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Effective
Kinds of Effective Terms modified by Effective Selected AbstractsIS CORPORATE R&D INVESTMENT IN HIGH-TECH SECTORS MORE EFFECTIVE?CONTEMPORARY ECONOMIC POLICY, Issue 3 2010RAQUEL ORTEGA-ARGILÉS This paper discusses the link between R&D and productivity across the European industrial and service sectors. The empirical analysis is based on both the European sectoral OECD data and on a unique micro-longitudinal database consisting of 532 top European R&D investors. The main conclusions are as follows. First, the R&D stock has a significant positive impact on labor productivity; this general result is largely consistent with previous literature in terms of the sign, the significance, and the magnitude of the estimated coefficients. More interestingly, both at sectoral and firm levels the R&D coefficient increases monotonically (both in significance and magnitude) when we move from the low-tech to the medium- and high-tech sectors. This outcome means that corporate R&D investment is more effective in the high-tech sectors and this may need to be taken into account when designing policy instruments (subsidies, fiscal incentives, etc.) in support of private R&D. However, R&D investment is not the sole source of productivity gains; technological change embodied in gross investment is of comparable importance on aggregate and is the main determinant of productivity increase in the low-tech sectors. Hence, an economic policy aiming to increase productivity in the low-tech sectors should support overall capital formation. [source] THYROIDECTOMY IS SAFE AND EFFECTIVE FOR RETROSTERNAL GOITREANZ JOURNAL OF SURGERY, Issue 4 2006Ajay Chauhan Background: Retrosternal goitre was defined as any thyroid enlargement identified below the thoracic inlet at operation, with the patient's neck held in extension. The aim of this study was to determine the characteristics of the patients, the goitres, the surgery and its morbidity (including tracheomalacia, recurrent laryngeal nerve palsy and hypocalcaemia) and the incidence of malignancy in order to establish guidelines for managing patients with a retrosternal goitre. Methods: Data were collected prospectively on all thyroidectomies carried out by a single surgeon over 14 years. Patients underwent appropriate preoperative assessment and thyroidectomy was carried out using a standardized capsular dissection technique. There were 199 cases of retrosternal extension. Results: Retrosternal extension was significantly more common on the left side than on the right side (ratio 3:2, P < 0.05). Most patients (83.4%) had significant symptoms that were relieved by surgery. Of the 199 thyroidectomies, none required a sternal split. The rate of malignancy was low (2.5%). Postoperative morbidity was 30%, the majority being asymptomatic temporary hypocalcaemia. There were no patients with permanent recurrent laryngeal nerve palsies or permanent hypoparathyroidism. There was one case of tracheomalacia. There was no death. Conclusion: Retrosternal goitre is a frequently symptomatic condition, with a low but definite rate of malignancy. Surgery is usually possible through a cervical incision and with an acceptable risk of significant morbidity. Thyroidectomy should be recommended as the treatment of choice. [source] The role of the ,-adrenergic receptor in the leg vasoconstrictor response to orthostatic stressACTA PHYSIOLOGICA, Issue 3 2009M. Kooijman Abstract Aim:, The prompt increase in peripheral vascular resistance, mediated by sympathetic ,-adrenergic stimulation, is believed to be the key event in blood pressure control during postural stress. However, despite the absence of central sympathetic control of the leg vasculature, postural leg vasoconstriction is preserved in spinal cord-injured individuals (SCI). This study aimed at assessing the contribution of both central and local sympathetically induced ,-adrenergic leg vasoconstriction to head-up tilt (HUT) by including healthy individuals and SCI, who lack central sympathetic baroreflex control over the leg vascular bed. Methods:, In 10 controls and nine SCI the femoral artery was cannulated for drug infusion. Upper leg blood flow (LBF) was measured bilaterally using venous occlusion strain gauge plethysmography before and during 30° HUT throughout intra-arterial infusion of saline or the non-selective ,-adrenergic receptor antagonist phentolamine respectively. Additionally, in six controls the leg vascular response to the cold pressor test was assessed during continued infusion of phentolamine, in order to confirm complete ,-adrenergic blockade by phentolamine. Results:, During infusion of phentolamine HUT still caused vasoconstriction in both groups: leg vascular resistance (mean arterial pressure/LBF) increased by 10 ± 2 AU (compared with 12 ± 2 AU during saline infusion), and 13 ± 3 AU (compared with 7 ± 3 AU during saline infusion) in controls and SCI respectively. Conclusion:, Effective ,-adrenergic blockade did not reduce HUT-induced vasoconstriction, regardless of intact baroreflex control of the leg vasculature. Apparently, redundant mechanisms compensate for the absence of sympathetic ,-adrenoceptor leg vasoconstriction in response to postural stress. [source] Cotton Dental Rolls for Effective and Cost-Efficient HemostasisDERMATOLOGIC SURGERY, Issue 5 2009GREGORY J. FULCHIERO JR., MS BIOENG No abstract is available for this article. [source] Arousal, but not nursing, is necessary to elicit a decreased fear reaction toward humans in rabbit (Oryctolagus cuniculus) pupsDEVELOPMENTAL PSYCHOBIOLOGY, Issue 3 2003Péter Pongrácz Abstract Rabbits that are handled at the time of feeding during the first week postpartum show reduced fear of humans later in their lives as compared to unhandled controls. Effective handling has been shown to be confined to a sensitive period. Our study aimed to investigate if feeding itself (provided by a second doe, 6 hr after the standard nursing time) affects the levels of fear of humans later in life. Our results showed that (a) the prenursing state of excitement is only characteristic of the standard nursing and is not elicited by a second feeding 6 hr past the usual nursing time, repeated daily across the first week postpartum; and (b) handling linked to a second feeding 6 hr after the standard nursing does not reduce fear responses toward humans at weaning. We conclude that the aroused state, per se, is essential for the reduction of a rabbit's fear response toward humans provoked by early handling. © 2003 Wiley Periodicals, Inc. Dev Psychobiol 43: 192,199, 2003. [source] Human Patient Simulation Is Effective for Teaching Paramedic Students Endotracheal IntubationACADEMIC EMERGENCY MEDICINE, Issue 9 2005FRCPC, Robert E. Hall BSc Abstract Objectives: The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR). Methods: Paramedic students (n= 36) with no prior ETI training received identical didactic and mannequin teaching. After randomization, students were trained for ten hours on a patient simulator (SIM) or with 15 intubations on human subjects in the OR. All students then underwent a formalized test of 15 intubations in the OR. The primary outcome was the rate of successful intubation. Secondary outcomes were the success rate at first attempt and the complication rate. The study was powered to detect a 10% difference for the overall success rate (,= 0.05, ,= 0.20). Results: The overall intubation success rate was 87.8% in the SIM group and 84.8% in the OR group (difference of 3.0% [95% confidence interval {CI} =,4.2% to 10.1%; p = 0.42]). The success rate on the first attempt was 84.4% in the SIM group and 80.0% in the OR group (difference of 4.4% [95% CI =,3.4% to 12.3%; p = 0.27]). The complication rate was 6.3% in the SIM group and 4.4% in the OR group (difference of 1.9% [95% CI =,2.9% to 6.6%; p = 0.44]). Conclusions: When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI. [source] A Modified Atkins Diet Is Effective for the Treatment of Intractable Pediatric EpilepsyEPILEPSIA, Issue 2 2006Eric H. Kossoff Summary:,Purpose: The Atkins diet may induce ketosis as does the ketogenic diet, without restrictions on calories, fluids, protein, or need for an inpatient fast and admission. Our objective was to evaluate the efficacy and tolerability of a modified Atkins diet for intractable childhood epilepsy. Methods: Twenty children were treated prospectively in a hospital-based ambulatory clinic from September 2003 to May 2005. Children aged 3,18 years, with at least three seizures per week, who had been treated with at least two anticonvulsants, were enrolled and received the diet over a 6-month period. Carbohydrates were initially limited to 10 g/day, and fats were encouraged. Parents measured urinary ketones semiweekly and recorded seizures daily. All children received vitamin and calcium supplementation. Results: In all children, at least moderate urinary ketosis developed within 4 days (mean, 1.9). Sixteen (80%) completed the 6-month study; 14 chose to remain on the diet afterward. At 6 months, 13 (65%) had >50% improvement, and seven (35%) had >90% improvement (four were seizure free). Mean seizure frequency after 6 months was 40 per week (p = 0.005). Over a 6-month period, mean serum blood urea nitrogen increased from 12 to 17 mg/dl (p = 0.01); creatinine was unchanged. Cholesterol increased from 192 to 221 mg/dl, (p = 0.06). Weight did not change significantly (34.0,33.7 kg); only six children lost weight. A stable body mass index over time correlated with >90% improvement (p = 0.004). Conclusions: A modified Atkins diet is an effective and well-tolerated therapy for intractable pediatric epilepsy. [source] Antiepileptogenesis and Seizure Prevention Trials with Antiepileptic Drugs: Meta-Analysis of Controlled TrialsEPILEPSIA, Issue 4 2001Nancy R. Temkin Summary: ,Purpose: To synthesize evidence concerning the effect of antiepileptic drugs (AEDs) for seizure prevention and to contrast their effectiveness for provoked versus unprovoked seizures. Methods: Medline, Embase, and The Cochrane Clinical Trials Register were the primary sources of trials, but all trials found were included. Minimal requirements: seizure-prevention outcome given as fraction of cases; AED or control assigned by random or quasi-random mechanism. Single abstracter. Aggregate relative risk and heterogeneity evaluated using Mantel,Haenszel analyses; random effects model used if heterogeneity was significant. Results: Forty-seven trials evaluated seven drugs or combinations for preventing seizures associated with fever, alcohol, malaria, perinatal asphyxia, contrast media, tumors, craniotomy, and traumatic brain injury. Effective: Phenobarbital for recurrence of febrile seizures [relative risk (RR), 0.51; 95% confidence interval (CI), 0.32,0.82) and cerebral malaria (RR, 0.36; CI, 0.23,0.56). Diazepam for contrast media,associated seizures (RR, 0.10; CI, 0.01,0.79). Phenytoin for provoked seizures after craniotomy or traumatic brain injury (craniotomy: RR, 0.42; CI, 0.25,0.71; TBI: RR, 0.33; CI, 0.19,0.59). Carbamazepine for provoked seizures after traumatic brain injury (RR, 0.39; CI, 0.17,0.92). Lorazepam for alcohol-related seizures (RR, 0.12; CI, 0.04,0.40). More than 25% reduction ruled out valproate for unprovoked seizures after traumatic brain injury (RR, 1.28; CI, 0.76,2.16), and carbamazepine for unprovoked seizures after craniotomy (RR, 1.30; CI, 0.75,2.25). Conclusions: Effective or promising results predominate for provoked (acute, symptomatic) seizures. For unprovoked (epileptic) seizures, no drug has been shown to be effective, and some have had a clinically important effect ruled out. [source] How Effective is Farmer Early Retirement Policy?EUROCHOICES, Issue 3 2008Quelle est l'efficacité de la politique de préretraite pour les agriculteurs? Summary How Effective is Farmer Early Retirement Policy? Financial support for EU farmers seeking early retirement is a discretionary element of CAP rural development policy and some EU member states, most notably France, Ireland and Greece have chosen to implement the measure. We explore whether the introduction of such schemes is likely to represent good value for money. We use data from Northern Ireland, a region with a relatively small-scale family-farm structure, where there have been periodic calls from farmer groups to introduce support for early retirement. We estimate the benefits that might arise from the introduction of such a scheme using FADN data and a separate survey of 350 farmers aged 50 to 65. We find that farm scale is a significant determinant of profit per hectare but that operator age is not. Benefits from releasing land through an early retirement scheme are conditional on such transfers bringing about significant farm expansion and changes in land use. Even when these conditions are satisfied, however, pensions payments of only about one-third the statutory maximum could be justified in a best-case scenario. Almost a quarter of all payments would incur deadweight losses, i.e., go to farmers who would be retiring anyway. Overall, the economic case for such a scheme is considered to be weak. Le soutien financier aux agriculteurs de l'Union européenne qui veulent prendre une retraite anticipée est un élément discrétionnaire de la politique de développement rural de la PAC et certains pays membres, en tout premier lieu la France, l'Irlande et la Grèce, ont choisi de mettre en place cette mesure. Nous recherchons si l'introduction de telles mesures serait intéressante par rapport au coût financier. L'analyse porte sur des données nord-irlandaises, région d'exploitations familiales de taille relativement petite dans laquelle les représentants agricoles ont régulièrement appeléà la mise en place de soutien pour la retraite anticipée. Nous estimons les avantages que pourrait procurer l'introduction de cette mesure à l'aide de données du RICA et d'une enquête indépendante portant sur 350 agriculteurs âgés de 50 à 65 ans. Nous trouvons que la taille de l'exploitation est un déterminant significatif du profit par hectare mais que l'âge de l'exploitant n'en est pas un. Les avantages de la mise à disposition de terres grâce à un programme de préretraite dépendent de la capacité de ces transferts à entraîner un accroissement notable de la taille des exploitations et des modifications de l'utilisation des terres. Cependant, même lorsque ces conditions sont remplies, seuls des paiements représentant un tiers du niveau maximum prévu dans le programme de préretraite pourraient se justifier dans un scénario optimal. Pratiquement un quart du total des paiements serait liéà des pertes de bien-être, c'est-à-dire que les bénéficiaires seraient des agriculteurs qui aurait pris leur retraite de toute façon. Globalement, l'intérêt économique d'un tel programme est considéré comme faible. Die finanzielle Unterstützung von Landwirten in der EU, die in den Vorruhestand gehen möchten, stellt in der Politik der GAP zur Entwicklung des ländlichen Raums ein diskretionäres Element dar; in einigen Mitgliedsstaaten wie z.B. Frankreich, Irland und Griechenland wird diese Maßnahme angeboten. Wir untersuchen, ob es möglicherweise finanziell sinnvoll wäre, solche Programme einzuführen. Dazu ziehen wir Daten aus Nordirland heran, einer Region mit relativ kleinen landwirtschaftlichen Familienbetrieben, in der sich Landwirte regelmäßig dafür aussprechen, Vorruhestandprogramme einzuführen. Wir schätzen den Nutzen, der sich aus der Einführung eines solchen Programms ergeben könnte, anhand von INLB-Daten und einer gesonderten Befragung von 350 Landwirten im Alter von 50 bis 65 Jahren. Wir stellen fest, dass es sich bei der Betriebsgröße , im Gegensatz zum Alter des Betreibers , um einen entscheidenden Faktor für die Höhe des Gewinns pro Hektar handelt. Ein Nutzen aus der Landübertragung aufgrund eines Vorruhestandprogramms beruht auf solchen Transfers, die eine bedeutsame Betriebserweiterung und veränderte Flächennutzung zur Folge haben. Selbst wenn diese Bedingungen erfüllt werden, könnten günstigstenfalls nur Rentenzahlungen in Höhe von etwa einem Drittel der gesetzlich verankerten Höchstsumme gerechtfertigt werden. Beinahe ein Viertel aller Zahlungen wäre mit Mitnahmeeffekten verbunden, d.h. Landwirten zukommen, die ohnehin den Ruhestand antreten würden. Aus ökonomischer Sicht muss ein solches Programm als schwach eingestuft werden. [source] Improved Synthesis and Isolation of 2,- O -Methyladenosine: Effective and Scalable Enzymatic Separation of 2,/3,- O -Methyladenosine RegioisomersEUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 19 2009Saúl Martínez-Montero Abstract An efficient separation of a mixture of 2,/3,- O -methyladenosine regioisomers (1 + 2; 1:1) has been developed by selective enzymatic acylation using immobilized Pseudomonas cepacia lipase (PSL-C) in combination with acetonoxime levulinate as acyl donor. The 3,-hydroxy group of 2,- O -methyladenosine (1) was acylated with high selectivity (ca. 70,%), whereas an equal amount of 3,- O -methyladenosine (2) in the same solution resulted in minor acylation of 5,-hydroxy group (ca. 8,%). The differential behavior of both regioisomers towards enzymatic acylation allowed to develop a separation protocol. Upon extraction of the acylated products, the 3,- O -methyladenosine was isolated in 81,% yield and 97,% purity from the aqueous layer. Hydrolysis of acylated products in organic layer furnished 2,- O -methyladenosine in 67,% yield and 99,% purity. The separation process was successfully applied to the crude reaction mixture of methylated products (ca. 3:1 of 1/2) on 5-g scale. We also report on the use of methyl p -toluenesulfonate as a safe reagent for 2,- O -methylation of adenosine.(© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009) [source] An Effective and Convenient Method for the Preparation of KAD-1229HELVETICA CHIMICA ACTA, Issue 8 2004Jianchao Liu A new convenient method for the asymmetric synthesis of the potent hypoglycemic agent KAD-1229 was developed. The key step of this method is diasteroselective alkylation of 1 to give crude 2 (d.e.>93%) in good yield with the easily available Oppolzer's camphorsultam as chiral auxiliary. The overall yield of the product was 57%. [source] Copper(II) Triflate as a Source of Triflic Acid: Effective, Green Catalysis of Hydroalkoxylation ReactionsADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 14-15 2009Mathieu J.-L. Abstract The hydroalkoxylation of dicyclopentadiene (DCPD) and norbornene (NB) with 2-hydroxyethyl methacrylate (HEMA) for the synthesis of industrially relevant monomers has been investigated with various metal-based Lewis acids and strong Brønsted acids. In the absence of other additives, copper(II) triflate is the most efficient catalyst system. Kinetics, electron spin resonance (ESR), catalyst poisoning and cross experiments indicate that triflic acid (TfOH) is the true active catalyst in these reactions. This in situ generation of TfOH occurs via reduction of Cu(OTf)2 by the olefin reagent (DCPD, NB). The copper ions present in the reaction mixture act as radical polymerization retardants, preventing polymerization of HEMA (which is observed with most other metal salts and strong Brønsted acids investigated), thus improving the selectivity and yield (up to 95%) for the desired products. These observations have led to the development of a highly effective green process, using bulk reagents (no solvent) and a cheap, metal-free catalyst system, based on TfOH and a phenolic radical inhibitor (2,5-di- tert -butylhydroxytoluene, BHT). [source] Foundational Value of Statistics Education for Management CurriculumINTERNATIONAL STATISTICAL REVIEW, Issue 3 2007Hirokuni Tamura Traitement humain de l'information; Education/Enseignement; Prise de décision; Prévision; Modèles statistiques Summary The purpose of this paper is to propose a unique and distinct value of statistics education for management. The 1986 inaugural conference on Making Statistics More Effective in Schools of Business (MSMESB) proposed valuable guidelines for reforming statistics education in schools of business. However, a survey conducted by McAlevey & Everett (2001) identified that their impact has been minimal, and argued that structural problems many business schools have are the potential cause. We argue these structural problems exist because the value of the body of statistical tools for management is ambiguous and has not been made explicit. The unique and distinct value of statistics for management can be identified as the body of tools necessary to meet the inherent needs of a manager charged with making predictive judgments facing data. The need arises because human information-processing capacity is quite limited, as the findings of researchers in cognitive psychology testify. These findings also affirm that the basic statistical concepts needed for processing data cannot be learned from management experiences. The model of a manager faced with data, while considering the evidence of inherent limitations of human information-processing capacity, establishes the foundational value of statistics training in the management curriculum. Statistics education in business schools will be made more effective when management educators recognize such value of the discipline, lend their support and reward the ownership commitment for continuous improvement and innovations of the business statistics curriculum. Résumé Le but de cet article est de proposer une valeur unique et particulière de l'enseignement des statistiques dans le domaine de la gestion. La conférence inaugurale de 1986 traitant des moyens d'améliorer l'efficacité de cet enseignement dans les écoles de gestion a proposé des lignes directrices valables pour la réforme de l'enseignement des statistiques dans les écoles de gestion. Néanmoins, un sondage effectué par McAlevey & Everett (2001), a identifié leur impact comme étant minimal et en attribue la cause probable aux problèmes structurels des écoles de gestion. Nous considérons que ces problèmes existent parce que la valeur du corpus statistique de gestion est ambigüe et n'a pas été mise en lumière. La valeur unique et distincte des statistiques de gestion peut être identifiée comme un corpus d'outils nécessaires pour répondre aux besoins inhérents d'un gestionnaire chargé de faire des prévisions au moyen d'informations brutes. Ce besoin vient du fait que la capacité humaine de traitement de l'information est limitée ainsi qu'en témoignent les recherches en psychologie cognitive. Ces résultats affirment également que les concepts statistiques basiques nécessaires pour le traitement de l'information ne peuvent être acquis par l'expérience de la gestion. Le modèle du gestionnaire confronté de l'information, une fois l'évidence des limites des capacités humaines en matière de traitement de l'information est prise en compte, établi la valeur fondatrice de l'entrainement aux statistiques dans un curriculum de gestion. L'enseignement des statistiques dans les écoles de commerce sera plus efficace quand les responsables de l'éducation reconnaitront cette valeur de la discipline, y apporteront leur soutien et récompenseront les actions visant à l'amélioration et l'innovation constante au sein du curriculum statistique de gestion. [source] Can Force Still Be Effective?INTERNATIONAL STUDIES REVIEW, Issue 2 2003Robert Mandel No abstract is available for this article. [source] Intrathecal sufentanil decreases the median effective dose (ED50) of intrathecal hyperbaric ropivacaine for caesarean deliveryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010X. CHEN Background: The addition of opioid to local anaesthetics has become a well-accepted practice of spinal anaesthesia for caesarean delivery. Successful caesarean delivery anaesthesia has been reported with the use of a low dose of intrathecal hyperbaric ropivacaine coadministered with sufentanil. This prospective, double-blinded study determined the median effective dose (ED50) of intrathecal hyperbaric ropivacaine with and without sufentanil for caesarean delivery, to quantify the sparing effect of sufentanil on the ED50 of intrathecal hyperbaric ropivacaine. Methods: Sixty-four parturients undergoing elective caesarean delivery with combined spinal,epidural anaesthesia were randomized into two groups: Group R (ropivacaine) and Group RS (ropivacaine plus sufentanil 5 ,g). The initial dose of ropivacaine was 13 mg in Group R and 10 mg in Group RS. The effective dose was defined as a T6 level attained within 10 min and no supplemental epidural anaesthetic required during surgery. Effective or ineffective responses determined, respectively, a 0.3 mg decrease or increase of the dose of ropivacaine for the next patient using an up,down sequential allocation. Results: The ED50 of intrathecal ropivacaine was 11.2 mg [confidence interval (CI) 95%: 11.0,11.6] in Group R vs. 8.1 mg (CI 95%: 7.8,8.3) in Group RS. Motor block was markedly more intense in Group R than in Group RS, and the incidence of shivering was lower in Group RS than in Group R. There were no differences in the onset time of sensory block or motor block, in the incidence of hypotension, nausea and vomiting. Conclusion: Intrathecal sufentanil 5 ,g produced a 28% reduction of ED50 of intrathecal hyperbaric ropivacaine for caesarean delivery. [source] Is Transformational Leadership Always Perceived as Effective?JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 4 2009Male Subordinates' Devaluation of Female Transformational Leaders This study investigated the impact of the gender composition of the leader,subordinate dyad on the relationship between leaders' transformational leadership behavior and their subordinates' ratings of the leaders' effectiveness. There were 109 dyads of leaders (58 male, 51 female) paired with a subordinate who was either the same or a different gender from themselves. The relationship between a leader's self-report on transformational leadership and their subordinates' evaluation of their performance was significantly less positive for female leaders with male subordinates than for female leaders with female subordinates. The male and female subordinates of male leaders rated their performance as equally effective, regardless of their levels of transformational leadership. [source] Is a School-Based Physical Activity Intervention Effective for Increasing Tibial Bone Strength in Boys and Girls?,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2007Heather M Macdonald Abstract This 16-month randomized, controlled school-based study compared change in tibial bone strength between 281 boys and girls participating in a daily program of physical activity (Action Schools! BC) and 129 same-sex controls. The simple, pragmatic intervention increased distal tibia bone strength in prepubertal boys; it had no effect in early pubertal boys or pre or early pubertal girls. Introduction: Numerous school-based exercise interventions have proven effective for enhancing BMC, but none have used pQCT to evaluate the effects of increased loading on bone strength during growth. Thus, our aim was to determine whether a daily program of physical activity, Action Schools! BC (AS! BC) would improve tibial bone strength in boys and girls who were pre- (Tanner stage 1) or early pubertal (Tanner stage 2 or 3) at baseline. Materials and Methods: Ten schools were randomized to intervention (INT, 7 schools) or control (CON, 3 schools). The bone-loading component of AS! BC included a daily jumping program (Bounce at the Bell) plus 15 minutes/day of classroom physical activity in addition to regular physical education. We used pQCT to compare 16-month change in bone strength index (BSI, mg2/mm4) at the distal tibia (8% site) and polar strength strain index (SSIp, mm3) at the tibial midshaft (50% site) in 281 boys and girls participating in AS! BC and 129 same-sex controls. We used a linear mixed effects model to analyze our data. Results: Children were 10.2 ± 0.6 years at baseline. Intervention boys tended to have a greater increase in BSI (+774.6 mg2/mm4; 95% CI: 672.7, 876.4) than CON boys (+650.9 mg2/mm4; 95% CI: 496.4, 805.4), but the difference was only significant in prepubertal boys (p = 0.03 for group × maturity interaction). Intervention boys also tended to have a greater increase in SSIp (+198.6 mm3; 95% CI: 182.9, 214.3) than CON boys (+177.1 mm3; 95% CI: 153.5, 200.7). Change in BSI and SSIp was similar between CON and INT girls. Conclusions: Our findings suggest that a simple, pragmatic program of daily activity enhances bone strength at the distal tibia in prepubertal boys. The precise exercise prescription needed to elicit a similar response in more mature boys or in girls might be best addressed in a dose,response trial. [source] Adding sufentanil to levobupivacaine or ropivacaine intrathecal anaesthesia affects the minimum local anaesthetic dose requiredACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009R. PARPAGLIONI Background: We carried out this prospective, randomized, double-blind study in order to evaluate whether the intrathecal addition of sufentanil 3.3 mcg affects both the minimum local anaesthetic dose (MLAD) of spinal levobupivacaine and ropivacaine for a caesarean section and enhances the spinal block characteristics. Methods: One hundred and eighty women were randomly allocated into four groups: levobupivacaine (Group L), levobupivacaine plus sufentanil (Group L+S), ropivacaine (Group R) and ropivacaine plus sufentanil (Group R+S). Each received 3 ml of the study solution intrathecally as part of a combined spinal/epidural technique. The initial dose was 12 mg for Groups L and L+S, and 15 mg for Groups R and R+S. The test solution was required to achieve a visual analogue pain score (VAPS) of 30 mm or less to be considered effective at skin incision, uterine incision, birth, peritoneal closure and at the conclusion of surgery. Effective or ineffective responses determined a 0.5 mg decrease or increase of the same drug, respectively, for the next patient in the same group, using an up,down sequential allocation. Results: Using the Dixon and Massey formula, the MLAD was 10.65 mg [confidence interval (CI) 95%: 10.14,11.56] in Group L, 4.73 mg (CI 95%: 4.39,5.07) in Group L+S, 14.12 mg (CI 95%: 13.50,14.60) in Group R and 6.44 mg (CI 95%: 5.86,7.02) in Group R+S. Conclusions: The addition of sufentanil reduced the MLAD of both the local anaesthetics. It did not affect their potency ratio significantly and resulted in enhanced spinal anaesthesia. [source] Are Lifestyle Interventions in the Management of Hypertension Effective?JOURNAL OF CLINICAL HYPERTENSION, Issue 6 2005How Long Should You Wait Before Starting Specific Medical Therapy? No abstract is available for this article. [source] B-cell diversity decreases in old age and is correlated with poor health statusAGING CELL, Issue 1 2009Kate L. Gibson Summary Older people suffer from a decline in immune system, which affects their ability to respond to infections and to raise efficient responses to vaccines. Effective and specific antibodies in responses from older individuals are decreased in favour of non-specific antibody production. We investigated the B-cell repertoire in DNA samples from peripheral blood of individuals aged 86,94 years, and a control group aged 19,54 years, using spectratype analysis of the IGHV complementarity determining region (CDR)3. We found that a proportion of older individuals had a dramatic collapse in their B-cell repertoire diversity. Sequencing of polymerase chain reaction products from a selection of samples indicated that this loss of diversity was characterized by clonal expansions of B cells in vivo. Statistical analysis of the spectratypes enabled objective comparisons and showed that loss of diversity correlated very strongly with the general health status of the individuals; a distorted spectratype can be used to predict frailty. Correlations with survival and vitamin B12 status were also seen. We conclude that B-cell diversity can decrease dramatically with age and may have important implications for the immune health of older people. B-cell immune frailty is also a marker of general frailty. [source] In response to: Medical admission order sets: Effective, practical, generalizable,but not perfectJOURNAL OF HOSPITAL MEDICINE, Issue 7 2009Gregory A. Maynard MD [source] Which Microfinance Institutions Are Becoming More Cost Effective with Time?JOURNAL OF MONEY, CREDIT AND BANKING, Issue 4 2009Evidence from a Mixture Model microfinance; mixture model; Eastern Europe; Central Asia Microfinance institutions (MFIs) play a key role in many developing countries. Utilizing data from Eastern Europe and Central Asia, MFIs are found to generally operate with lower costs the longer they are in operation. Given the differences in operating environments, subsidies, and organizational form, this finding of increasing cost effectiveness may not aptly characterize all MFIs. Estimation of a mixture model reveals that roughly half of the MFIs are able to operate with reduced costs over time, while half do not. Among other things, we find that larger MFIs offering deposits and those receiving lower subsidies operate more cost effectively over time. [source] Alternative drug delivery approaches for the therapy of inflammatory bowel diseaseJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 8 2008Yvette Meissner Abstract This article shall give an overview on drug delivery systems for new therapeutic strategies in the treatment of inflammatory bowel disease. The various features of the different approaches allowing locally restricted drug delivery to the inflamed colon are discussed including the main physiological and pathophysiological limitations for the different systems. Conventional drug delivery systems are tightly adapted from developments for colonic delivery by oral administration triggered by release mechanisms owing to the physiological environment that these systems encounter in the colonic region. The newer developments in this context aim for an increased selectivity of drug delivery by targeting mechanisms which have a closer relation to pathophysiological particularities of the disease. Therefore, we were focused especially on new strategies for such treatment including liposomal formulations, cyclodextrins, micro- or nanoparticles, viral gene therapy approaches, and others. Effective and selective delivery even of an otherwise nonspecifically acting drug could provide new therapeutic pathways in the treatment of inflammatory bowel disease. © 2007 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 97: 2878,2891, 2008 [source] Recombinant Human Lactoferrin is Effective in the Treatment of Helicobacter felis -infected MiceJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 12 2000E. J. DIAL Recombinant human lactoferrin possesses in-vitro antibiotic and anti-inflammatory activity similar to the native form. It was tested for in-vivo activity in mice infected with the gastritis-inducing bacterium Helicobacter felis. A two-week course of treatment with lactoferrin was sufficient to partially reverse both infection-induced gastritis and the infection rate, and fully reverse gastric surface hydro-phobicity changes. A comparison of lactoferrin with amoxicillin and standard triple therapy revealed no differences in infection rate. These results show that recombinant human lactoferrin is effective in a mouse model of Helicobacter infection, and support further testing of this promising agent for this application. [source] Screening for Hazardous Drinking Using the Michigan Alcohol Screening Test,Geriatric Version (MAST-G) in Elderly Persons With Acute Cerebrovascular AccidentsALCOHOLISM, Issue 9 2009Doug Johnson-Greene Background:, Effective and valid screening methods are needed to identify hazardous drinking in elderly persons with new onset acute medical illness. The goal of the current study was to examine the effectiveness of the Michigan Alcohol Screening Test,Geriatric Version (MAST-G) in identifying hazardous drinking among elderly patients with acute cerebrovascular accidents (CVA) and to compare the effectiveness of 2 shorter versions of the MAST-G with the full instrument. Methods:, The study sample included 100 men and women who averaged 12 days posthemorrhagic or ischemic CVA admitted to a rehabilitation unit and who were at least 50 years of age and free of substance use other than alcohol. This cross-sectional validation study compared the 24-item full MAST-G, the 10-item Short MAST-G (SMAST-G), and a 2-item regression analysis derived Mini MAST-G (MMAST-G) to the reference standard of hazardous drinking during the past 3 months. Alcohol use was collected using the Timeline Followback (TLFB). Recent and lifetime alcohol-related consequences were collected using the Short Inventory of Problems (SIP). Results:, Nearly one-third (28%) of the study sample met the World Health Organization (WHO) criteria for hazardous drinking. Moderately strong associations were found for the MAST-G, SMAST-G, and MMAST-G with alcohol quantity and frequency and recent and lifetime alcohol consequences. All 3 MAST-G versions could differentiate hazardous from nonhazardous drinkers and had nearly identical area under the curve characteristics. Comparable sensitivity was found across the 3 MAST-G measures. The optimal screening threshold for hazardous drinking was 5 for the MAST-G, 2 for the SMAST-G, and 1 for the MMAST-G. Conclusions:, The 10-item SMAST-G and 2-item MMAST-G are brief screening tests that show comparable effectiveness in detecting hazardous drinking in elderly patients with acute CVA compared with the full 24-item MAST-G. Implications for research and clinical practice are discussed. [source] Development and validation of a method based on a QuEChERS procedure and heart-cutting GC-MS for determination of five mycotoxins in cereal productsJOURNAL OF SEPARATION SCIENCE, JSS, Issue 4-5 2010Sara C. Cunha Abstract A new analytical method for the rapid and simultaneous determination of five mycotoxins (zearelenone, deoxynivalenol, Fusarenon X, 15-acetyldeoxynivalenol and nivalenol) in breakfast cereals and flours by heart-cutting GC-MS has been developed and validated. Extraction was performed with MeCN, applying a modified QuEChERS (QUick, Easy, CHeap, Effective, Rugged and Safe) procedure, and the extracts were analyzed after a silylation of the analytes under study. Careful optimization of the parameters of Deans Switch device and GC-MS was achieved in order to attain a fast separation in SIM mode, allowing a total run time of only 8,min. Acceptable recoveries for all mycotoxins at two different spiking levels (20 and 100,,g/kg) were achieved with good repeatability (from 9 to 21%). LOD ranged from 2 to 15,,g/kg and LOQ ranged from 5 to 50,,g/kg, which were lower than the maximum limit legal established by the European Union (EU). The method developed was applied to commercial breakfast cereals and flours; among the mycotoxins studied, deoxynivalenol and zearalenone were the most predominant. [source] Effective and tolerant wide-range solutions for ultra-wideband indented-disk monopole antennaMICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 4 2006Chin-Ju Pan Abstract Solutions obtained from a wide range of parameters for the optimized design of the antenna are presented. Wide-bandwidth impedance matching can be achieved using a simply designed indented-disk monopole antenna for ultra-wideband (UWB) applications. The design is based on a genetic algorithm (GA)-based refined method to improve the solution to the UWB antenna design problem. A new optimization process is used to determine a wide range of feasible solutions rather than just the few solutions that can be obtained by trial and error. The wide range of solutions support the manufacturing tolerance effectively. © 2006 Wiley Periodicals, Inc. Microwave Opt Technol Lett 48: 693,695, 2006; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.21445 [source] Educational Programs: Effective or Not?NURSING FOR WOMENS HEALTH, Issue 3 2010Rosemary Theroux PhD First page of article [source] Perceptions of Effective and Ineffective Nurse,Physician Communication in HospitalsNURSING FORUM, Issue 3 2010F. Patrick Robinson PhD PROBLEM., Nurse,physician communication affects patient safety. Such communication has been well studied using a variety of survey and observational methods; however, missing from the literature is an investigation of what constitutes effective and ineffective interprofessional communication from the perspective of the professionals involved. The purpose of this study was to explore nurse and physician perceptions of effective and ineffective communication between the two professions. METHODS., Using focus group methodology, we asked nurses and physicians with at least 5 years' acute care hospital experience to reflect on effective and ineffective interprofessional communication and to provide examples. Three focus groups were held with 6 participants each (total sample 18). Sessions were audio recorded and transcribed verbatim. Transcripts were coded into categories of effective and ineffective communication. FINDINGS., The following themes were found. For effective communication: clarity and precision of message that relies on verification, collaborative problem solving, calm and supportive demeanor under stress, maintenance of mutual respect, and authentic understanding of the unique role. For ineffective communication: making someone less than, dependence on electronic systems, and linguistic and cultural barriers. CONCLUSION., These themes may be useful in designing learning activities to promote effective interprofessional communication. [source] How Effective Are Lifestyle Changes in the Prevention of Type 2 Diabetes Mellitus?NUTRITION REVIEWS, Issue 3 2007F. Xavier Pi-Sunyer MD Obesity and impaired glucose tolerance are associated with a greater risk for a number of conditions, including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, coagulation abnormalities, inflammatory markers, and coronary heart disease. Lifestyle changes can delay or prevent the development of type 2 diabetes in patients with obesity and impaired glucose tolerance. The risks improve with weight loss and increased physical activity. A decrease of 7% to 10% or more from baseline weight can have a significant effect. This has now been documented in a number of randomized, controlled studies. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||