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Effective Combination (effective + combination)
Selected AbstractsWhat happens after diagnosis?HEALTH EXPECTATIONS, Issue 2 2009Understanding the experiences of patients with newly-diagnosed bipolar disorder Abstract Bipolar disorder is chronic condition involving episodes of both depression and elevated mood, associated with significant disability and high relapse rates. Recent estimates suggest a lifetime prevalence of 5%. Little is known about the subjective experiences of patients after receiving a diagnosis of bipolar disorder, and the impact of these experiences on patients' willingness and ability to work with their health professionals to find the most effective combination of treatments and to set up self-management plans. Objective, This paper describes a qualitative study exploring the experiences and difficulties faced by patients after they have received a diagnosis of bipolar disorder, as expressed online to expert patients trained to provide informed support. Design, Qualitative study. Setting, Online communication within a public health service setting. Participants, Twenty-six participants with recently-diagnosed bipolar disorder communicated online with ,Informed Supporters', people who had been managing their bipolar disorder effectively for 2 years or more, as part of an online psycho-education programme. Results, Participants cited unwanted side-effects of medication, coping with unpleasant symptoms, positive and negative reactions to the diagnosis, identifying early warning signs and triggers of the illness, the loss of a sense of self, uncertainty about their future and stigma as issues of major importance after diagnosis. Conclusions, Personal concerns and difficulties following diagnosis can undermine effective treatment, thwart self-management efforts and interfere with effective functioning. Such data are important for clinicians to take into account when they work in partnership with their patients to fine-tune treatments and help them set up self-management plans. [source] Combination propofol,ketamine anaesthesia in sick neonatesPEDIATRIC ANESTHESIA, Issue 1 2001Samuel Golden MD Two critically ill, opioid-tolerant neonates were anaesthetized using pancuronium and a mixture of propofol (PROP) and ketamine (KET). Three mg of KET were added per ml (10 mg) of PROP in a single syringe and infused at a rate of 100,150 ,g·kg,1·min,1 of the PROP component (30,45 ,g·kg,1·min,1 KET). Total doses of 12,15 and 3.6,4.5 mg·kg,1 of PROP and KET, respectively, were administered. Both patients remained haemodynamically stable throughout their surgical procedures. PROP-KET is a rational and effective combination for intravenous anaesthesia in critically ill neonates who are likely to be opioid-tolerant when an anaesthesia vaporizer is not readily available. [source] A new effective combination of a thin-film extractor and gravity setterTHE CANADIAN JOURNAL OF CHEMICAL ENGINEERING, Issue 3 2001Yuli Berman Abstract Previous and present studies demonstrate that the new thin-film extractor with the gravity settler have superior performance over other conventional devices. This is because the volume of the extractor and the settler are significantly reduced, on the average, by factors of 100 and 10, respectively, for a similar power input. Correlations for a water-iodine-kerosene liquid system developed in the past (Berman and Tamir, 2000) for the mass transfer and pressure drop were modified by incorporating the ratio R/Rr This ratio takes into account the impact of the liquids on the walls of the reactor where R is the radius of the free film and Rr is the radius of the reactor. In addition, an equation was proposed, which demonstrates the dependence of the extraction efficiency on the operating parameters. The gravity settler combined with the thin-film extractor was tested thoroughly yielding two correlations for estimating its height, i.e. the fluidized-bed and dense-packed zones. In the present case the sedimentation zone is absent. A scale up procedure based on the model developed is proposed as well as a principle scheme of a pilot plant based on the new effective combination Les études antérieures tout comme la présente étude démontrent que le nouvel extracteur à film mince combiné à un séparateur gravitaire a une performance supérieure par rapport à d'autres systèmes conventionnels. Cela est dû au fait que les volumes de l'extracteur et du sédimenteur sont largement réduit, en moyenne, d'un facteur 100 et 10 respectivement, pour une alimentation énergétique comparable. En introduisant le rapport R/Rr on a modifié des corrélations pour un système liquide eau-iode-kérosène déjà établies (Berman et Tamir, 2000) pour le transfert de matière et la perte de charge. Ce rapport tient compte de l'impact des liquides sur les parois du réacteur, où R est le rayon du film libre et Rr le rayon du réacteur. De plus, une équation est proposée, qui démontre que l'efficacité d'extraction dépend des paramètres de fonctionnement. Le séparateur gravitaire combiné à l'extracteur à film mince a été testé en profondeur, ce qui a conduit à deux corrélations pour estimer sa hauteur, c'est-à-dire les zones lit fluidisé et garnie-dense. Dans le cas présent, la zone de sédimentation est absente. Une mise à l'échelle est proposée d'après le modèle élaboré ainsi qu'un schéma de principe d'une usine pilote à partir de cette nouvelle combinaison efficace. [source] Supplementary oxygen and temperature management during live transportation of greenlip abalone, Haliotis laevigata (Donovan, 1808)AQUACULTURE RESEARCH, Issue 7 2009Erin J Bubner Abstract Live greenlip abalone, Haliotis laevigata, are highly valued in Australian export markets with demand increasingly being met with cultured stock. Live transportation of abalone requires the maintenance of favourable conditions within transport containers for periods exceeding 35 h. We examined the combined effects of temperature regulation (ice provision) and of supplemental oxygen (60% and 100% concentrations) on mortality rates of abalone over 7 days following a 35-h simulated live-transport experiment. We also examined the physiological condition of greenlip abalone (oxygen consumption rate, haemolymph pH and weight) during the simulation experiment. The provision of ice and supplementary oxygen reduced abalone mortalities. Omission of ice and supplementary oxygen during the transport simulation resulted in mortality rates ranging from 70% to 100%. The addition of ice to containers with ambient oxygen concentrations decreased average mortality rates by 50%. While supplementary oxygen further reduced these rates, the provision of both ice and 100% oxygen was by far the most effective combination, reducing mortalities to between 2% and 6%. Supplementary oxygen increased oxygen consumption rates of abalone above those transported at ambient oxygen concentrations. Live-transport decreased haemolymph pH in all treatments but was most pronounced in treatments without ice or supplementary oxygen. On average, abalone lost 7,13% of their weight during the simulation but this loss was independent of transport treatment. [source] A systematic review of professional support interventions for breastfeedingJOURNAL OF CLINICAL NURSING, Issue 9 2008Leena Hannula PhD Objectives., The objectives of this systematic review were first, to describe how breastfeeding is professionally supported during pregnancy, at maternity hospitals and during the postnatal period. Secondly, to find out how effective interventions are in supporting breastfeeding. Background., Breastfeeding is an effective way to promote the health of infants. In many countries, the rates for breastfeeding remain lower than recommended. Many studies have examined breastfeeding promotion interventions; some of them are successful and some fail. It is important to find effective combinations of support. Design. Systematic review. Methods., Search of CINAHL, Medline and Cochrane Central Register databases were conducted for data collection. The search was limited to articles published in Finnish, Swedish and English between the year 2000 and March 2006, focusing on breastfeeding and breastfeeding support interventions. Two reviewers independently analysed 36 articles in the final analysis. Results., Interventions expanding from pregnancy to the intrapartum period and throughout the postnatal period were more effective than interventions concentrating on a shorter period. In addition, intervention packages using various methods of education and support from well-trained professionals are more effective than interventions concentrating on a single method. Conclusions., During pregnancy, the effective interventions were interactive, involving mothers in conversation. The Baby Friendly Hospital Initiative (BFHI) as well as practical hands off -teaching, when combined with support and encouragement, were effective approaches. Postnatally effective were home visits, telephone support and breastfeeding centres combined with peer support. Relevance to clinical practice., Professionals need breastfeeding education and support of their organisations to act as breastfeeding supporters. The BFHI -programme is effective and it would be wise to include the core components of the programme in breastfeeding promotion interventions. Mothers benefit from breastfeeding encouragement and guidance that supports their self-efficacy and feelings of being capable and empowered, and is tailored to their individual needs. [source] Generation of functionally mature dendritic cells from elutriated monocytes using polyinosinic : polycytidylic acid and soluble CD40 ligand for clinical applicationCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2008S. Kim Summary Despite the increasing use of dendritic cell (DC) vaccination in clinical trials, optimal conditions for the generation of functionally mature DCs remain to be established. The current standard DC maturation protocol for clinical trials has been used as an inflammatory cytokine cocktail [tumour necrosis factor (TNF)-,, interleukin (IL)-1,, IL-6 and prostaglandin E2], but this cocktail induced insufficient maturation of DCs derived from elutriated monocytes when cultured in X-VIVO 15. The aim of this study was to define effective combinations of stimulators for generating functionally mature DCs from elutriated monocytes under current good manufacturing practice conditions. We compared the functional capacity of DCs in response to all possible pairwise combinations of four different classes of stimuli: TNF-,, peptidoglycan, polyinosinic : polycytidylic acid [poly(I:C)] and soluble CD40 ligand (CD40L). Maturation status of DCs stimulated with combination of four stimuli was similar to that of the cytokine cocktail as assessed by the cell surface phenotype. However, only the combination of poly(I:C) + CD40L induced complete functional activation of the whole DC population, assessing IL-12p70 production, allostimulatory activity, migratory response to CCL19 and T helper 1-polarizing capacity. Thus, the protocol based on the combination of poly(I:C) and CD40L is more effective for the induction of clinical-grade DCs from elutriated monocytes than the standard cytokine cocktail. [source] | ||||||||||