Long-term radiographic follow-up of the Nissen fundoplication in children

This study examined 46 children 5–9 years (mean 6.7) after Nissen fundoplication surgery for gastroesophageal reflux (GER). Eleven were deceased and ten of the 35 families declined objective evaluation. The remaining 25 children (71%) had a barium swallow examination. In 16 of the 25 patients the fundoplication was intact. In 2 patients a small portion of the fundoplication was displaced above the diaphragm. In 5 patients there was residual esophageal disease. In 3 patients (one with esophageal disease), with a hiatus hernia prior to surgery, despite immediate postoperative reduction, the barium swallow examination done for this study revealed recurrent hiatus hernia but no GER. Long-term results of the Nissen fundoplication reveal success in eliminating clinically significant gastroesophageal reflux. Those patients with esophageal disease prior to the surgery need close interval follow-up to monitor continuing problems.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46689/1/247_2006_Article_BF02389563.pd

THE EFFECTS OF INSTRUCTION IN HOLISTIC HEALTH ON SELF-CONCEPT, ANXIETY, AND RESPONSES OF LAY PASTORAL CARE MINISTERS

Recent changes in health care delivery have made it necessary for hospital administrators to economize to a greater extent than formerly. In many instances, there are fewer health care professionals to care for the needs of very ill patients. Because their expertise is needed in the area of physical care, they often are not able to take the time to attend to the emotional and spiritual needs of their patients. Assistance has been provided by volunteers from church-sponsored lay pastoral care programs. Although studies have shown that it is important for persons to have a positive self-concept in order to minister effectively to others, programs of instruction for lay pastoral care ministers typically do not address this area of concern. In addition, volunteers often share doubts about their ability to be effective in responding to sick or troubled persons. This study measured the self-concepts of the volunteers, the amount of anxiety which they bring to their role, and the types of responses which they prefer to give to those who are sick and troubled. Experienced volunteers from parishes and hospitals in Milwaukee County were selected at random and placed in either an experimental group or a control group. Those in the experimental group answered the Tennessee Self Concept Scale, the State Anxiety Inventory, and the Pastoral Counseling Response Scale, before participating in a workshop on holistic health and again, four weeks later. Persons in the control group answered the same three inventories at the beginning and end of a four week period. They were not invited to attend the workshop. Results showed a significant difference in descriptions of basic identity, moral-ethical worth, and in the number of instructive responses chosen. Mild anxiety was reported in interacting with sick persons. Developmental and supportive responses were preferred. Few persons chose empathic responses. This study indicates a need for lay pastoral care ministers to have instruction in holistic health, communication skills, and alleviation of anxiety when relating to sick and troubled persons. This instruction could be integrated into existing programs of preparation for lay volunteers

A Dependable Detection Mechanism for Intersection Management of Connected Autonomous Vehicles (Interactive Presentation)

Traffic intersections will become automated in the near future with the advent of Connected Autonomous Vehicles (CAVs). Researchers have proposed intersection management approaches that use the position and velocity that are reported by vehicles to compute a schedule for vehicles to safely and efficiently traverse the intersection. However, a vehicle may fail to follow intersection manager (IM) scheduling commands due to erroneous sensor readings or unexpected incidents like engine failure, which can cause an accident if the failure happens inside the intersection. Additionally, rogue vehicles can take the advantage of the IM by providing false position and velocity data and cause traffic congestion. In this paper, we present a new technique and infrastructure to detect anomalies and inform the IM. We propose a vision system that can monitor the position of incoming vehicles and provide real-time data for the IM. The IM can use this data to verify the trajectories of CAVs and broadcast a warning when a vehicle fails to follow commands, making the IM more resilient against attacks and false data. We implemented our method by building infrastructure for an intersection with 1/10 scale model CAVs. Results show our method, when combined with an IM dataflows, is more dependable in the event of a failure compared to an IM without it