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Acceptable

Distribution by Scientific Domains
Medical Sciences52%
Chemistry15%
Humanities and Social Sciences9%
Life Sciences5%
Engineering4%
Business, Economics, Finance and Accounting3%
Psychology3%
Earth and Environmental Science2%
6 Other Domains7%
Distribution within Medical Sciences
Consumer Health General5%
Anesthesia & Pain Management3%
64 Other Subdomains77%

Kinds of Acceptable

  • highly acceptable
    		•

    Terms modified by Acceptable

  • acceptable accuracy
  • acceptable agreement
  • acceptable alternative
  • acceptable approach
  • acceptable complication rate
  • acceptable correlation
  • acceptable cost
  • acceptable daily intake
  • acceptable definition
  • acceptable degree
    		•
  • acceptable error
  • acceptable fit
  • acceptable internal consistency
  • acceptable level
  • acceptable limit
  • acceptable method
  • acceptable morbidity
  • acceptable outcome
  • acceptable performance
  • acceptable precision
    		•
  • acceptable psychometric property
  • acceptable quality
  • acceptable range
  • acceptable rate
  • acceptable reliability
  • acceptable result
  • acceptable risk
  • acceptable safety profile
  • acceptable sensitivity
  • acceptable solution
    		•
  • acceptable standard
  • acceptable standards
  • acceptable time
  • acceptable toxicity
  • acceptable toxicity profile
  • acceptable treatment
  • acceptable validity
  • acceptable way

    • Selected Abstracts

    The esthetic outcome of autotransplanted premolars replacing maxillary incisors

    DENTAL TRAUMATOLOGY, Issue 5 2002
    Ewa Monika Czochrowska
    Abstract ,,,Autotransplantation of developing premolars to replace maxillary incisors has been documented to provide physiologically sound results, but comprehensive studies of the esthetic outcome have not been made previously. In order to assess the applicability of this approach and to identify factors important for planning of treatment, 22 autotransplanted premolars reshaped to incisor morphology were compared to their natural, contralateral maxillary incisors by scoring of features considered important for esthetics (color, soft tissue appearance, tooth morphology, and position). The sum of scores for each feature was used to place the reshaped transplant in one of three categories , Match, Deviate, Mismatch. The 22 patients were asked to fill in a questionnaire which addressed the same features that were examined professionally, and the responses were categorized as either Satisfied, Acceptable, or Dissatisfied. Eleven of the 22 patients had received orthodontic treatment with fixed appliances following the transplantation. Most of the transplanted premolars matched the contralateral incisor, and the majority of patients were satisfied with the appearance of the transplant. Fourteen percentage of the transplants were categorized as Mismatch and 18% of patients reported dissatisfaction. The distribution in categories assessed professionally and by the patients was not significantly different. The color and gingival width of the transplanted tooth were scored as different from the natural incisor in about half of the bilateral comparisons. For those teeth categorized professionally as Mismatch and by patients as Dissatisfied, a potential for esthetic improvement could be identified, as allocation to these categories was primarily due to suboptimal positioning and restorative build-up of the transplant. Inter-disciplinary planning is important for successful esthetic results. [source]

    Comments on editorial entitled "ISCN (2005) Is Not Acceptable for Describing Clonal Evolution in Cancer"

    GENES, CHROMOSOMES AND CANCER, Issue 5 2007
    FHGSA, FRCPA, Lynda J Campbell MB
    No abstract is available for this article. [source]

    A note on stochastically acceptable quality

    QUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 1 2001
    Max S. Finkelstein
    Abstract A random variable of quality, characterized by the quality distribution function, is considered both for continuous and discrete cases. The acceptable quality distribution function is introduced and different types of stochastic comparison are discussed: comparison in the mean, ordering in distribution, variability ordering and hazard-rate ordering. Acceptable, unacceptable and intermediate regions for levels of quality are determined by the discretization procedure. It is assumed that the quality of a product is revealed through usage. A simple reliability setting is considered when the quality of a product is directly dependent on its reliability characteristics in usage. Possible generalizations are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source]

    ,Acceptable' and ,unacceptable' risks

    PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2002
    WILLIAM A. SILVERMAN
    No abstract is available for this article. [source]

    Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study,, 1993,1999

    ACTA PAEDIATRICA, Issue 5 2001
    S Berra
    The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at-risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24,48 h after birth and a follow-up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer-Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26,2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58,6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79,4.21), the first mother-child contact occurring after 90min of life (OR =1.88; 95% CI 1.22,2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05,2.15). The calibration of the model was acceptable in the CLACYD I sample (p= 0.54), as well as in the CLACYD II sample (p= 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning. [source]

    Automatic Facsimile of Chinese Calligraphic Writings

    COMPUTER GRAPHICS FORUM, Issue 7 2008
    Songhua Xu
    Abstract To imitate personal handwritings is non-trivial. In this paper, we attempt to address the challenging problem of automatic handwriting facsimile. We focus on Chinese calligraphic writings due to their rich variation in style, high artistic values and also the fact that they are among the most difficult candidates for the problem. We first analyze the structures and shapes of the constituent components, i.e., strokes and radicals, of characters in sample calligraphic writings by the same writer. To generate calligraphic writing in the style of the writer, we facsimile the individual character elements as well as the layout relationships used to compose the character, both in the writer's personal writing style. To test our algorithm, we compare our facsimileing results of Chinese calligraphic writings with the original writings. Our results are found to be acceptable for most cases, some of which are difficult to differentiate from the real ones. More results and supplementary materials are provided in our project website at http://www.cs.hku.hk/~songhua/facsimile/. [source]

    Multiobjective Optimization of Concrete Frames by Simulated Annealing

    COMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 8 2008
    Ignacio Paya
    The evaluation of solutions follows the Spanish Code for structural concrete. The methodology was applied to a symmetrical building frame with two bays and four floors. This example has 77 design variables. Pareto results of the MOSA algorithm indicate that more practical, more constructable, more sustainable, and safer solutions than the lowest cost solution are available at a cost increment acceptable in practice. Results Ns -SMOSA1 and Ns -SMOSA2 of the cost versus constructability Pareto front are finally recommended because they are especially good in terms of cost, constructability, and environmental impact. Further, the methodology proposed will help structural engineers to enhance their designs of building frames. [source]

    "I Am Not Alone": The Feasibility and Acceptability of Interactive Voice Response-Facilitated Telephone Peer Support Among Older Adults With Heart Failure

    CONGESTIVE HEART FAILURE, Issue 3 2007
    Michele Heisler MD
    Patient self-management is a critical determinant of heart failure (HF) outcomes, yet patients with HF are often frail and socially isolated, factors that may limit their ability to manage self-care and access clinic-based services. Mobilizing peer support among HF patients is a promising strategy to improve self-management support. In this pilot, the authors evaluated the feasibility and acceptability of an interactive voice response (IVR)-based platform to facilitate telephone peer support among older adults with HF. Participants completed a baseline survey, were offered a 3-hour training session in peer communication skills, and were paired with another patient who had HF. Participants were asked to contact their partner weekly using a toll-free IVR phone system that protected their anonymity and provided automated reminders if contacts were not made. Times and duration of participants' telephone contacts were monitored and recorded. After the 7-week intervention, participants completed surveys and brief face-to-face interviews. The authors found high levels of use and satisfaction and improvements in depressive symptoms among the 20 pilot study participants. An IVR peer-support intervention is feasible, is acceptable to patients, and may have positive effects on patients' HF social support and health outcomes, in conjunction with structured health system support, that warrant more rigorous evaluation in a randomized trial. [source]

    The Northwest Forest Plan as a Model for Broad-Scale Ecosystem Management: a Social Perspective

    CONSERVATION BIOLOGY, Issue 2 2006
    SUSAN CHARNLEY
    conservación y desarrollo; comunidades rurales; gestión forestal; monitoreo socioeconómico Abstract:,I evaluated the Northwest Forest Plan as a model for ecosystem management to achieve social and economic goals in communities located around federal forests in the U.S. Pacific Northwest. My assessment is based on the results of socioeconomic monitoring conducted to evaluate progress in achieving the plan's goals during its first 10 years. The assessment criteria I used related to economic development and social justice. The Northwest Forest Plan incorporated economic development and social justice goals in its design. Socioeconomic monitoring results indicate that plan implementation to achieve those goals met with mixed success, however. I hypothesize there are two important reasons the plan's socioeconomic goals were not fully met: some of the key assumptions underlying the implementation strategies were flawed and agency institutional capacity to achieve the goals was limited. To improve broad-scale ecosystem management in the future, decision makers should ensure that natural-resource management policies are socially acceptable; land-management agencies have the institutional capacity to achieve their management goals; and social and economic management goals (and the strategies for implementing them) are based on accurate assumptions about the relations between the resources being managed and well-being in local communities. One of the difficulties of incorporating economic development and social justice goals in conservation initiatives is finding ways to link conservation behavior and development activities. From a social perspective, the Northwest Forest Plan as a model for ecosystem management is perhaps most valuable in its attempt to link the biophysical and socioeconomic goals of forest management by creating high-quality jobs for residents of forest communities in forest stewardship and ecosystem management work, thereby contributing to conservation. Resumen:,Evalué el Plan Forestal del Noroeste como un modelo para la gestión de ecosistemas para alcanzar metas sociales y económicas en comunidades localizadas alrededor de bosques federales en el Pacífico Noroeste de E.U.A. Mi evaluación se basa en los resultados del monitoreo socioeconómico desarrollado para evaluar el progreso en el logro de las metas del plan durantes sus 10 primeros años. Los criterios de evaluación que utilicé se relacionan con el desarrollo económico y la justicia social. El diseño del Plan Forestal del Noroeste incorporó metas de desarrollo económico y de justicia social. Sin embargo, los resultados del monitoreo socioeconómico indican que éxito en la implementación del plan para alcanzar esas metas fue combinado. Postulé la hipótesis de que hay dos razones importantes por las que las metas socioeconómicas del plan no se cumplieron totalmente: algunas de las suposiciones clave en las estrategias de implementación fueron deficientes y la capacidad institucional de la agencia para alcanzar las metas era limitada. Para mejorar la gestión de ecosistemas a gran escala en el futuro, los tomadores de decisiones deberán asegurarse que las políticas de gestión de recursos naturales sean aceptables socialmente; que las agencias de gestión de tierras tengan la capacidad institucional para cumplir sus metas de gestión; y que las metas de gestión sociales y económicas (y las estrategias para su implementación) se basen en suposiciones precisas de las relaciones entre los recursos a gestionar y el bienestar de las comunidades locales. La manera de vincular comportamiento de conservación y actividades de desarrollo es una de las dificultades para la incorporación de metas de desarrollo económico y de justicia social en las iniciativas de conservación. Desde una perspectiva social, el Plan Forestal del Noroeste como modelo para la gestión de ecosistemas quizás es más valioso por su intento de vincular las metas biofísicas y socioeconómicas de la gestión forestal mediante la creación de empleos de alta calidad para residentes de las comunidades en labores de regulación y supervisión forestal y de gestión de ecosistemas, por lo tanto contribuye a la conservación. [source]

    Nonindigenous Species: Ecological Explanation, Environmental Ethics, and Public Policy

    CONSERVATION BIOLOGY, Issue 1 2003
    David M. Lodge
    Misunderstandings and tension exist regarding the science, values, environmental ethics, and public policy relevant to invasive species, which are the subset of nonindigenous species that cause economic or environmental damage. Although there is a natural background rate at which species invasions occur, it is much lower than the current human-induced rates at which species are being moved around the globe. Contrary to some recently voiced opinions , the fact that some species invasions occur without human assistance does not confer acceptability on all species invasions. Also, despite claims to the contrary, the reductions of native biodiversity caused by nonindigenous species are large and well documented. Even if that were not true, an emphasis on species numbers alone as a metric for the impact of nonindigenous species does not adequately incorporate the high value many humans place on the uniqueness of regional biota. Because regional biota are being homogenized by species invasions, it has become an appropriate and official public policy goal in the United States to reduce the harm done by invasive species. The goal is not, however, a reduction of numbers of nonindigenous species per se, as recently claimed by some authors, but a reduction in the damage caused by invasive species, including many sorts of environmental and economic damage. A major challenge remaining for ecology, environmental ethics, and public policy is therefore the development of widely applicable risk-assessment protocols that are acceptable to diverse constituencies. Despite apparent disagreements among scholars, little real disagreement exists about the occurrence, effects, or public-policy implications of nonindigenous species. Resumen: El público está recibiendo un mensaje confuso de ecologistas, otros académicos y periodistas sobre el tema de especies no nativas. Existen malos entendidos y tensión en relación con la ciencia, los valores, la ética ambiental y las políticas públicas relevantes a las especies invasoras, que son un subconjunto de las especies no nativas que causan daños económicos o ambientales. Aunque existe una tasa natural a la que ocurren invasiones, es mucho más baja que las actuales tasas, inducidas por humanos, a las que especies son movidas alrededor del mundo. Al contrario de algunos autores recientes, el hecho de que algunas invasiones de especies ocurren sin asistencia humana no le confiere aceptabilidad moral sobre todas las invasiones de especies. También, a pesar de recientes afirmaciones de lo contrario, las reducciones de biodiversidad nativa debido a especies no nativas son notables y están bien documentadas. Aún si no fuera verdad, el énfasis sólo en el número de especies como una medida del impacto de especies no nativas no incorpora adecuadamente el alto valor que muchos humanos reconocen en la singularidad de la biota regional. Debido a que la biota regional está siendo homogeneizada por invasiones de especies, la reducción del daño causado por especies invasoras se ha convertido en una política pública apropiada y oficial en los Estados Unidos. Sin embargo, la meta no es la reducción de especies no nativas, en si, como afirman algunos autores recientes, sino una reducción de los impactos dañinos de las especies invasoras, incluyendo muchos tipos de daño económico y ambiental. Por lo tanto, un reto mayor para la ecología, la ética ambiental y la política pública es el desarrollo de protocolos de evaluación de riesgos ampliamente aplicables que sean aceptables para electores diversos. A pesar de aparentes desacuerdos entre académicos, existe poco desacuerdo real acerca de la ocurrencia, el impacto o las implicancias en política pública de las especies no nativas. [source]

    FS13.3 Development of risk reduction strategies for preventing dermatitis

    CONTACT DERMATITIS, Issue 3 2004
    Terry Brown
    Introduction:, A recent survey of the UK printing industry found a prevalence of 11% of occupational contact dermatitis (OCD), much higher than previously identified. Objective:, This pilot study aimed to evaluate risk reduction strategies derived from recommendations of a literature review of preventive intervention studies and a series of focus groups of printers and observations of printers undertaking their normal duties. Methods:, Four interventions were evaluated: (1) Provision of gloves of the correct size/type, plus use of an after-work skin cream; (2) Provision of information; (3) Provision of skin checks; (4) Development of best practice skin care policy. Each intervention was evaluated in two companies over a three-month period, at the end of which printers and managers were interviewed as to the effectiveness and acceptability of each intervention. Results:, Although this pilot study was short, all interventions were acceptable to some extent. The prevalence of frank dermatitis fell over the study period, particularly in intervention (3). Intervention (1) achieved an improvement of awareness in both management and workforce and an increase in the use of both gloves and cream. Intervention (2) highlighted problems of dissemination and the need for relevant information in an appropriate format. However. no single intervention was completely effective. Conclusions:, This qualitative research approach forms an essential first stage to improving understanding of ways in which OCD may be reduced among workers in the printing industry, and points towards the need for further testing of preventive strategies in larger-scale intervention trials, in printing and other industries. [source]

    A North American multilaboratory study of CD4 counts using flow cytometric panleukogating (PLG): A NIAID-DAIDS Immunology Quality Assessment Program Study,,§¶

    CYTOMETRY, Issue S1 2008
    Thomas N. Denny
    Abstract Background The global HIV/AIDS pandemic and guidelines for initiating anti-retroviral therapy (ART) and opportunistic infection prophylaxis demand affordable, reliable, and accurate CD4 testing. A simple innovative approach applicable to existing technology that has been successfully applied in resource-challenged settings, PanLeukogated CD4 (PLG), could offer solutions for cost saving and improved precision. Methods Day-old whole blood from 99 HIV+ donors was simultaneously studied in five North-American laboratories to compare the performance of their predicate methods with the dual-platform PLG method. The predicate technology included varying 4-color CD45/CD3/CD4/CD8 protocols on different flow cytometers. Each laboratory also assayed eight replicate specimens of day-old blood from 10 to 14 local donors. Bias and precision of predicate and PLG methods was studied between- and within-participating laboratories. Results Significantly (P < 0.0001) improved between-laboratory precision/coefficient of variation (CV%) was noted using the PLG method (overall median 9.3% vs. predicate median CV 13.1%). Within-laboratory precision was also significantly (P < 0.0001) better overall using PLG (median 4.6% vs. predicate median CV 6.2%) and in 3 of the 5 laboratories. PLG counts tended to be 11% smaller than predicate methods (P < 0.0001) for shipped (median of predicate,PLG = 31) and local specimens (median of predicate,PLG = 23), both overall and in 4 of 5 laboratories (median decreases of 4, 16, 20, and 21% in shipped specimens); the other laboratory had a median increase of 5%. Conclusion Laboratories using predicate CD4 methods similar to those in this study could improve their between-laboratory and their within-laboratory precision, and reduce costs, by switching to the PLG method after adequate training, if a change (usually, a decrease) in CD4 counts is acceptable to their health systems. © 2008 Clinical Cytometry Society [source]

    Application of a New Intense Pulsed Light Device in the Treatment of Photoaging Skin in Asian Patients

    DERMATOLOGIC SURGERY, Issue 11 2008
    YUAN-HONG LI MD
    BACKGROUND Intense pulsed light (IPL) technology has long been used in the treatment of photoaging skin. OBJECTIVE To evaluate the efficacy and safety of a new IPL device in the treatment of photoaging skin in Asian patients. METHODS One hundred fifty-two Chinese women with photoaging skin were enrolled in this open-labeled study. Subjects received four IPL treatments at 3- to 4-week intervals. Changes of photoaging were evaluated using a global evaluation, an overall self-assessment, a Mexameter, and a Corneometer. RESULTS One hundred thirty-nine of 152 patients (91.44%) experienced a score decrease of 3 or 2 grades, according to the dermatologist. One hundred thirty-six of 152 patients (89.47%) rated their overall improvement as excellent or good. The mean skin melanin index (MI) and erythema index values deceased with each session. MI on forehead and EI on cheilion decreased most significantly. Adverse effects were limited to mild pain and transient erythema. CONCLUSION IPL treatment is a safe and effective method for photoaging skin in Asian patients. Adverse effects were minimal and acceptable. [source]

    A Validated Brow Positioning Grading Scale

    DERMATOLOGIC SURGERY, Issue 2008
    ALASTAIR CARRUTHERS MD
    BACKGROUND One of the first areas to show facial aging is the periorbital region, where brow malposition contributes to the overall appearance of aging. Movement and positioning of the brows are also sex specific. Men may desire a low brow, whereas women may prefer high, arched brows. OBJECTIVES To develop the Brow Positioning Grading Scale for objective quantification of eyebrow position and to establish the reliability of this photonumeric scale for clinical research and practice. MATERIALS AND METHODS A 5-point photonumeric rating scale was developed to objectively quantify positioning of eyebrows at rest. Nine experts rated photographs of 35 subjects twice with regard to positioning of the eyebrow in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients. RESULTS Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts. The test,retest correlation coefficients were acceptable for each expert. CONCLUSION The 5-point photonumeric scale generated spans the positioning of the eyebrow for which patients commonly seek correction. The scale is well stratified for consistent rating. [source]

    Long-Pulsed Dye Laser Treatment for Facial Telangiectasias and Erythema: Evaluation of a Single Purpuric Pass versus Multiple Subpurpuric Passes

    DERMATOLOGIC SURGERY, Issue 8 2005
    Shilesh Iyer MD
    Background and Objective. Subpurpuric treatments with the pulsed dye laser can be effective for treatment of vascular lesions, although less so than when purpuric fluences are used. Increased efficacy may be achieved by performing multiple passes at the time of treatment. We performed a split-face bilateral paired comparison of multiple low-fluence subpurpuric passes compared with a single high-fluence purpuric pass in the treatment of facial telangiectasias. Materials and Methods. Nine patients were included in the study. One cheek was chosen to be treated with four passes of a nonpurpuric fluence, and the contralateral cheek was treated with a single purpuric pass. Reductions in vessel density, diameter, arborization, and background erythema were evaluated 3 weeks after treatment. Results. We found a 43.4% reduction in surface area covered by telangiectasias on the cheek treated with a single purpuric pass compared with 35.9% on the cheek treated with four subpurpuric passes. The purpuric fluences produced greater reduction in vessel diameter and arborization, whereas the subpurpuric protocol was more effective in reducing background erythema. Purpuric fluences were also noted to produce more significant edema and transient hyperpigmentation in one patient. Conclusion. The multipass subpurpuric approach to treatment with the pulsed dye laser is both cosmetically acceptable and effective, although purpuric treatments may be required to effectively eliminate larger-caliber, more highly networked vessels. [source]

    Upper Eyelid Full-Thickness Skin Graft in Facial Reconstruction

    DERMATOLOGIC SURGERY, Issue 1 2005
    Dogan Tuncali MD
    Background The potentially available upper eyelid skin, as an alternative donor site, deserves more attention in clinical use. Objective The objective of this study was to prospectively evaluate the clinical behavioral characteristics of upper eyelid full-thickness skin grafts in facial reconstruction. Methods Sixteen patients who concluded the 12-month follow-up period were included in the study. Graft dimensions were measured in place before the graft harvest. Defect sizes were measured following lesion excision and postgrafting. Graft sizes were measured postoperatively at 1, 3, 6, and 12 months. Results The largest and smallest grafts were 46 × 22 mm and 40 × 15 mm (average 43.1 × 19.3 mm) in size, respectively. The largest and smallest defect dimensions were 33 × 23 mm and 17 × 9 mm (average 22.6 × 15.6 mm), respectively. The average postgrafting size was 21.1 × 14.6 mm. Grafts and donor sites healed very well. Generally, an acceptable to good texture and color match was observed beyond 6 months. Wound bed contraction was not observed beyond the first month (p < .05). Conclusion Special characteristics of hairless skin, good color and texture matching, and inconspicuous and hidden donor scar make the upper eyelid a good alternative donor site for small- to medium-sized facial skin defects. The main disadvantages that limit its clinical use are the age of the patient, a lack of adnexal structures, comparatively limited sun exposure, and possible insufficient thickness, especially when deep defects are of concern. DOGAN TUNCALI, MD, LEVENT ATES, MD, AND GÜRCAN ASLAN, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source]

    The medical and surgical therapy of pseudofolliculitis barbae

    DERMATOLOGIC THERAPY, Issue 2 2004
    Sharon Bridgeman-Shah
    ABSTRACT:, Pseudofolliculitis barbae (PFB) is a common, chronic, inflammatory skin disorder seen mainly in individuals with curly hair. This condition is seen most frequently in black men who shave their beards but may also be seen in women of all races who wax or shave the axillary and pubic skin. The etiology of PFB is multifactorial, and heretofore a cure has been considered impossible for those desiring a clean-shaven face. The following article serves to discuss the current medical and surgical therapies available for this condition. Medical treatments for this condition include various combinations of topical antibiotics, corticosteroids, and retinoids. In the surgical arena, laser therapy has revolutionized the treatment of PFB and has enabled cure for the first time for those plagued by this disorder and for whom a beardless face is acceptable. [source]

    Detecting language problems: accuracy of five language screening instruments in preschool children

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2007
    H M E Van Agt MA
    To identify a simple and effective screening instrument for language delays in 3-year-old children the reliability, validity, and accuracy of five screening instruments were examined. A postal questionnaire sent to parents of 11423 children included the Dutch version of the General Language Screen (GLS), the Van Wiechen (VW) items, the Language Screening Instrument for 3- to 4-year-olds, consisting of a parent form (LSI-PF) and a child test (LSI-CT), and parents' own judgement of their child's language development on a visual analogue scale (VAS). The response rate was 78% or 8877 children. Reliability (internal consistency) was found to be acceptable (,=0.67,0.72) for all instruments. Significant correlations between the screening instruments (r=0.29,0.55, p<0.01) indicated good concurrent validity. Accuracy was estimated by the sensitivity, specificity, and receiver operating characteristic (ROC) curves against two reference tests based on parent report and specialists' judgement. If the test would classify approximately 5% of the population as screen-positive, the mean sensitivity was 50%; assigning between 20% and 30% of the population as screen-positive, the mean sensitivity was 77%. The sensitivity was lowest for the LSI-CT (range 43,62%), whereas short instruments like the LSI-PF, VW, and the one-item VAS exhibited high levels of sensitivity (range 50,86%). The area under the ROC curves, ranged from 0.75 to 0.87. Apparently, short and simple parent report instruments like the LSI-PF and the one-item VAS perform remarkably well in detecting language delays in preschool children. [source]

    Glucose sensors: a review of current and emerging technology

    DIABETIC MEDICINE, Issue 3 2009
    N. S. Oliver
    Abstract Glucose monitoring technology has been used in the management of diabetes for three decades. Traditional devices use enzymatic methods to measure glucose concentration and provide point sample information. More recently continuous glucose monitoring devices have become available providing more detailed data on glucose excursions. In future applications the continuous glucose sensor may become a critical component of the closed loop insulin delivery system and, as such, must be selective, rapid, predictable and acceptable for continuous patient use. Many potential sensing modalities are being pursued including optical and transdermal techniques. This review aims to summarize existing technology, the methods for assessing glucose sensing devices and provide an overview of emergent sensing modalities. [source]

    Near patient testing for glycated haemoglobin in people with Type 2 diabetes mellitus managed in primary care: acceptability and satisfaction

    DIABETIC MEDICINE, Issue 7 2007
    M. A. Stone
    Abstract Aims To assess the acceptability of and satisfaction with near patient testing for glycated haemoglobin in primary care in patients and health professionals. Methods A questionnaire survey and qualitative study were nested within a randomized controlled trial conducted in eight general practices in Leicester-shire, UK. Satisfaction with diabetes care was compared in the intervention group (near patient test) and in the control subjects (usual laboratory test), using the Diabetes Clinic Satisfaction Questionnaire. Semistructured interviews were conducted with a purposive sample of patients and healthcare professionals and analysed using thematic coding and framework charting. Results Questionnaire data for 344 patients were analysed and interviews were conducted with 15 patients and 11 health professionals. Interviews indicated that the near patient test was highly acceptable to patients and staff and confirmed that there may be potential benefits such as time saving, reduced anxiety and impact on patient management and job satisfaction. However, both the survey and the interviews identified high pre-existing levels of satisfaction with diabetes care in both intervention and control group patients and survey results failed to confirm increased patient satisfaction as a result of rapid testing. Limited patient understanding of glycated haemoglobin testing was noted. Conclusions We were unable to confirm actual rather than potential advantages of the near patient test. Widespread adoption in primary care cannot be recommended without further evidence of benefit. [source]

    Sick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trial

    DIABETIC MEDICINE, Issue 3 2006
    L. M. B. Laffel
    Abstract Aims Diabetic ketoacidosis (DKA), a life-threatening acute complication of Type 1 diabetes, may be preventable with frequent monitoring of glycaemia and ketosis along with timely supplemental insulin. This prospective, two-centre study assessed sick day management using blood 3-hydroxybutyrate (3-OHB) monitoring compared with traditional urine ketone testing, aimed at averting emergency assessment and hospitalization. Methods One hundred and twenty-three children, adolescents and young adults, aged 3,22 years, and their families received sick day education. Participants were randomized to receive either a blood glucose monitor that also measures blood 3-OHB (blood ketone group, n = 62) or a monitor plus urine ketone strips (urine ketone group, n = 61). All were encouraged to check glucose levels , 3 times daily and to check ketones during acute illness or stress, when glucose levels were consistently elevated (, 13.9 mmol/l on two consecutive readings), or when symptoms of DKA were present. Frequency of sick days, hyperglycaemia, ketosis, and hospitalization/emergency assessment were ascertained prospectively for 6 months. Results There were 578 sick days during 21 548 days of follow-up. Participants in the blood ketone group checked ketones significantly more during sick days (276 of 304 episodes, 90.8%) than participants in the urine ketone group (168 of 274 episodes, 61.3%) (P < 0.001). The incidence of hospitalization/emergency assessment was significantly lower in the blood ketone group (38/100 patient-years) compared with the urine ketone group (75/100 patient-years) (P = 0.05). Conclusions Blood ketone monitoring during sick days appears acceptable to and preferred by young people with Type 1 diabetes. Routine implementation of blood 3-OHB monitoring for the management of sick days and impending DKA can potentially reduce hospitalization/emergency assessment compared with urine ketone testing and offers potential cost savings. [source]

    Feasibility of using the TOSCA telescreening procedures for diabetic retinopathy

    DIABETIC MEDICINE, Issue 10 2004
    S. Luzio
    Abstract Aims The TOSCA project was set up to establish a tele-ophthalmology service to screen for diabetic retinopathy (DR) in Europe. The aim of this study was to determine the feasibility of establishing telemedicine-based digital screening for detecting DR and to evaluate the satisfaction of both patients and healthcare professionals with the screening procedures used within the TOSCA project. Methods The study was a non-randomized, multicentre study carried out in four different countries over a period of 3 months. Patients (n = 390) with diabetes aged > 12 years were included. Two digital retinal images per eye (macular and nasal) were taken and exported to a central server. Patients were asked to complete a questionnaire to assess satisfaction. Accredited graders carried out grading remotely and the results were reported back to the referring centre. Previously graded patient data chosen randomly to represent examples of both DR and no DR were also sent anonymously to the grading centre at a frequency of approximately every 10 patients. Results Most (99%) of the images were assessable enabling a retinopathy grade to be assigned to the patient. Patients found the retinal photography procedures acceptable; only 6% in one centre would not recommend the procedure. Healthcare professionals (photographers and graders) were also satisfied with the overall procedures. The average time taken to grade each patient was approximately 5 min. Conclusions This study demonstrated that it is feasible to electronically transmit and grade retinal images remotely using the TOSCA process. Built-in quality assurance procedures proved acceptable. [source]

    The Health Sector Gap in the Southern Africa Crisis in 2002/2003

    DISASTERS, Issue 4 2004
    Andre Griekspoor
    The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides a steep learning curve for the international humanitarian system in understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. It also provoked much debate about the severity and causes of this emergency, and the appropriateness of the response by the humanitarian community. The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor. This neglect occurred because analytical frameworks were too narrowly focused on food security, and large-scale support to health service delivery was seen as a long-term developmental issue that could not easily be dealt with by short-term humanitarian action. Furthermore, there were insufficient countrywide data on acute malnutrition, mortality rates and performance of the public health system to make better-balanced evidence-based decisions. In this crisis, humanitarian organisations providing health services could not assume their traditional roles of short-term assistance in a limited geographical area until the governing authorities resume their responsibilities. However, relegating health service delivery as a long-term developmental issue is not acceptable. Improved multisectoral analytical frameworks that include a multidisciplinary team are needed to ensure all aspects of public health are dealt with in similar future emergencies. Humanitarian organisations must advocate for improved delivery and access to health services in this region. They can target limited geographical areas with high mortality and acute malnutrition rates to deliver their services. Finally, to address the underlying problem of the health sector gap, a long-term strategy to ensure improved and sustainable health sector performance can only be accomplished with truly adequate resources. This will require renewed efforts on part of governments, donors and the international community. Public health interventions, complementing those addressing food insecurity, were and are still needed to reduce the impact of the crisis, and to allow people to re-establish their livelihoods. These will increase the population's resilience to prevent or mitigate future disasters. [source]

    Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatment

    DRUG AND ALCOHOL REVIEW, Issue 3 2007
    BIANCA WATSON
    Abstract Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study. [source]

    SPECIAL SECTION: EVALUATION OF THE WESTERN AUSTRALIAN CANNABIS INFRINGEMENT NOTICE SCHEME,PHASE 1: Community attitudes towards cannabis law and the proposed Cannabis Infringement Notice scheme in Western Australia

    DRUG AND ALCOHOL REVIEW, Issue 4 2005
    JAMES FETHERSTON
    Abstract Western Australia (WA) became the fourth Australian jurisdiction to adopt a prohibition with civil penalties scheme for minor cannabis offences when its Cannabis Infringement Notice (CIN) scheme became law on 22 March 2004. Previous criminological research has demonstrated the importance of public attitudes towards the law in determining the effectiveness of legislation. This survey represents the first phase of a pre-post study that attempted to gauge public attitudes towards the legal status of cannabis, the proposed legislative reforms surrounding the drug and their likely effects. A random telephone survey of 809 members of the WA population was conducted prior to the implementation of the new laws with a view to exploring contemporary views of the existing legal status of cannabis, attitudes to the proposed legislative model and respondent perceptions of its likely effects. Despite cannabis being viewed negatively by large numbers of the sample, criminal penalties for minor cannabis offences were viewed as inappropriate and ineffective. Once explained, the proposed civil penalty scheme was viewed as ,a good idea' by 79% of the sample, despite significant differences due to personal experience of cannabis use, political affiliation, religiosity and age of offspring. Most believed that the legislative change would not result in changes to levels of cannabis use (70%) or ease of obtaining cannabis (59%). These data suggest that prior to its implementation the new legislation was highly acceptable to the majority of the community. These baseline data will be compared with data to be collected at the post-change phase of the study to allow empirical observations of attitudinal and behavioural changes occurring in the community. [source]

    Increasing practice nurse access to alcohol training

    DRUG AND ALCOHOL REVIEW, Issue 3 2002
    ANN DEEHAN
    Abstract Policy makers have repeatedly placed emphasis on the role of primary care in screening for at-risk alcohol consumption and delivering public health messages to the general population. Research has pointed to primary care staff holding negative attitudes towards alcohol misusing patients. Training has traditionally been seen as the key to increasing the capacity of the medical field to engage with alcohol misusing patients but little work has been undertaken to examine the potential barriers to training take up. Consequently, the aim of this study was to explore the willingness of practice nurses to be trained in alcohol screening and brief intervention, and whether identifiable barriers to training exist and how they may be overcome. All practice nurses (n = 82) in an outer London (UK) Health Authority Area were twice mailed an invitation to an alcohol training seminar and a telephone invitation was made to all of those who did not reply to the mailings. Those who did not attend (n = 66) were contacted to take part in a short structured telephone interview ,89% (59/66) were contacted successfully and interviewed. Respondents were experienced in primary care and viewed health promotional activity as a valid part of their role. Few had undertaken previous alcohol training and as a group they were highly active in attending training events with training undertaken tending to be related directly to perceived practice needs and priorities: thus this group could not be characterized as unwilling to be trained. Barriers to training at alcohol events were found to be either personal or work-related, with most nurses interested in receiving further training or information. These data imply that the ways in which training is organized and delivered require sensitivity to identifiable barriers if it is to reach and effect changing practice among practice nurses successfully. A range of possibilities are identified as alternative approaches to the provision of elective training events which may be more acceptable to the target population of health-care staff. [source]

    Identifying young people who drink too much: the clinical utility of the five-item Alcohol Use Disorders Identification Test (AUDIT)

    DRUG AND ALCOHOL REVIEW, Issue 1 2001
    HELEN MILES Researcher
    Abstract The current study investigated the patterns and consequences of alcohol use among young people and their perceptions of associate health risk, and explored the clinical utility of the five-item version of the Alcohol Use Disorders Identification Test (AUDIT) in screening young people for hazardous drinking. A cross-sectional sample of 393 young people aged 16,19 years were accessed through two tertiary colleges in South London and self-completed an anonymous, confidential questionnaire recording the five-item AUDIT, patterns of alcohol consumption, hazardous consequences and perception of associate health risk. Over 90% of the sample reported drinking alcohol regularly, commonly excessive weekend use and related physical, psychological and social consequences. A significant minority (20.4% of males, 18.0% of females) reported consumption of alcohol in excess of UK recommended limits, while almost a third (34.2% of males, 30.2% of females) reported scores in the ,hazardous' range of the five-item AUDIT. However, the majority had little perception of associate health risk, perceiving their use to be ,light' and unproblematic. Only one in 10 of those drinking at ,hazardous' levels recognized their alcohol use as problematic, most believing the hazardous consequences of this use were acceptable. Self-reported patterns of alcohol consumption (except age first used) and total number of psychological and social hazardous consequences were found to significantly predict AUDIT scores using linear regression analysis. Therefore the five-item AUDIT appears to have predictive validity, reflecting self-reported alcohol consumption, perception of associate health risk and hazardous consequences among young people. It is concluded that it may consequently have clinical utility as a simple screening tool (suitable for use by a variety of professionals in contact with young people) for the identification of hazardous alcohol consumption among this population. [source]

    Interobserver and Intraobserver Variability of Flow-Mediated Vasodilatation of the Brachial Artery

    ECHOCARDIOGRAPHY, Issue 1 2008
    Iana Simova M.D.
    Flow-mediated endothelial-dependent vasodilatation (FMD) of the brachial artery is a method capable of detecting endothelial dysfunction. In order to implement this method in future clinical research studies, its reproducibility and precision have to be assessed. The aim of the study is to evaluate the inter- and intraobserver variability of FMD performed in our department. We investigate 40 patients. FMD is measured by two independent observers to test the interobserver variability, and repeated by the first observer to test the intraobserver variability. We compare the baseline and post-ischemic diameter of the brachial artery and the percent dilatation. The correlation coefficients for these comparisons are high (>0.92) with a significance of less than 0.001. The inter- and intraobserver variability is further tested comparing the mean values of the baseline and post ischemic diameter of the brachial artery and the percent dilatation. The absolute values of the mean paired differences and the standard deviations (SDs) of the differences are 0.02850 ± 0.05942, P = 0.004, 0.01175 ± 0.08177, P = 0.369 and 0.28375 ± 1.61561, P = 0.273, respectively for the interobserver variability and 0.00475 ± 0.04663, P = 0.523, 0.00050 ± 0.05267, P = 0.952 and 0.15725 ± 1.19922, P = 0.412, respectively for the intraobserver variability. It can be concluded that the inter- and intraobserver variability for FMD performed in our department is acceptable. FMD can be performed precisely and accurately, with a satisfactory reproducibility and can be safely and reliably implemented in future clinical research studies. [source]

    The Reliability of Echocardiographic Left Ventricular Wall Motion Index to Identify High-Risk Patients for Multicenter Studies

    ECHOCARDIOGRAPHY, Issue 1 2006
    Gunnar H. Gislason M.D.
    Objective: To study whether the use of echocardiographic left ventricular (LV) wall motion index (WMI) is a dependable parameter for identifying patients with LV dysfunction to be enrolled in multicenter trials. Methods: Videotaped echocardiographic examinations from 200 randomly selected patients that were screened for inclusion into the DIAMOND-CHF and DIAMOND-MI trials were reevaluated by an external expert echocardiographer. WMI was calculated using the 16-segment LV model. Results: The external echocardiographer systematically found lower values of WMI than the core laboratory. The average difference in WMI was 0.18 (SD: 0.33) in the DIAMOND-CHF trial and 0.09 (SD: 0.33) in the DIAMOND-MI trial. The difference in WMI exceeded 0.33 in 34% of the patients in both trials. The cutoff value for inclusion into the DIAMOND trials was WMI , 1.2. There was an agreement on WMI dichotomized to below or above 1.2 in 82% of the patients in both trials ( , coefficient 0.66 for the DIAMOND-CHF and 0.55 for the DIAMOND-MI). Conclusions: Despite substantial interlaboratory variation in WMI in individual patients and a systematic lower WMI score by the external echocardiographer there was an acceptable overall agreement for identifying patients with severe impairment of LV function. This not only underscores the value of LV-WMI as a useful tool for selecting high-risk patients to be included in multicenter studies but also serves to warn against the use of rigid cutoff values for WMI in the treatment of individual patients. [source]

    The Cannabis Use Problems Identification Test (CUPIT): development, reliability, concurrent and predictive validity among adolescents and adults

    ADDICTION, Issue 4 2010
    Jan Bashford
    ABSTRACT Aims To describe the empirical construction and initial validation of the Cannabis Use Problems Identification Test (CUPIT), a brief self-report screening instrument for detection of currently and potentially problematic cannabis use. Design In a three-phase prospective design an item pool of candidate questions was generated from a literature review and extensive expert consultation. The CUPIT internal structure, cross-sectional and longitudinal psychometric properties were then systematically tested among heterogeneous past-year users. Participants Volunteer participants were 212 high-risk adolescents (n = 138) and adults (n = 74) aged 13,61 years from multiple community settings. Measurements The comprehensive assessment battery included several established measures of cannabis-related pathology for CUPIT validation, with DSM-IV/ICD-10 diagnoses of cannabis use disorders as criterion standard. Findings Sixteen items loading highly on two subscales derived from principal components analysis exhibited good to excellent test,retest (0.89,0.99) and internal consistency reliability (0.92, 0.83), and highly significant ability to discriminate diagnostic subgroups along the severity continuum (non-problematic, risky, problematic use). Twelve months later, baseline CUPIT scores demonstrated highly significant longitudinal predictive utility for respondents' follow-up diagnostic group membership. Receiver operating characteristic (ROC) analysis identified a CUPIT score of 12 to be the optimal cut-point for maximizing sensitivity for both currently diagnosable cannabis use disorder and those at risk of meeting diagnostic criteria in the following 12 months. Conclusions The CUPIT is a brief cannabis screener that is reliable, valid and acceptable for use across diverse community settings and consumers of all ages. The CUPIT has clear potential to assist with achievement of public health goals to reduce cannabis-related harms in the community. [source]