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Northfield, VT, United States

Norwich University – The Military College of Vermont is a private university located in Northfield, Vermont . It is the oldest private military college in the United States. The university was founded in 1819 at Norwich, Vermont, as the American Literary, Scientific and Military Academy. It is the oldest of six senior military colleges, and is recognized by the United States Department of Defense as the "Birthplace of ROTC" . Norwich University has a mixed student body that includes a Corps of Cadets and traditional civilian students. Wikipedia.

Hamilton L.,Norwich University
Rheumatology (Oxford, England) | Year: 2011

. To investigate the services offered to patients with AS in the UK in 2010. Two thousand non-health-care professional members of the National Ankylosing Spondylitis Society (NASS) were sent a questionnaire asking about their experiences surrounding diagnosis, treatment and access to therapies (response rate 40%). A separate questionnaire was sent to a consultant rheumatologist in every acute NHS trust in the UK, asking about services offered to patients with AS (response rate 68%). Overall, there was a mean diagnostic delay of 8.57 years. Almost one-third (32.2%) of patients were not reviewed in secondary care. Non-attendance was associated with increasing age and longer disease duration. Twenty per cent of patients were taking anti-TNF drugs, but 18.8% of departments reported that their ability to give anti-TNF therapy was restricted (64% reported primary-care trust rationing and 14% lack of staff). Almost all rheumatology departments had access to MRI, but 70.9% still used X-ray radiographs as their first-line investigation. A minority (5.6%) of patients reported they had never seen a physiotherapist, but less than one-third could self-refer for treatment during a flare. This is the first study to explore the services available to people with AS in the UK. Almost one-third of patients are not seen in rheumatology departments and therefore may be under-treated. For those who are seen, access to anti-TNF drugs and other therapies remains an issue.

Tam M.D.,Norwich University
Anatomical sciences education | Year: 2010

Radiology and radiologists are recognized as increasingly valuable resources for the teaching and learning of anatomy. State-of-the-art radiology department workstations with industry-standard software applications can provide exquisite demonstrations of anatomy, pathology, and more recently, physiology. Similar advances in personal computers and increasingly available software can allow anatomy departments and their students to build their own three-dimensional virtual models. Appropriate selection of a data-set, followed by processing and presentation are the key steps in creating virtual models. The construction, presentation, clinical application, and educational potential of postprocessed imaging techniques including multiplanar reformats, minimum intensity projections, segmentation, volume-rendering, surface-rendering, fly-throughs, virtual endoscopy, angiography, and cine-loops are reviewed using examples created with only a personal computer and freeware software. Although only static images are presented in this article, further material is available online within the electronic version of this article. Through the use of basic and advanced image reconstruction and also paying attention to optimized presentation and integration, anatomy courses can be strengthened with appropriate radiological material. There are several key advantages for the anatomy department, which is equipped with the ability to produce virtual models using radiology images: (1) Opportunities to present anatomy using state-of-the-art technology as an adjunct to current practices, (2) a means to forge an improved relationship with the local radiology department, and (3) the ability to create material locally, which is integrated with the local curriculum avoiding the problem of information overload when using the internet or other commercially available resources.

Fractionation regimes for individual tumour sites have varied greatly across the UK for many years. This has been particularly true for breast cancer which accounts for up to 40% of a radiotherapy department's work load. Over the last 30 years or so many UK oncology centres have coped with this large case load and a lack of megavoltage machines by reducing fractionation and routinely using internationally non standard regimes so that these regimes have themselves become one of the options for standard treatment. Nowadays, medicine is largely evidence based rather than historically relying more on clinical experience or intuition. Large studies particularly in the UK and Canada set out to address this question and have shown that fewer fractions are equivalent in terms of local recurrence, late tissue effects and cosmesis. Current studies are focusing on further hypofractionation and partial breast radiotherapy (see papers Yarnold (2010) Is it safe to push " hypofractionation" further? The Breast (this issue). Lehman (2010) The less than whole breast radiotherapy approach. The Breast (this issue)). © 2010 Elsevier Ltd.

Ntatsaki E.,Norwich University
Rheumatology (Oxford, England) | Year: 2011

The ANCA-associated vasculitides (AAVs) are conventionally treated with a strategy of remission induction followed by maintenance therapy using glucocorticoids combined with CYC during induction and AZA for maintenance. Recently, several randomized controlled trials have been published that question whether these drugs should remain those of choice. B-cell depletion using rituximab is at least as effective as CYC for remission induction in newly presenting patients, but long-term efficacy, safety and cost-effectiveness data are awaited, and thus rituximab should be reserved for patients at high risk of infertility. Rituximab seems to be effective at inducing remission in relapsing patients. Whether routine pre-emptive treatment with rituximab for remission maintenance is a better approach than waiting for relapse is unknown. MTX and LEF have similar efficacy to AZA, but are not significantly safer; while MMF is less effective. Thus, AZA remains the conventional maintenance drug of choice.

Temple R.,Norwich University
Best Practice and Research: Clinical Obstetrics and Gynaecology | Year: 2011

The association between hyperglycaemia and congenital malformations was first recognised over 40 years ago and was followed by the development of preconception clinics for women with diabetes. A fresh look at preconception care is needed as many studies were conducted during the late 1970s and early 1980s, before the introduction of regular home blood glucose monitoring and glycosylated haemoglobin assays, and when many patients with diabetes had microvascular complications. Recent observational studies and a meta-analysis suggest preconception care is effective with an approximately threefold reduction in the risk of malformations. There is now a worldwide epidemic of type 2 diabetes, but only few studies of preconception care have included women with type 2 diabetes. Furthermore, few studies have addressed the relationship between preconception care and perinatal morbidity. This article will review the evidence for preconception care in women with diabetes, evaluate different models of preconception care and discuss future strategies. © 2010 Elsevier Ltd. All rights reserved.

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