A Case of Primary Squamous Cell Carcinoma of the Liver Arising in a Solitary Cyst

A case of primary squamous cell carcinoma in a pre-existing hepatic cyst is presented. A review of the literature suggests that this rare type of liver tumor tends to arise from solitary, nonparasitic cysts, lined with squamous epithelium. Effective therapy is not available, the prognosis is grave

Angel Whispers : Reverie Transcription

https://digitalcommons.library.umaine.edu/mmb-ps/1361/thumbnail.jp

Beet Workers of Colorado

The sugar-beet industry was chosen as the subject matter for this Thesis since Boulder is in the heart of the sugar-beet territory. &nbsp; The composition portrays a group of beet workers who are busy weeding the beets. A background of farm houses and mountains provides a suitable or typical setting for the workers. &nbsp; The panel thirty-three inches by forty-five inches was made of '1 Presdwood' 1 treated with a casein size and ground which affords the best surface for the medium used. Egg tempera was selected as the medium because of its numerous possibilities in soft-textured surfaces and luminous color quality. &nbsp; This Thesis problem afforded a splendid opportunity for the application of principles of composition, color theory, and techniques in medium learned in academic work.</p

Positron emission tomography for staging of oesophageal and gastroesophageal malignancy.

Positron emission tomography (PET) with [18F]-fluoro-2-deoxy-D-glucose (FDG) was prospectively investigated as a means of detecting metastatic disease in patients with oesophageal tumours and compared with computerized tomography (CT), with the surgical findings as a gold standard. Twenty-six patients with a malignant tumour of the oesophagus or gastroesophageal junction underwent CT and PET of the chest and the abdomen. Seven patients underwent laparoscopy to establish resectability. Fifteen patients underwent laparotomy without prior laparoscopy. Four patients did not undergo surgery. The primary tumour was visualized in 81% of patients with CT and in 96% with PET. Neither CT nor PET were suited to assess the extent of wall invasion. Surgically assessed nodal status corresponded in 62% with CT and in 90% with PET. Distant metastases were found in five patients with CT and in eight with PET. The diagnostic accuracy of CT in determining resectability was 65% and for PET 88%. For CT and PET together this was 92%. The present study indicates that FDG-PET can be of importance for staging patients with oesophageal tumours. PET has a higher sensitivity for nodal and distant metastases and a higher accuracy for determining respectability than CT. PET and CT together would have decreased ill-advised surgery by 90%

Assessing time use in long-term institutional care:development, validity and inter-rater reliability of the Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC)

BACKGROUND: Limited research has examined what is actually done in the process of care by nursing staff in long-term institutional care. The applied instruments employed different terminologies, and psychometric properties were inadequately described. This study aimed to develop and test an observational instrument to identify and examine the amount of time spent on nursing interventions in long-term institutional care using a standardized language. METHODS: The Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC) is based on the conceptual framework of the Nursing Interventions Classification. Developmental, validation, and reliability stages of the GO-LTIC included: 1) item generation to identify potential setting-specific interventions; 2) examining content validity with a Delphi panel resulting in relevant interventions by calculating the item content validity index; 3) testing feasibility with trained observers observing nursing assistants; and 4) calculating inter-rater reliability using (non) agreement and Cohen's kappa for the identification of interventions and an intraclass correlation coefficient for the amount of time spent on interventions. Bland-Altman plots were applied to visualize the agreement between observers. A one-sample student T-test verified if the difference between observers differed significantly from zero. RESULTS: The final version of the GO-LTIC comprised 116 nursing interventions categorized into six domains. Substantial to almost perfect kappa's were found for interventions in the domains basic (0.67-0.92) and complex (0.70-0.94) physiological care. For the domains of behavioral, family, and health system interventions, the kappa's ranged from fair to almost perfect (0.30-1.00). Intraclass correlation coefficients for the amount of time spent on interventions ranged from fair to excellent for the physiological domains (0.48-0.99) and poor to excellent for the other domains (0.00-1.00). Bland Altman plots indicated that the clinical magnitude of differences in minutes was small. No statistical significant differences between observers (p > 0.05) were found. CONCLUSIONS: The GO-LTIC shows good content validity and acceptable inter-rater reliability to examine the amount of time spent on nursing interventions by nursing staff. This may provide managers with valuable information to make decisions about resource allocation, task allocation of nursing staff, and the examination of the costs of nursing services

Analysis for the Design of a Sustainable Housing Complex in Haiti

This paper presents sustainable strategies for the design of a prototype sustainable housing complex in tropical climate that applies specifically to Haiti. The tropical climate zone is hot and humid with abundant rainfall and luxuriant vegetation growth. Despite its beautiful environment most of the countries in this zone are undeveloped and poverty manifests itself in different faces especially in poor housing condition. In this study, the history, geography, and culture of Haiti are analyzed in the context of family unit, community, and economic aspects. The climate conditions are also investigated in the context of residents’ comfort and energy savings. The construction materials appropriate for Haiti climate are explored. Rainwater harvesting and gray water reuses are discussed. Finally, sustainable design principles are proposed. Sustainable housing design refers to a strategy to plan and build a housing complex that uses efficient energy and water management while minimizing the overall adverse health and environmental problems. This means keeping the conventional comfort and environment conditions in housing by using natural sources of energy, like sun and wind, to provide natural heating, cooling, ventilation, lighting, and water management while contributing to a responsible natural resources use. The proposed guiding principles target to be utilized for the design of sustainable housing complex in Haiti located in a tropical climate