : formerly the Brettonnierre Farm, now the Caldwall Farm : about 4 miles from Peck Slip Ferry in Williamsburgh /

Cadastral survey map of proposed streets and lots, showing dimensions, lot numbers, and existing buildings.

Annual Report 2-15 Office of the Chief Information Officer, January 2016

In 2015, the OCIO worked across a broad range of projects and key initiatives in alignment with these goals. As an IT organization supporting services consumed by every agency of the State of Iowa (State), our key enterprise initiatives are conducted in addition to the day-to-day support activities required to keep government IT services operational and secure. These initiatives maintain alignment with key efficiency goals established by Governor Branstad and with specific legislative mandates.

Management Of Severe Thoracic Impalement Trauma Against Two-wheeled Horse Carriage: A Case Report And Literature Review.

Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.

A contribuição da Educação Fisica no processo de humanização do adolescente

Universidade Estadual de Campinas. Faculdade de Educação Física

Maxillary protraction after surgically assisted maxillary expansion

This case report describes the orthodontic treatment of a 32-year-old woman with a Class III malocclusion, whose chief compliant was her dentofacial esthetics. The pretreatment lateral cephalometric tracings showed the presence of a Class III dentoskeletal malocclusion with components of maxillary deficiency. After discussion with the patient, the treatment option included surgically assisted rapid maxillary expansion (SARME) followed by orthopedic protraction (Sky Hook) and Class III elastics. Patient compliance was excellent and satisfactory dentofacial esthetics was achieved after treatment completion.

Computed tomography and scintigraphy exams for diagnosis and treatment planning of the condylar osteochondroma: a case report

PURPOSE: To report an uncommon case of osteochondroma affecting the mandibular condyle of a young patient and to illustrate the important contributions of different imaging resources to the diagnosis and treatment planning of this lesion. CASE DESCRIPTION: A 24-year-old female patient with the chief complaint of an increasing facial asymmetry and pain in the left pre-auricular region, revealing a reduced mouth opening, mandibular deviation and posterior cross-bite over a period of 18 months. Panoramic radiography revealed an enlargement of the left condyle, whereas computed tomography (CT) sections and three-dimensional CT showed a well-defined bone growth arising from condylar neck. The scintigraphy exam showed an abnormal osteogenic activity in the left temporomandibular joint. The condyle was surgically removed and after 18 months follow-up the panoramic radiography and CT scans showed no signs of recurrence. CONCLUSION: Although osteochondroma is a benign bone tumor that rarely arises in cranial and maxillofacial region, it should be considered in the differential diagnosis of slow-growing masses of the temporomandibular area and the use of different imaging exams significantly contribute to the correct diagnosis and treatment planning of this pathological condition.

Upper limit on the diffuse flux of ultrahigh energy tau neutrinos from the Pierre Auger Observatory

The surface detector array of the Pierre Auger Observatory is sensitive to Earth-skimming tau neutrinos that interact in Earth's crust. Tau leptons from nu(tau) charged-current interactions can emerge and decay in the atmosphere to produce a nearly horizontal shower with a significant electromagnetic component. The data collected between 1 January 2004 and 31 August 2007 are used to place an upper limit on the diffuse flux of nu(tau) at EeV energies. Assuming an E(nu)(-2) differential energy spectrum the limit set at 90% C. L. is E(nu)(2)dN(nu tau)/dE(nu) < 1: 3 x 10(-7) GeV cm(-2) s(-1) sr(-1) in the energy range 2 x 10(17) eV< E(nu) < 2 x 10(19) eV.

Modeling of Effect of Plastic Deformation on Barkhausen Noise and Magnetoacoustic Emission in Iron With 2% Silicon

Before one models the effect of plastic deformation on magnetoacoustic emission (MAE), one must first treat non-180 degrees domain wall motion. In this paper, we take the Alessandro-Beatrice-Bertotti-Montorsi (ABBM) model and modify it to treat non-180 degrees wall motion. We then insert a modified stress-dependent Jiles-Atherton model, which treats plastic deformation, into the modified ABBM model to treat MAE and magnetic Barkhausen noise (HBN). In fitting the dependence of these quantities on plastic deformation, we apply a model for when deformation gets into the stage where dislocation tangles are formed, noting two chief effects, one due to increased density of emission centers owing to increased dislocation density, and the other due to a more gentle increase in the residual stress in the vicinity of the dislocation tangles as deformation is increased.

Growth performance and body composition of pacu Piaractus mesopotamicus (Holmberg 1887) in response to dietary protein and energy levels

Improper dietary protein and energy levels and their ratio will lead to increased fish production cost. This work evaluated effects of dietary protein : energy ratio on growth and body composition of pacu, Piaractus mesopotamicus. Fingerling pacu (15.5 +/- 0.4 g) were fed twice a day for 10 weeks until apparent satiation with diets containing 220, 260, 300, 340 or 380 g kg-1 crude protein (CP) and 10.9, 11.7, 12.6, 13.4 or 14.2 MJ kg-1 digestible energy (DE) in a totally randomized experimental design, 5 x 5 factorial scheme (n = 3). Weight gain, specific growth rate increased and feed conversion ratio (FCR) decreased significantly (P < 0.05) when CP increased from 220 to 271, 268 and 281 g kg-1 respectively. Pacu was able to adjust feed consumption in a wide range of dietary DE concentration. Fish fed 260 CP diets showed best (P < 0.05) protein efficiency ratio and FCR with 11.7-12.6 MJ kg-1; but for the 380 CP-diets group, significant differences were observed only at 14.2 MJ kg-1 dietary energy level, suggesting that pacu favours protein as energy source. DE was the chief influence on whole body chemical composition. Minimum dietary protein requirement of pacu is 270 g kg-1, with an optimum CP : DE of 22.2 g MJ-1.