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(PICC) line. Though PICC lines can be scary for pediatric patients, and require caregivers to be trained in their use and care, many doctors often prefer them to oral medicines for long-term antibiotic treatments. One CHOP researcher, Ron Keren, MD, |
MPH, director of the Center for Pediatric Clinical Effectiveness, was recently awarded nearly two million dollars from the Patient-Centered Outcomes Research Institute (PCORI) to lead a study examining whether oral antibiotics are as effective at treating infection over an extended |
period as PICC lines. “These two antibiotic treatment options have major implications for the overall experience of the child, families and caregivers, but there is a lack of real-world evidence on their benefits and drawbacks to help clinicians and patient |
families make an informed choice,” said Dr. Keren. A type of intravenous (IV) catheter, a PICC line is a long, flexible tube that is inserted in a peripheral vein, often in the arm or neck, and advanced until its tip |
rests near the heart. Because they tap directly into the circulatory system, PICC lines offer maximum drug delivery. Unlike regular IV catheters, PICC lines can stay in the body for weeks to months, but they require regular maintenance. PICC lines |
must be flushed daily, their dressings have to be inspected and changed, and patients with PICC lines must avoid getting them wet or dirty — a tall order for some active pediatric patients. In addition, a variety of equipment is |
required to use and maintain PICC lines, including infusion pumps and portable IV poles. PICC lines do have some risks. They can clot, break, or become dislodged. And because they sit in large blood vessels directly above the heart, any |
bacteria that are inadvertently introduced into the catheter go directly to the heart and are pumped throughout the body, which can lead to a dangerous infection called sepsis. Oral antibiotics, on the other hand, are much easier for patients to |
take and caregivers to manage. However, because oral medications must pass through the digestive system, to have the same efficacy as IV medications oral antibiotics must have high “bioavailability” — the percentage of the drug that reaches the blood. Drugs |
administered via PICC lines have, by definition, 100 percent bioavailability. “If we find that the prolonged IV option is no better than the oral route, we think that most families would prefer for their child to take oral antibiotics,” Dr. |
Keren noted. “However, if IV antibiotics are marginally better than oral antibiotics, then that benefit will need to be weighed against any reduction in quality of life and complications that we anticipate with the PICC lines.” |
When the last oil well runs dry Just as certain as death and taxes is the knowledge that we shall one day be forced to learn to live without oil. Exactly when that day will dawn nobody knows, but people in middle age today can probably expect to be here for it. Long before it arrives we shall have had |
to commit ourselves to one or more of several possible energy futures. And the momentous decisions we take in the next few years will determine whether our heirs thank or curse us for the energy choices we bequeath to them. There will always be some oil somewhere, but it may soon cost too much to extract and burn it. I... |
may be too technically difficult, too expensive compared with other fuels, or too polluting. An article in Scientific American in March 1998 by Dr Colin Campbell and Jean Laherrere concluded: "The world is not running out of oil - at least not yet. "What our society does face, and soon, is the end of the abundant and c... |
which all industrial nations depend." They suggested there were perhaps 1,000 billion barrels of conventional oil still to be produced, though the US Geological Survey's World Petroleum Assessment 2000 put the figure at about 3,000 billion barrels. Too good to burn The world is now producing about 75 million barrels pe... |
global oil production from all possible sources, including shale, bitumen and deep-water wells, will peak at around 2015 at about 90 million bpd, allowing a fairly modest increase in consumption. Peaking is at hand, not years away... If I'm right, the unforeseen consequences are devastating Matthew Simmons, former US g... |
about 30 years at 90 million bpd, so drastic change could be necessary soon after 2030. And it would be drastic: 90% of the world's transport depends on oil, for a start. Most of the chemical and plastic trappings of life which we scarcely notice - furniture, pharmaceuticals, communications - need oil as a feedstock. T... |
to stop using oil for transport immediately and keep it for irreplaceable purposes like these. In May 2003 the Association for the Study of Peak Oil and Gas (Aspo), founded by Colin Campbell, held a workshop on oil depletion in Paris. One of the speakers was an investment banker, Matthew Simmons, a former adviser to Pr... |
Wilderness Publications reported him as saying: "Any serious analysis now shows solid evidence that the non-FSU [former Soviet Union], non-Opec [Organisation of Petroleum Exporting Countries] oil has certainly petered out and has probably peaked... No cheap oil, no cheap food "I think basically that peaking of oil will... |
occur, and my analysis is... that peaking is at hand, not years away. "If I'm right, the unforeseen consequences are devastating... If the world's oil supply does peak, the world's issues start to look very different. "There really aren't any good energy solutions for bridges, to buy some time, from oil and gas to the ... |
now is to shrink our economies." Planning pays off Aspo suggests the key date is not when the oil runs out, but when production peaks, meaning supplies decline. It believes the peak may come by about 2010. Fundamental change may be closing on us fast. And even if the oil is there, we may do better to leave it untouched... |
Many scientists are arguing for cuts in emissions of the main greenhouse gas we produce, carbon dioxide, by at least 60% by mid-century, to try to avoid runaway climate change. That would mean burning far less oil than today, not looking for more. There are other forms of energy, and many are falling fast in price and ... |
with oil on cost, if not for convenience. So there is every reason to plan for the post-oil age. Does it have to be devastating? Different, yes - but our forebears lived without oil and thought themselves none the worse. We shall have to do the same, so we might as well make the best of it. And the best |
Water and sediment samples are being taken prior to oil reaching the area to determine water quality and sediment conditions that are typical of selected bays and beaches in Louisiana, Mississippi, Alabama, and the Florida panhandle. This data will be used to supplement existing data generated from previous water quali... |
surveys conducted by states, EPA, and others. Water sampling will continue once the oil reaches the shore; periodic samples will be collected to document water quality changes. EPA will make data publicly available as quickly as possible. Other state and federal agencies make beach closure and seafood harvesting and co... |
determinations, but the data generated by EPA will assist in their evaluations. Why is EPA sampling and monitoring the water? EPA is tracking the prevalence of potentially harmful chemicals in the water as a result of this spill to determine the level of risk posed to fish and other wildlife. |
While these chemicals can impact ecosystems, drinking water supplies are not expected to be affected. The oil itself can cause direct effects on fish and wildlife, for example when it coats the feathers of waterfowl and other types of birds. In addition, other chemical compounds can have detrimental effects. Monitoring |
information allows EPA to estimate the amount of these compounds that may reach ecological systems. When combined with available information on the toxicity of these compounds, EPA scientists can estimate the likely magnitude of effects on fish, wildlife, and human health. To Learn More: |
All-metal hip implants can damage soft tissue: FDA (Reuters) - Metal-on-metal hip implants can cause soft-tissue damage and pain, which could lead to further surgery to replace the implant, the |
U.S. health regulator said, following several recalls of the artificial hip parts. All-metal hip implants were developed to be more durable than traditional implants but have become a major cause |
of concern following several safety issues and user discomforts. The traditional implants combine a ceramic or metal ball with a plastic socket. The U.S. Food and Drug Administration said all-metal |
implants can shed metal where two components connect, such as the ball and the cup that slide against each other during walking or running. Such release of metal will cause |
wear and tear of the implant and can damage bone and soft tissue surrounding the implant. The agency said surgeons should select a metal-on-metal hip implant for their patient only |
after determining that its benefits outweigh that of an alternative hip system. Johnson & Johnson, the biggest manufacturer of all-metal devices, recalled its ASR hip implant in 2010 following safety |
problems. Smith & Nephew withdrew a component of one of its all-metal artificial hip systems last June, following higher level of patient problems with the device. Stryker Corp begun recalling |
some components of its implant in July due to risks associated with corrosion. Other hip implant makers include Zimmer Holdings Inc and Wright Medical Group. The regulator, however, added that |
it does not have enough data to specify the concentration of metal ions in a patient's body or blood necessary to produce adverse effects. The reaction seemed to be specific |
King Research and Education Institute As we approach Martin Luther King Jr. Day, take a moment to learn more about the great American leader. This site collects all kinds of documents pertaining to King, lists the latest news and much more. Number to Know 1983: Year when President Ronald Reagan |
signed Martin Luther King Jr. Day into law. This Day in History Jan. 16, 2003: The Space Shuttle Columbia takes off for mission STS-107, which would be its final one. Columbia disintegrated 16 days later on re-entry. Today’s Featured Birthday Baseball star Albert Pujols (33) “I look to a day |
See what questions a doctor would ask. Leri-Weil syndrome (medical condition): A rare genetic disorder characterized by short forearms...more » These medical condition or symptom topics may be relevant to medical information for Leri-Weil syndrome: Leri-Weil syndrome is listed as a "rare disease" by the Office of Rare ... |
subtype of Leri-Weil syndrome, affects less than 200,000 people in the US population. Source - National Institutes of Health (NIH) Leri-Weil syndrome: Leri-Weil syndrome is listed as a type of (or associated with) the following medical conditions in our database: These medical disease topics may be related to Leri-Weil... |
Healthy Affordable Food RWJF Priority: Increase access to high-quality, affordable foods through new or improved grocery stores and healthier corner stores and bodegas Research shows that having a supermarket or |
grocery store in a neighborhood increases residents’ fruit and vegetable consumption and is associated with lower body mass index (BMI) among adolescents. Yet, many families do not have access to |
Last Friday, The Hill’s Congress Blog highlighted the innovative ways governments, NGO’s and the private sector are using to aid for global health. Programs like the Global Alliance for Vaccines and Immunization (GAVI) and The Global Fund to fight AIDS, TB and Malaria are not only ensuring that health interventions are... |
are helping to promote market growth and drive down prices. Here’s an excerpt on public-private partnerships from the blog: “Millions of lives are saved today in developing countries because of bold, innovative financing arrangements over last 10 years. These financing mechanisms are good examples of private sector par... |
public sector funding with private sector resources, thus allowing tax payers funds to have much larger impact than would otherwise be possible. Some of the examples are given below.” USAID’s Neglected Tropical Disease (NTD) Program is one such collaboration. In a press statement released last fall, Dr. Ariel Pablos-Me... |
NTD program is the largest public-private partnership collaboration in our 50 year history. Over the past six years, USAID has leveraged over $3 billion in donated medicines reflecting one of the most cost effective public health programs. Because of this support, we are beginning to document control and elimination of... |
Stat: Of all infertile women, an estimated 15 percent are infertile because of PID. What is it exactly? "Pelvic inflammatory disease" is shorthand for any serious, non-specific bacterial infection of the reproductive organs that are housed in the pelvis: the uterus, uterine lining, fallopian tubes, and/or ovaries. Thes... |
20% of PID cases are found in teens, who often are afraid or unable to get reproductive health care. PID can result in permanent infertility and chronic pain. About how many people have it? About one million cases of PID are reported in the United States annually. How is it spread? In most cases, other sexually transmi... |
chlamydia are at the root of PID, especially when they are left untreated. Some cases of PID are due to infections with more than one type of bacteria. What are its symptoms? • painful periods that may last longer than previous cycles • unusual vaginal discharge • spotting or cramping between periods • pain or cramping... |
lower back or abdominal pain • nausea or vomiting • pain during vaginal intercourse How is it diagnosed? PID is often difficult to diagnose, and it is widely thought that millions of cases each year go undiagnosed. To diagnose PID, you will need a pelvic exam which includes a Pap smear, and a possible laparoscopy (a di... |
in an office visit) in order for your doctor or clinician to take a close look at your reproductive system. It is also imperative that you tell your doctor or clinician if you have been sexually active with a partner and what your sexual history has been. Is it treatable? In some cases, antibiotics, bed rest, and sexua... |
surgery may be required, including the possible removal of some reproductive organs. Is it curable? In some cases, but it can recur even once treated if the person becomes reinfected. Can it effect fertility? PID can lead to permanent sterility or ectopic pregnancy. Can it cause death? Almost any bacterial infection, i... |
potentially cause severe injury or death. How can we protect against it? Using condoms during vaginal intercourse offers a very high level of protection from PID. Annual STD screenings also reduce the risk by finding other STDs or STIs and treating them before they can progress to cause PID. Because PID is caused by ot... |
Ever wonder what would happen if every single adult in the U.S. took a few hours each month to support a program that supports the well-being of children? Perhaps you would choose to advocate for a child in an unstable environment; or a child in poor health; or one who is struggling with their academics; or one who fac... |
bully? What kind of impact would that make on the future of our country? I recently came across some information about National Make a Difference in Children Month; a grassroots call to action sponsored by long-time child advocate, Kim Ratz. The intention of this annual observance is to bring awareness on how our actio... |
a child. Ms. Ratz outlines 4 key actions we can take to have a direct impact on the life of a child on her Website: 1. Pick one (or more) event or activity to do with a child … that will make some kind of positive difference or impact on that child. Need ideas? Read 100+ Ways to Make a |
Difference to Children. 2. Support an organization that serves children …It could be your local community ed. or schools, YMCA, Boy or Girl Scouts, place of worship, park and recreation or any other organization that serves kids. 3. Tell your policy makers to support initiatives that are good for kids … like your schoo... |
legislators & congressional delegation; summer is generally a more relaxed time to communicate with them. Share your own story about Making a Difference to Children … and WHY it’s important to support programs for children … 4. Tell other people about this campaign …like your neighbors, relatives, friends, people at wo... |
from Early Childhood News and Resources on how you can make a difference to a child this month: - Volunteer at a local center that helps teen or single mothers (or fathers) - Volunteer with your local elementary school - Help at a soup kitchen for needy families - Help at church with Sunday School, VBS or another faith... |
- Locate a service in your area that assists homeless children with school supplies, medical care or social-emotional development - Volunteer to read for kids at your local library - Teach classes at a local rec center or community center: arts, crafts, reading, sports, ASL, music, etc. - Offer your time at the Foundat... |
children’s classes) - Find a local farm that hosts classes for special needs kiddos and volunteer there (horse therapy, etc) - Don’t have time to volunteer your time? How about a simple donation? What can YOU do to help a child in need? Share your ideas and inspiration! |
XML and the Second-Generation Web; May 1999; Scientific American Magazine; by Bosak, Bray; 5 Page(s) Give people a few hints, and they can figure out the rest. They can look at this page, see some large type followed by blocks of small type and know that they are looking at the start of a magazine article. They can loo... |
and see shopping instructions. They can look at some rows of numbers and understand the state of their bank account. Computers, of course, are not that smart; they need to be told exactly what things are, how they are related and how to deal with them. Extensible Markup Language (XML for short) is a new language design... |
self-describing. This simple-sounding change in how computers communicate has the potential to extend the Internet beyond information delivery to many other kinds of human activity. Indeed, since XML was completed in early 1998 by the World Wide Web Consortium (usually called the W3C), the standard has spread like wild... |
Please Read How You Can Help Keep the Encyclopedia Free Absolute and Relational Theories of Space and Motion Since antiquity, natural philosophers have struggled to comprehend the nature of three tightly interconnected concepts: space, time, and motion. A proper understanding of motion, in particular, has been seen to ... |
and their interconnections. Since the time of Newton and Leibniz, philosophers’ struggles to comprehend these concepts have often appeared to take the form of a dispute between absolute conceptions of space, time and motion, and relational conceptions. This article guides the reader through some of the history of these... |
or reproducing the standard dialectic recounted in most introductory texts, we have chosen to scrutinize carefully the history of the thinking of the canonical participants in these debates — principally Descartes, Newton, Leibniz, Mach and Einstein. Readers interested in following up either the historical questions or... |
and references scattered through the discussion and in the Other Internet Resources section below. - 1. Introduction - 2. Aristotle - 3. Descartes - 4. Newton - 5. Absolute Space in the Twentieth Century - 6. Leibniz - 7. ‘Not-Newton’ versus ‘Be-Leibniz’ - 8. Mach and Later Machians - 9. Relativity and Motion - 10. Con... |
- Related Entries Things change. A platitude perhaps, but still a crucial feature of the world, and one which causes many philosophical perplexities — see for instance the entry on Zeno's Paradoxes. For Aristotle, motion (he would have called it ‘locomotion’) was just one kind of change, like generation, growth, decay,... |
contrary that all change was in reality the motion of atoms into new configurations, an idea that was not to begin to realize its full potential until the Seventeenth Century, particularly in the work of Descartes. (Of course, modern physics seems to show that the physical state of a system goes well beyond the geometr... |
determined by the states of bodies, are not themselves configurations of bodies if interpreted literally, and in quantum mechanics bodies have ‘internal states' such as particle spin.) While not all changes seem to be merely the (loco)motions of bodies in physical space. Yet since antiquity, in the western tradition, t... |
of change. And since motion is a crucial concept in physical theories, one is forced to address the question of what exactly it is. The question might seem trivial, for surely what is usually meant by saying that something is moving is to say that it is moving relative to something, often tacitly understood between spe... |
is moving at 60mph (relative to the road and things along it), the plane is flying (relative) to London, the rocket is lifting off (the ground), or the passenger is moving (to the front of the speeding train). Typically the relative reference body is either the surroundings of the speakers, or the Earth, but this is no... |
For instance, it seems to make sense to ask whether the Earth rotates about its axis West-East diurnally or whether it is instead the heavens that rotate East-West; but if all motions are to be reckoned relative to the Earth, then its rotation seems impossible. But if the Earth does not offer a unique frame of referenc... |
of motion, then we may wonder whether any arbitrary object can be used for the definition of motions: are all such motions on a par, none privileged over any other? It is unclear whether anyone has really, consistently espoused this view: Aristotle, perhaps, in the Metaphysics; Descartes and Leibniz are often thought t... |
are suspect; possibly Huygens, though his remarks remain cryptic; Mach at some moments perhaps. If this view were correct, then the question of whether the Earth or heavens rotate would be meaningless, merely different but equivalent expressions of the facts. But suppose, like Aristotle, you take ordinary language accu... |
gravitational field directed towards the center of the Earth, but for Aristotle, as we shall see, this usage helped identify an important structural feature of the universe, which itself was required for the explanation of weight. Now a further question arises: how should a structure, such as a preferred point in the u... |
makes that point privileged? One might expect that Aristotle simply identified it with the center of the Earth, and so relative to that particular body; but in fact he did not adopt that tacit convention as fundamental, for he thought it possible for the Earth to move from the ‘down’ point. Thus the question arises (al... |
it explicitly) of whether the preferred point is somewhere picked out in some other way by the bodies in the universe —the center of the heavens perhaps? Or is it picked out quite independently of the arrangements of matter? The issues that arise in this simple theory help frame the debates between later physicists and... |
motion; in particular, we will focus on the theories of Descartes, Newton, Leibniz, Mach and Einstein, and their interpretations. But similar issues circulate through the different contexts: is there any kind of privileged sense of motion, a sense in which things can be said to move or not, not just relative to this or... |
so, can this true motion be analyzed in terms of motions relative to other bodies — to some special body, or to the entire universe perhaps? (And in relativity, in which distances, times and measures of relative motion are frame-dependent, what relations are relevant?) If not, then how is the privileged kind of motion ... |
space itself — something physical but non-material — perhaps? Or can some kinds of motion be best understood as not being spatial changes — changes of relative location or of place — at all? To see that the problem of the interpretation of spatiotemporal quantities as absolute or relative is endemic to almost any kind ... |
or weight of the former and the levity of the latter. This account only makes sense if ‘up’ and ‘down’ can be unequivocally determined for each body. According to Aristotle, up and down are fixed by the position of the body in question relative to the center of the universe, a point coincident with the center of the Ea... |
is, the theory holds that heavy bodies naturally move towards the center, while light bodies naturally move away. Does this theory involve absolute or merely relative quantities? It depends on how the center is conceived. If the center were identified with the center of the Earth, then the theory could be taken to esch... |
that the natural motions of any body depend on its position relative to another, namely the Earth. But Aristotle is explicit that the center of the universe is not identical with, but merely coincident with the center of the Earth (e.g., On the Heavens II.14): since the Earth itself is heavy, if it were not at the cent... |
move there! So the center is not identified with any body, and so perhaps direction-to-center is an absolute quantity in the theory, not understood fundamentally as direction to some body (merely contingently as such if some body happens to occupy the center). But this conclusion is not clear either. In On the Heavens ... |
issue, Aristotle suggests that the center itself is ‘determined’ by the outer spherical shell of the universe (the aetherial region of the fixed stars). If this is what he intends, then the natural law prescribes motion relative to another body after all — namely up or down with respect to the mathematical center of th... |
push Aristotle's writings too hard to suggest that he was consciously wrestling with the issue of whether mechanics required absolute or relative quantities of motion, but what is clear is that these questions arise in his physics and his remarks impinge on them. His theory also gives a simple model of how these questi... |
will say that ‘under such-and-such circumstances, motion of so-and-so a kind will occur’ — and the question of whether that kind of motion makes sense in terms of the relations between bodies alone arises automatically. Aristotle may not have recognized the question explicitly, but we see it as one issue in the backgro... |
issues are, however, far more explicit in Descartes' physics; and since the form of his theory is different the ‘kinds of motion’ in question are quite different — as they change with all the different theories that we discuss. For Descartes argued in his 1644 Principles of Philosophy (see Book II) that the essence of ... |
and shape) because any other attribute of bodies could be imagined away without imagining away matter itself. But he also held that extension constitutes the nature of space, hence he concluded that space and matter were one and the same thing. An immediate consequence of the identification is the impossibility of the ... |
region of matter, then there can be no space without matter. Thus Descartes' universe is ‘hydrodynamical’ — completely full of mobile matter of in different sized pieces in motion, rather like a bucket full of water and lumps of ice of different sizes, which has been stirred around. Since fundamentally the pieces of ma... |
is in fact nothing but a system of geometric bodies in motion without any gaps. (Descartes held that all other properties arise from the configurations and motions of such bodies — from geometric complexes. See Garber 1992 for a comprehensive study.) The identification of space and matter poses a puzzle about motion: i... |
is the matter of the body, then when the body — i.e., the matter — moves, so does the space that it occupies. Thus it doesn't change place, which is should be to say that it doesn't move after all! Descartes resolved this difficulty by taking all motion to be the motion of bodies relative to one another, not a |
literal change of space. Now, a body has as many relative motions as there are bodies but it does not follow that all are equally significant. Indeed, Descartes uses several different concepts of relational motion. First there is ‘change of place’, which is nothing but motion relative to this or that arbitrary referenc... |
of a body is privileged, since the speed, direction, and even curve of a trajectory depends on the reference body, and none is singled out. Next, he discusses motion in ‘the ordinary sense’ (II.24). This is often conflated with mere change of arbitrary place, but it in fact differs because according to the rules of ord... |
motion only to bodies whose motion is caused by some action, not to any relative motion. (For instance, a person sitting on a speeding boat is ordinarily said to be at rest, since ‘he feels no action in himself’.) Finally, he defined motion ‘properly speaking’ (II.25) to be a body's motion relative to the matter contig... |
impossibility of a vacuum guarantees to exist. (Descartes’ definition is complicated by the fact that he modifies this technical concept to make it conform more closely to the pre-theoretical sense of ‘motion’; however, in our discussion transference is all that matters, so we will ignore those complications.) Since a ... |
argued that this standard of motion was unique. What we see here is that Descartes, despite holding motion to be the motion of bodies relative to one another, also held there to be a privileged sense of motion; in a terminology sometimes employed by writers of the period, he held there to be a sense of ‘true motion’, o... |
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