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Interventional Cardiology for Congenital Heart Disease
Damien Kenny 대한심장학회 2018 Korean Circulation Journal Vol.48 No.5
Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth. Increasing parental and physician expectancy has inevitably lead to higher risk interventions on smaller infants and appreciation of the consequences of these interventions on departmental outcome data needs to be considered. Registry data evaluating congenital heart interventions remain less robust than surgical registries, leading to a lack of insight into the longer-term consequences of our interventions. Increasing collaboration with surgical colleagues has not been met with necessary development of dedicated equipment for hybrid interventions aimed at minimizing the longer-term consequences of scar to the heart. Therefore, great challenges remain to ensure children and adults with congenital heart disease continue to benefit from an exponential growth in minimally invasive interventions and technology. This can only be achieved through a concerted collaborative approach from physicians, industry, academia and regulatory bodies supporting great innovators to continue the philosophy of thinking beyond the limits that has been the foundation of our specialty for the past 50 years.
IT-BASED TEACHING AND LEARNING SYSTEMS USED IN THE DEPARTMENT OF EDUCATION IN PAPUA NEW GUINEA
Damien Rapese,Michael Tapo,John Volmer 한국멀티미디어학회 2007 한국멀티미디어학회 국제학술대회 Vol.2007 No.-
Worldwide there is an increasing use of ICT based resources to promote and enhance teaching and learning experiences for both formal and non formal education and training activities for all sectors of society. The pace of global ICT developments continues to impact all sectors of society. Successive governments in Papua New Guinea have been trying to address the complex issues of the development of a national ICT policy and privatization/competition in the telecommunications marketplace. For the education sector in PNG where the vast majority of schools and students are in rural communities, the issues are more complex. Basic infrastructure requirements such affordable electricity supply, school buildings to accommodate ICT resources, and affordable communications bandwidth require resolution prior to the introduction of any ICT based resources. Ongoing technical support and the training of teachers in rural locations is an additional recurrent cost that must be serious addressed at the national and provincial levels for any program to succeed. This paper highlights the experiences to date of a number of initiatives to introduce teachers and students to ICT resources in selected vocational and secondary schools in Papua New Guinea.
Democratic Consolidation in Timor-Leste: Achievements, Problems and Prospects
Damien Kingsbury 서울대학교행정대학원 2014 Asian Journal of Political Science Vol.22 No.2
Timor-Leste has had three rounds of major elections, all of which have been widely regarded as meeting international criteria for being free and fair. There has also been one change of government on the basis of these elections. On these grounds, some observers have suggested that Timor-Leste has met the benchmark for having consolidated its democracy. Timor-Leste can be said to meet the criteria for an expanded minimalist definition of democracy, holding regular, free and fair elections within an open competitive political environment, with relatively little violence and intimidation and general freedom of expression. This political process has, as defined by the literature, also consolidated. However, Timor-Leste continues to face future economic challenges. The literature indicates that states with high levels of poverty, unemployment and with food shortages are more prone to political instability. Given that Timor-Leste's political party system relies heavily on charismatic individuals and, apart from Fretilin, has poor party structures, loss of current political leaders will add a further destabilising effect. Expected economic problems are likely to manifest around the same time that the current generation of political leaders are no longer active. The question will be, in this increasingly challenging environment, whether Timor-Leste can sustain its democracy.
Damien Motavasseli,Camille Chesnel,Audrey Charlanes,Diane Menoux,Francis Charoenwong,Frédérique Le Breton,Gérard Amarenco 대한배뇨장애요실금학회 2018 International Neurourology Journal Vol.22 No.2
Purpose: To evaluate adherence to anticholinergic therapy (AT) and clean intermittent self-catheterization (CISC) in patients with multiple sclerosis (MS) and to identify factors associated with poor adherence. Methods: This single-center study prospectively included 49 patients suffering from MS who had been prescribed AT and/or CISC. Adherence was evaluated using a self-report questionnaire. The Expanded Disability Status Scale (EDSS), Patient Global Impression of Improvement, Mini-Mental State Examination, Urinary Symptom Profile, and Hospital Anxiety and Depression (HAD) instruments were administered, and the number of daily anticholinergic pills and/or catheterizations was noted. Whether patients were receiving concomitant intradetrusor botulinum toxin injections was assessed, as were barriers to treatment, side effects, number of spontaneous micturitions, reasons for the prescription, satisfaction, and difficulties. Results: Only 38% of patients were adherent to AT. Experiencing side effects was related to nonadherence (P=0.02). Only 29% of patients were adherent to CISC. More intense voiding dysfunction (P<0.001), a higher frequency of CISC (P=0.03), and a higher EDSS score (P=0.02) were associated with better adherence. Conversely, the HAD score (P<0.001), depression (P<0.001), the persistence of spontaneous micturition (P<0.001), a blocking sensation during catheterization (P=0.04), and the need to adapt one’s posture or gesture to perform catheterization (P=0.04) were associated with poorer adherence. Conclusions: Adherence to AT and CISC was poor in patients with MS suffering from bladder dysfunction. Several factors related to nonadherence were identified in this study, and addressing these factors might help to improve treatment adherence.
It’s the Speaker, Not the Language : Teaching SI into English in the Taiwan context
Damien Fan 한국통역번역학회 2011 통역과 번역 Vol.13 No.1
Simultaneous interpreting (SI) into the B language (usually English) is commonplace in the Asian markets, therefore SI into English is a compulsory course in many interpreting schools. However, due to insufficient English proficiency and underdeveloped multitasking skills, students’ performances are often not ideal. The paratactic nature of the Chinese language taxes students’ cognitive load and exacerbates performance. Class sessions get bogged down when the instructor spends too much time on fixing the output. Shifting the focus from the (English) output to the (Chinese) input may be a more effective strategy (and rewarding experience) for both students and teachers, at least in the Taiwanese classroom. This paper introduces a teaching method adopted in the SI into English classroom which is taught by the author. This step-by-step, process-oriented approach aims to familiarize students with the expressions they will need in the assigned topics, so as to minimize the interference and setbacks caused by inadequate B language proficiency. This will allow more time for the instructor to focus on SI strategies pertinent to the Taiwan context. The most important ones are being assertive when necessary and keeping the interpretations short and simple.
Damien Chaste,Emmanuel Vian,Gregory Verhoest,Pascal Blanchet 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.2
Translocation renal cell carcinoma (RCC) is a family of rare tumors recently identifiedin the pediatric and young adult population. We report the first case of a young womanfrom French West Indies with sickle cell anemia who developed a translocation RCCt(6;11)(p21;q12). Usually people with the sickle cell condition are known to develop renalmedullary carcinoma (RMC). To our knowledge, this is the first case described inthe literature of a translocation RCC associated with sickle cell disease. Here we discussthe relation between translocation RCC, RMC, and sickle cell disease.