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Discussion
Kinds of Discussion Terms modified by Discussion Selected AbstractsTHICKENING THE DISCUSSION: INSPECTING CONSTRUCTIVIST THEORIES OF KNOWLEDGE THROUGH A JAMESIAN LENSEDUCATIONAL THEORY, Issue 1 2002Bradford S. Woods First page of article [source] [Commentary] ALCOHOL AND SPONSORSHIP IN SPORT: SOME MUCH-NEEDED EVIDENCE IN AN IDEOLOGICAL DISCUSSIONADDICTION, Issue 12 2008J. REHM No abstract is available for this article. [source] GOVERNMENTAL ACCOUNTING IN NORWAY: A DISCUSSION WITH IMPLICATIONS FOR INTERNATIONAL DEVELOPMENTFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 2 2008Norvald Monsen Accrual accounting is now being introduced in governmental organizations internationally. Some scholars have, however, questioned this development, implying that other accounting theories, like cameral accounting, should also be considered for use in these organizations. Since Norway is a country, which has not introduced accrual accounting in the governmental sector, the purpose of this paper is to study the evolution of governmental accounting in this country. Based on the Norwegian experiences, the paper aims to present some conclusions for the further international development of governmental accounting. [source] Victims of Domestic Violence: A Proposal for a Community Diagnosis Based on One of Two Domains of NANDA Taxonomy IIINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Patricia Serpa de Souza Batista PURPOSE To explore and identify diagnostic components to amplify NANDA nursing diagnoses by modifying the root violence. Whereas violence is nondebatable as a diagnostic concept in nursing, other alternatives have not been identified in the two existing diagnoses. METHODS Using the case study method, this qualitative study sought to identify commonalties in a population of women who were "donnas da casa" (homemakers) in a small rural community of approximately 100 families, typical of the Brazilian northeast. The sample of 7 women was identified through a larger study that had been based on health needs of the community. Data were obtained through observation during a home visit and a semistructured interview based on NANDA Taxonomy II. Observations were focused on hygiene, manner of dress, home environment, and physical and emotional state. Data were analyzed by content and clustered into major categories. From these a profile of the women and another of the partners emerged. FINDINGS Subjects ranged in age from 33 to 43 years, and number of children between 3 and 7. One of the 7 women was literate; 5 were underweight; all were slovenly attired. They appeared sad and older than their age. The majority seemed relieved to unburden themselves to the interviewers as they went through a gamut of emotions such as sadness, anguish, and irritability expressed through crying, restlessness, changes in body language, and tone of voice. The shortage of beds was supplemented by hammocks and mats or cardboard. The women spoke of being confined to their home and of male partners who drank on weekends, thus leaving them with little money for necessities of life. There were accounts of beatings when the partner returned home after drinking, overt nonacceptance of children from previous marriages, and general destruction of the family environment. New children were regarded as just another mouth to feed. DISCUSSION The profiles pointed to the necessity of identifying a new nursing diagnosis that would be linked, only tangentially, by the root violence to the two diagnoses in NANDA Taxonomies I and II. This insight led us to consider that a new method of listing NANDA diagnoses, by root only, is imperative in the evolution of Taxonomy II. Proposed descriptors, Victims of (Axis 3) and Domestic (Axis 6) would be identified by Axes, thereby facilitating the process of classifying in the Domains and Classes. The two existing NANDA diagnoses, risk for other-directed violence and risk for self-directed violence, are proposed for classification in Class 3, Violence, in Domain 11 of Taxonomy II. Safety/Protection could, by virtue of their modification power, find anchor in another domain such as Domain 6, Self-Perception. CONCLUSIONS Although Safety/Protection seems the most logical domain for classification by root, the axes, dimensions of human responses, could pull the diagnosis in another direction, thereby dictating other nursing interventions and nursing outcomes [source] Fatigued Elderly Patients With Chronic Heart FailureINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Anna Ehrenberg PURPOSE To compare descriptions of fatigue based on the NANDA characteristics from interviews with elderly people with congestive heart failure (CHF) and data recorded by nurses at a Swedish outpatient heart failure clinic. METHODS Patients were screened for moderate to severe CHF. A total of 158 patients were interviewed using a revised form of the Fatigue Interview Schedule (FIS) based on the NANDA characteristics. Of these patients, half (n= 79) were offered visits at a nurse-monitored heart failure clinic. Nursing documentation of fatigue at the heart failure clinic was reviewed based on the NANDA characteristics and compared with the content in the patient interviews. FINDINGS Tiredness was documented in 43 (75%) records and indicated in 36 patients based on patient scores on the FIS (X,= 5.5; range 1,9). The most frequently recorded observation related to fatigue was the symptom emotionally labile or irritable, followed by notes on lack of energy and decreased performance. Patients' descriptions of their fatigue were expressed as a decreased ability to perform and a perceived need for additional energy. Results indicated poor concordance in patients' descriptions and record content concerning fatigue. Whereas patients emphasized the physical characteristics of fatigue, nurses emphasised the emotional features. Decreased libido was linked to fatigue according to the patients but not according to the nurses' records. Whereas cognitive characteristics of fatigue occurred rarely in the records, they were more frequent in the patient interviews. DISCUSSION Symptoms such as irritability and accident-proneness may be seen as manifestations of the patients' experiencing the need for more energy or a feeling of decreased performance. These consequences of being fatigued, rather than the different dimensions of fatigue, seemed to have been easy for the nurses to observe and document. Earlier studies indicate that poor observation, medication, and diet in patients with heart failure might partly be explained by cognitive impairment. CONCLUSIONS Findings of this study highlight the need for nurses to pay attention to the experience of fatigue in patients who suffer from CHF, and to validate their observations with the patients own expressions. Using the patients' words and expressions and the diagnostic characteristics of fatigue in recording can support the nurses in developing both understanding of patients living with CHF and strategies to help patients cope with their restricted ability in daily life. [source] Nursing Diagnoses in Psychiatric Acute Wards in Switzerland and AustriaINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Harald Stefan PURPOSE To examine the frequency and quality of documented nursing diagnoses and to compare the diagnoses regarding ward and patient characteristics. METHODS The following data were collected from 11 acute care wards in five psychiatric hospitals in Switzerland and Austria: documented nursing diagnoses, demographic characteristics of an unselected sample of 30 consecutively discharged patients in each ward, ward data, and data from three randomly selected complete charts from each ward. Free-text diagnoses were recoded into NANDA terminology. Frequencies were calculated and compared across settings and regarding patient and ward characteristics. Diagnoses were examined for quality and structure of the diagnostic statements. FINDINGS Mean age of patients was 40 ± 13 years, and the main psychiatric diagnoses were schizophrenia, mood disorders, substance abuse, and neurotic and personality disorders. Of the 664 nursing diagnoses located in 330 nursing records, 635 were proper nursing diagnoses; 83% of patients had at least 1 nursing diagnosis (X,= 2). The number of diagnoses correlated weakly with patient length of stay. Of the nursing diagnoses, 20% were made on admission day, and the majority of nursing diagnoses was active at discharge. Ninety percent of the diagnoses were formulated using NANDA terminology. The most frequently used categories were coping-related diagnoses,disturbed thought processes and self-care deficits. Numerous problem,etiology,symptom (PES)formatted diagnoses had diagnostic labels nested within the etiology. Countryand setting-specific similarities and differences were found with a significantly higher number of nursing diagnoses in Austria where use is mandated. In Austria, more somatic nursing diagnoses were found. The most frequent nursing diagnoses were similar in both countries. DISCUSSION The number of diagnoses corresponds to results reported in the international literature suggesting the justification for international comparison. Ten categories represent 60% of nursing diagnoses. Approximately 50% of nursing diagnoses were made in the first days after hospitalization, rendering their use practicable. A minority of nursing diagnoses were discontinued, possibly suggesting that some problems are difficult to solve or evaluate. The PES format and the NANDA terminology are used quite extensively even when not mandatory. NANDA terminology is deemed useful and practical, but problems occur when nursing diagnoses CONCLUSIONS Nursing diagnoses represent the main areas of nursing, but cultural differences exist regarding the diagnostic process. Thus, research is needed to test the appropriateness of nursing diagnoses to characterize nursing populations. [source] NANDA and NIC: Mediators to Describe Irish Intellectual Disability NursingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Fintan Sheerin PURPOSE To identify the foci of interest specific to nursing interventions within residential, intellectual disability nursing through the use of the terms and meanings presented in NANDA and NIC. METHODS Data were collected using a Delphi approach involving a purposive sample of 8 individuals with relevant expertise, followed up by the conduct of three focus groups held with a total sample of 17 intellectual disability nurses working in three Irish service settings: traditional residential, community residential, and nurse education. Data were examined for contextual meaning as well as consensus of perceptions. FINDINGS Many potential interventions and diagnoses were identified for the field of residential learning disability nursing. Interventions that elicited a >50% consensus among participants across groups were examined for contextual meaning, based on the taped and noted responses, and potentially related NIC interventional labels were then applied. These led, through a reverse NIC-NANDA linkage exercise, to the identification of 8 potentially related interventions. The contextual aspect directed the analysis process to identify the nursing diagnoses associated with the interventions to be used, and 21 resultant diagnoses were identified. DISCUSSION Further analysis and study are needed to verify the relevance of these diagnoses and interventions to residential learning disability. A quick comparison of the results with those of studies carried out in other countries demonstrates that certain diagnoses have been identified by one or more authors in their studies. CONCLUSIONS This study identified a number of foci that have achieved various levels of consensus among the study participants. The ongoing study plan will further examine nurses' and managers' perceptions while also looking at these within the context of current service philosophy. [source] An Internet-Based Survey of Icelandic Nurses on Their Use of and Attitudes Toward NANDA, NIC, and NOCINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Gyda Bjornsdottir PURPOSE To gain understanding of how Icelandic nurses can be supported during a mandated change to the use of NANDA and NIC in clinical documentation practices. METHODS All members of the Icelandic Nurses Association of working age were invited to participate in an Internet-based survey. Each nurse was assigned a unique password mailed to his/her home along with information on how to access the survey Web site. Each nurse could submit answers only once. On submission, data were automatically coded and saved in a database under encrypted numerical identifiers. FINDINGS A total of 463 nurses (18% response rate) participated by submitting answers. The sample was representative of the population in terms of demographic characteristics. Information resources most valued when planning nursing care included text-based progress notes (77%), nursing care plans (52%), doctor's orders (49%), verbal information (48%), and documented nursing diagnoses (37%). Of the participants, 58% said NANDA was used in their workplace; 28% said no standardized nursing documentation was used; 19% reported using NIC always or sometimes when documenting nursing interventions; and 20% never used NIC. NOC use was reported only by researchers. Of the sample, 86% reported that it is important or necessary for nurses to standardize documentation practices; 30% found NANDA useful in education; 56% found it useful for clinical work; 17% for research; and 7% found it not useful at all. Nine percent believed that NANDA diagnoses were not descriptive enough of patients' problems, and 23% found their wording problematic. No statistically significant differences were found between reported use of or attitudes toward NANDA and NIC when comparing nurses who use electronic patient record systems that support NANDA and NIC documentation and those who use paper documentation only. DISCUSSION The sample may have been somewhat biased toward computer use and classification system use for standardized and computerized documentation. However, results indicate that although Icelandic nurses give free-text progress notes and verbal information a higher priority than nursing diagnoses as an information resource for care planning, they have a positive attitude toward NANDA. NANDA and NIC are still used inconsistently in clinical practice, and 28% of participants claimed not to use any form of standardized documentation. CONCLUSIONS In an effort to standardize clinical documentation among nurses, Icelandic health authorities must follow their documentation mandates with educational and technologic support to facilitate the use of NANDA, NIC, and (after its translation) NOC in nursing documentation practices. Electronic patient record system developers must find ways to further facilitate standardized nursing documentation because currently there seems to be no difference between users and nonusers in terms of how they use NANDA and NIC in their documentation practices. [source] Estimated Time and Educational Requirements to Perform NIC InterventionsINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Gloria M. Bulechek PURPOSE To estimate the time to perform and type of personnel to deliver each of the 486 interventions listed and described in the third edition of NIC. METHODS Small groups of research team members rated selected interventions in their area of expertise on education and time needed for each intervention. Education needed was defined as the minimal educational level necessary to perform the intervention in most cases in most states. Rating categories were (a) nursing assistant (NA/LPN/LVN/technician), (b) RN (basic education whether baccalaureate, associate degree, or diploma), or (c) RN with post-basic education or certification. Time needed was defined as the average time needed to perform the intervention. Raters selected one of five possible time estimates: (a) <15 minutes, (b) 16,30 minutes, (c) 31,45 minutes, (d) 46,60 minutes, or (e) >1 hour. All ratings were reviewed across groups to ensure overall consistency. FINDINGS Results of this exercise provide beginning estimates of the time and education needed for 486 NIC interventions. Twenty percent required <15 minutes, 30% required 16,30 minutes, 17% required 31,45 minutes, 12% required 46,60 minutes, and 21% required >1 hour. More than 70% of the interventions were judged as needing basic RN education to perform. Raters judged RN post-basic education to be required to performi 16% of the interventions, and 14% were deemed appropriate for personnel with NA/LPN education to perform. A monograph, Estimated Time and Educational Requirements to Perform 486 Nursing Interventions, available from http://www.nursing@uiowa.ed/cnc, includes lists of interventions appropriate for each time and education category, as well as time and education ratings according to NIC domains and classes. DISCUSSION The estimates of time and education provided by expert ratings provide a good beginning for cost estimates, resource planning, and reimbursement. The results of this study add to the small but growing body of literature that demonstrates that estimates of time to perform interventions by nurses who are familiar with the interventions is an accurate and efficient method to determine time values. A description of how this information can be used in a costing model is in the July/August 2001 issue of Nursing Economics. CONCLUSIONS NIC has identified the interventions that nurses perform. This study of time to perform and type of personnel to deliver each of the NIC interventions can help nurse leaders make better-informed decisions about cost-effective nursing care. [source] Using NIC to Describe the Role of the Nurse PractitionerINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Cindy S. Haugsdal PURPOSE To have nurse practitioners (NPs) identify the 20 most prevalent NIC interventions describing their nursing practice; to determine if the NIC is applicable to the NP role. METHODS The study used a descriptive survey design. NPs with prescriptive privileges in the state of Minnesota received a cover letter and survey that included a description of NIC and a list of the 486 intervention labels and their definitions from the NIC (3rd ed.). Each participant was asked to identify all interventions performed at least once per month in their practice and to provide basic demographic data, including identification of NP specialty. FINDINGS A total of 1,190 surveys were mailed with a return rate of 37%. NPs' average age was 45 years; the average number of years of NP practice was 9. Employment in a clinic represented the work setting of 72% of respondents followed by hospital practice (11%) and long-term care (10%). Specialty (certified) areas were family practice (27%), pediatrics (21%), adult (19%), women's health (16%), geriatrics (11%), psychiatric (5%), and oncology (1%). The educational level was primarily master's degree (73%). NPs identified an average of 120 interventions they performed at least once per month. These interventions reflected areas of patient education and support, as well as documentation and physician collaboration. The 20 most frequently selected interventions were reported by 71%, 90% of respondents. Four core interventions ,"documentation,""telephone consultation,""teaching: prescribed medication," and "emotional support", were used at least once per month by all specialties. DISCUSSION The level of consistency (70%) among responses validates the strong foundation that professional nursing, as described by NIC, provides NPs in their role. Four core interventions and the remaining 16 most frequently selected interventions that are more specific to each specialty practice indicates that NIC is comprehensive enough to meet the needs of a variety of NP practices. CONCLUSIONS NIC encompasses key areas of interventions (health screening, treatment and management, health promotion and education, psychosocial support, indirect activities) central to the role of NPs, but qualitative comments described the need for more language within NIC to characterize the NP role related to the prescribing of medications and treatments. Some respondents found the definitions to be unclear as to whether they were performing or ordering/prescribing the intervention. This lack of clarity could be addressed by further development of the NIC definitions and activities so the advanced role of the NP is more fully described. Development of documentation systems using the core interventions identified by the various NP specialties is needed. Using standardized nursing language for documentation will enable NPs to build clinical databases that reflect and describe the role. Future research needs to be focused by NP specialty and to go beyond the NIC definition and include analysis at the activity level. [source] HEALTH, HEALING AND WHOLENESS IN THE ECUMENICAL DISCUSSIONINTERNATIONAL REVIEW OF MISSION, Issue 356-357 2001Christoph Benn First page of article [source] FINANCIAL STRATEGY FOR MIDDLE MARKET COMPANIES: a ROUNDTABLE DISCUSSIONJOURNAL OF APPLIED CORPORATE FINANCE, Issue 4 2000Article first published online: 5 APR 200 Dennis Soter begins with the provocative observation that "U.S. companies, private as well as public, are systematically underleveraged," and goes on to suggest that debt-financed stock repurchases may help address the current valuation problems faced by many middle market companies (and by many larger firms in basic industries as well). Soter makes his case by presenting two case histories. In the first, Equifax, the Atlanta-based provider of credit information services, combined a leveraged Dutch auction stock repurchase with a multi-year series of open market repurchase programs and an EVA incentive plan to produce large increases in operating efficiency and shareholder value. In the second, FPL Group (the parent of Florida Power and Light) became the first profitable utility to cut its dividend, substituting a policy of ongoing stock repurchase for its 33% reduction in dividend payments. Following Soter, John Brehm, the CFO of IPALCO Enterprises (the parent of Indianapolis Power and Light), explains the rationale for his company's decision to become the first utility to do a leveraged recap (while also cutting its dividend by a third). As in the case of Equifax, IPALCO's dramatic change in capital structure (also combined with an EVA incentive plan) was associated with major operating improvements and a positive stock market response. But, of course, high leverage is not right for all companies. And, to reinforce that point, James Perry, CEO of Argosy Gaming, recounts his harrowing experience of having to raise new equity shortly after taking charge of his overleveraged company. By arranging an infusion of convertible preferred, Argosy was able not only to stave off bankruptcy, but to fund major new investment and engineer a remarkable turnaround of its operations. Finally, William Dutmers, Chairman of Knape & Vogt, a small midwestern manufacturing company, discusses the role of debt-financed stock repurchases and an EVA management approach in his company's recent operating improvements. [source] PREDICTING 2-YEAR MARITAL SATISFACTION FROM PARTNERS' DISCUSSION OF THEIR MARRIAGE CHECKUPJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 4 2002Christina B. Gee This study tested whether the observed marital interactions of partners follwing a marriage checkup predicted marital satisfaction 2 years later. In addition, this study examined whether recommendations to pursue therapy predicted subsequent treatment seeking and whether changes in marital distress follwing the checkup remained stable over 2 years. Results suggest that the affective tone of a couple's interaction predicts later marital satisfaction. Further, receiving a treatment recommendation predicted subsequent treatment seeking for wives. Finally, support was found for the hypothesis that changes in marital distress are self-sustaining. [source] Combination of T2*W and FLAIR Abnormalities for the Prediction of Parenchymal Hematoma Following Thrombolytic Therapy in 100 Stroke PatientsJOURNAL OF NEUROIMAGING, Issue 4 2009Jens Fiehler MD ABSTRACT INTRODUCTION The objective of our study was to determine whether the combination of hypointense spots ("cerebral microbleeds," CMBs) with a leukoaraiosis is associated with the risk of parenchymal hematoma (PH) after thrombolytic therapy. PATIENTS AND METHODS We analyzed magnetic resonance imaging (MRI) scans acquired within 6 hours after symptom onset from 100 ischemic stroke patients. Multiparametric MRI including a T2*-weighted (T2*w) MRI and fluid attenuated inversion recovery (FLAIR) was performed before thrombolysis in all patients. Initial T2*w imaging was rated by two independent observers for the presence of CMBs smaller than 5 mm. White matter changes were evaluated using an adapted scale of Fazekas and Schmidt. PH was defined in follow-up imaging. FINDINGS A PH was observed in seven per 100 patients. CMBs were detected by observer 1 in 22 and observer 2 in 20 patients. We found a very low sensitivity (0.14) for prediction of PH by the presence of CMBs. We found a concordant increase in the rate of PH when the periventricular hyperintensity in FLAIR was larger than a thin lining. Sensitivity was good-to-perfect (0.86 and 1.00, observers 1 and 2) and specificity was substantial (0.65 and 0.66). Using the combination of a periventricular matter lesion (PVML)>1 and the presence of CMBs did not improve the prediction of PH. DISCUSSION A marked periventricular hyperintensity in FLAIR imaging seems to be associated with a substantially increased risk of PH. A combination of CMBs with leukoaraiosis scores did not appear to be beneficial for prognosis. [source] CRISPY/CRUNCHY CRUSTS OF CELLULAR SOLID FOODS: A LITERATURE REVIEW WITH DISCUSSIONJOURNAL OF TEXTURE STUDIES, Issue 5 2004HANNEMIEKE LUYTEN ABSTRACT Literature on the crispy/crunchy behavior of cellular solid foods with a crust is discussed. The emphasis is on products with a dry crispy or crunchy crust as bread and various snacks and especially on mesoscopic and macroscopic aspects. Successively, the sensory sensations involved, the mechanical and fracture behavior of crispy/crunchy products, morphological aspects, and the relation between crispy and crunchy behavior and mobility of the macromolecules and plasticizer (primarily water) involved, are discussed. Finally, some ideas for an integrated approach of crispy/crunchy behavior of cellular solid foods with a dry crust will be discussed. [source] REPLY TO DISCUSSION by David G. Smith, Robert J. Davies-Colley, and John W. Nagels,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 1 2002"Oregon Water Quality Index: A Tool for Evaluating Water Quality Management" First page of article [source] DISCUSSION OF STEFANO BOLOGNINITHE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS, Issue 4 2002Janine Puget First page of article [source] CHAOS THEORYAS A NEW PARADIGM IN PSYCHOANALYSIS: A CONTRIBUTION TO THE DISCUSSION OF MODELSTHE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS, Issue 2 2002Warren R. Procci First page of article [source] Activation of innate immunity by prostate specific antigen (PSA),THE PROSTATE, Issue 15 2006James A. Kodak Abstract BACKGROUND Prostate specific antigen (PSA) is a serine protease secreted by the prostatic epithelium. The only known function of the protein is to cleave seminogelin. We wished to determine if PSA activated peripheral blood mononuclear cells (PBMC). METHODS PBMC and selected sub-populations were cultured with purified PSA. Secretion of IFN, was measured by cytokine capture flow cytometry and enzyme-linked immunosorbent assay. RESULTS We observed secretion of IFN, and a proliferative response in PBMC cultured with PSA. We found that NK cells were the source of the IFN, but NK cells were not directly stimulated by PSA. Rather, a soluble factor secreted primarily by CD14 monocytes in response to PSA stimulated NK cells to secrete IFN,. DISCUSSION PSA induces a pro-inflammatory response that results in the secretion of INF, by NK cells. The presence of large amounts of PSA could contribute to the common finding of inflammatory infiltrates in the prostate. Prostate 66: 1592,1599, 2006. Published 2006 Wiley-Liss, Inc. [source] QUALITATIVE ASSESSMENT OF BREAST RECONSTRUCTION IN A SPECIALIST ONCOPLASTIC UNIT: DISCUSSIONANZ JOURNAL OF SURGERY, Issue 6 2005FRCS (Ed), Julian J. Pribaz FRACS No abstract is available for this article. [source] CULTURAL CIRCUMCISION IN EU PUBLIC HOSPITALS , AN ETHICAL DISCUSSIONBIOETHICS, Issue 8 2009MARGHERITA BRUSA ABSTRACT The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system. We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation. From the unique structure of patient-medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian argument that finds hospital-based circumcision safer than non-medicalized alternatives. The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation. [source] BODYWORLDS AND THE ETHICS OF USING HUMAN REMAINS: A PRELIMINARY DISCUSSIONBIOETHICS, Issue 5 2006Y. MICHAEL BARILAN ABSTRACT Accepting the claim that the living have some moral duties with regard to dead bodies, this paper explores those duties and how they bear on the popular travelling exhibition Bodyworlds. I argue that the concept of informed consent presupposes substantial duties to the dead, namely duties that reckon with the meaning of the act in question. An attitude of respect and not regarding human remains as mere raw material are non-alienable substantial duties. I found the ethos of Bodyworlds premature but full of promises such as public attitudes to organ donations. At the practical level I conclude that Bodyworlds should use only willed donations or unclaimed bodies for which dignified funerals are not available. In the case of live donations, Bodyworlds has a duty to participate in the medical care of needy donors. However, secrecy with regard to the sources of cadavers seems to be the most troublesome aspect of Bodyworlds. [source] DISCUSSIONS AND ARGUMENTS ON VARIOUS SUBJECTS by John Henry Newman, introduction and notes by Gerard Tracey and James Tolhurst, Gracewing, Leominster & University of Notre Dame Press, Notre Dame IN, 2004, Pp. xlix + 490, £25.00 hbk.NEW BLACKFRIARS, Issue 1002 2005Todd C. Ream No abstract is available for this article. [source] On functional motor adaptations: from the quantification of motor strategies to the prevention of musculoskeletal disorders in the neck,shoulder regionACTA PHYSIOLOGICA, Issue 2010P. Madeleine Abstract Background:, Occupations characterized by a static low load and by repetitive actions show a high prevalence of work-related musculoskeletal disorders (WMSD) in the neck,shoulder region. Moreover, muscle fatigue and discomfort are reported to play a relevant initiating role in WMSD. Aims: To investigate relationships between altered sensory information, i.e. localized muscle fatigue, discomfort and pain and their associations to changes in motor control patterns. Materials & Methods:, In total 101 subjects participated. Questionnaires, subjective assessments of perceived exertion and pain intensity as well as surface electromyography (SEMG), mechanomyography (MMG), force and kinematics recordings were performed. Results:, Multi-channel SEMG and MMG revealed that the degree of heterogeneity of the trapezius muscle activation increased with fatigue. Further, the spatial organization of trapezius muscle activity changed in a dynamic manner during sustained contraction with acute experimental pain. A graduation of the motor changes in relation to the pain stage (acute, subchronic and chronic) and work experience were also found. The duration of the work task was shorter in presence of acute and chronic pain. Acute pain resulted in decreased activity of the painful muscle while in subchronic and chronic pain, a more static muscle activation was found. Posture and movement changed in the presence of neck,shoulder pain. Larger and smaller sizes of arm and trunk movement variability were respectively found in acute pain and subchronic/chronic pain. The size and structure of kinematics variability decreased also in the region of discomfort. Motor variability was higher in workers with high experience. Moreover, the pattern of activation of the upper trapezius muscle changed when receiving SEMG/MMG biofeedback during computer work. Discussion:, SEMG and MMG changes underlie functional mechanisms for the maintenance of force during fatiguing contraction and acute pain that may lead to the widespread pain seen in WMSD. A lack of harmonious muscle recruitment/derecruitment may play a role in pain transition. Motor behavior changed in shoulder pain conditions underlining that motor variability may play a role in the WMSD development as corroborated by the changes in kinematics variability seen with discomfort. This prognostic hypothesis was further, supported by the increased motor variability among workers with high experience. Conclusion:, Quantitative assessments of the functional motor adaptations can be a way to benchmark the pain status and help to indentify signs indicating WMSD development. Motor variability is an important characteristic in ergonomic situations. Future studies will investigate the potential benefit of inducing motor variability in occupational settings. [source] FS01.3 Disperse (yes), orange (yes), 3 (no): what do we test in textile dye dermatitis?CONTACT DERMATITIS, Issue 3 2004Christophe J Le Coz Introduction:, Patients sensitized to para-phenylenediamine (PPD) have a high degree of patch test reactivity to Disperse Orange 3 (DO3), and a lesser one to Disperse Red 1 and Red 17. Two successive patients positive to PPD, Disperse Red 1 and 17, negative to DO3 were real eye-openers for our considerations about purity of our current allergen DO3. Materials and methods:, We realized comparative thin-layer chromatography (TLC), with DO3 from Chemotechnique®(DO3-Chem) and Trolab®(both extracted from petrolatum), and "pure" DO3 from two chemical providers. TLC clearly indicated that DO3-Chem was not DO3. HPLC analysis with pure DO3 from Chemotechnique® and comparison of structures by NMR with samples of DO3, revealed that DO3-Chem was Disperse Orange 31 (DO31). In addition, signals through the GERDA network allowed the collection of test materials and observations. Among other members, only 2 used DO3-Chem (from 2 different batches) that was DO31 too, according to TLC Results: According to their data, they observed no or a lower reactivity to DO3 than expected (4 patients DO3-Chem + among 23 PPD+ e.g.). Finally, the error was proved to be due to the provider of the dye to Chemotechnique®, who likely deleted the 1 of Disperse Orange 31 on his packaging. Discussion:, Chemical structure of DO31 indicates a possible in vivo hydrolysis into nitroaniline and a second compound, a substituted PPD derivative that clearly does not frequently react in PPD positive patients. Like drugs, patch tests are submitted to post-commercialization controls. In addition to allergens providers who should enhance their quality controls, dermato-allergologists have to be vigilant, and must active networks when they observe a rare bird. [source] P03 Type-I and -IV hypersensitivity to platinum saltsCONTACT DERMATITIS, Issue 3 2004Willeke Kamphof A 28-year-old female analytical chemist visited our patch test clinic with initially complaints of severe hand dermatitis. Later on she developed rhinitis, bronchial asthma and tightness of the chest. The complaints seemed work related: her condition improved during holidays and on sick leaves. She worked in a laboratory with several platinum salts and used different kinds of gloves (latex, nitril, etc.). Methods:, Patch tests were performed with the European Standard series and prick tests with common inhalant allergens. Patch-, prick- and open patch tests were carried out with various aqueous dilutions of platinum chloride (PtCl2). Results:, Patch tests with 0.01,2% PtCl2 were positive on day 2, 3 and 6, and at 0.001% a follicular reaction was found. The prick-test was already positive at the lowest concentration tested (0.001%). The open patch test, carried out retro-auricular, showed a positive reaction at 1 and 2% PtCl2 after 20 min. Controls in healthy volunteers (n = 5) were all negative. Discussion:, It is well known that platinum salts can cause type-I hypersensitivity reactions like allergic rhinitis, conjunctivitis, bronchial asthma and urticaria, also referred to as platinosis. Contact dermatitis to platinum salts, however, is very rare. In our patch test clinic, 78 patients were tested between 1987 and 2001 with PtCl2 2%. Only 2 women showed a positive patch test for PtCl2. The patient presented here, stopped working with platinum salts and recovered from all complaints. We interpret our case as occupational type-I and type-IV hypersensitivity to platinum salts with mucosal and dermal manifestations. [source] P17 Allergic contact dermatitis from hydrolyzed wheat proteinCONTACT DERMATITIS, Issue 3 2004Olivia Bordalo Allergic Contact Dermatitis (ACD) from hydrolysed wheat protein (HWP) is rarely reported in the literature. We describe 2 cases of ACD to this new allergen. Case1- A 39-year-old non atopic woman presented with a dermatitis of the face, mainly eyelids and neck. She had been using a new cosmetic cream for 2 months. The lesions subsided with topical corticosteroids. Patch tests with the standard, cosmetic, fragrance series and with her own products gave positive reactions only to the new cosmetic cream. We also tested all the components of this cream and only HWP gave a doubtful reaction with occlusive tests and positive reaction with ROAT. Case 2 , A 48-year-old atopic woman presented with a dermatitis of the face and hands for 1 month. She had been using a new cosmetic cream for 11 months and kept using the product without any suspicion. The dermatitis subsided with cetirizine and topical corticosteroids. Patch tests with the standard, cosmetic, fragrance series and her own products revealed positive reactions to the cosmetic cream. Again, testing all the components of the cream, only HWP gave doubtful reactions with occlusive tests and positive reactions with ROAT. Discussion:, In recent years, a number of protein hydrolysates have been introduced into cosmetic manufacture. HWP is being used in cosmetic creams for its moisturizing properties. As far as we know, there is only one previously reported case of ACD induced by this allergen. More cases may be expected. [source] Discussion of "Audit Pricing, Legal Liability Regimes, and Big 4 Premiums: Theory and Cross-country Evidence",CONTEMPORARY ACCOUNTING RESEARCH, Issue 1 2008Michel L. Magnan First page of article [source] Discussion of "Letting the ,Tail Wag the Dog': The Debate over GAAP versus Street Earnings Revisited",CONTEMPORARY ACCOUNTING RESEARCH, Issue 3 2007Mark T. Bradshaw First page of article [source] Discussion of "Letting the ,Tail Wag the Dog': The Debate over GAAP versus Street Earnings Revisited",CONTEMPORARY ACCOUNTING RESEARCH, Issue 3 2007Theodore E. Christensen First page of article [source] | |||||||||||||||||||||||||||||||||||||||||||||||||