Home About us Contact
|
Home About us Contact | ||
|
|
||
High-quality
Terms modified by High-quality Selected AbstractsFormation of High-Quality, Epitaxial La2Zr2O7 Layers on Biaxially Textured Substrates by Slot-Die Coating of Chemical Solution PrecursorsJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 11 2007Sung-Hun Wee Crystallization studies were performed of epitaxial La2Zr2O7 (LZO) films on biaxially textured Ni,3at.%W substrates having thin Y2O3 (10 nm) seed layers. LZO films were deposited under controlled humid atmosphere using reel-to-reel slot-die coating of chemical solution precursors. Controlled crystallization under various processing conditions has revealed a broad phase space for obtaining high-quality, epitaxial LZO films without microcracks, with no degradation of crystallographic texture and with high surface crystallinity. Crack-free and strong c -axis aligned LZO films with no random orientation were obtained even at relatively low annealing temperatures of 850°,950°C in flowing one atmosphere gas mixtures of Ar,4% H2 with an effective oxygen partial pressure of P(O2),10,22 atm. Texture and reflection high-energy electron diffraction analyses reveal that low-temperature-annealed samples have strong cube-on-cube epitaxy and high surface crystallinity, comparable to those of LZO film annealed at high temperature of 1100°C. In addition, these samples have a smoother surface morphology than films annealed at higher temperatures. Ni diffusion rate into the LZO buffer film is also expected to be significantly reduced at the lower annealing temperatures. [source] Characterization, Cathodoluminescence, and Field-Emission Properties of Morphology-Tunable CdS Micro/NanostructuresADVANCED FUNCTIONAL MATERIALS, Issue 15 2009Tianyou Zhai Abstract High-quality, uniform one-dimensional CdS micro/nanostructures with different morphologies,microrods, sub-microwires and nanotips,are fabricated through an easy and effective thermal evaporation process. Their structural, cathodoluminescence and field-emission properties are systematically investigated. Microrods and nanotips exhibit sharp near-band-edge emission and broad deep-level emission, whereas sub-microwires show only the deep-level emission. A significant decrease in a deep-level/near-band-edge intensity ratio is observed along a tapered nanotip towards a smaller diameter part. This behavior is understood by consideration of defect concentrations in the nanotips, as analyzed with high-resolution transmission electron microscopy. Field-emission measurements show that the nanotips possess the best field-emission characteristics among all 1D CdS nanostructures reported to date, with a relatively low turn-on field of 5.28,V µm,1 and the highest field-enhancement factor of 4,819. The field-enhancement factor, turn-on and threshold fields are discussed related to structure morphology and vacuum gap variations under emission. [source] Sodium MRI using a density-adapted 3D radial acquisition techniqueMAGNETIC RESONANCE IN MEDICINE, Issue 6 2009Armin M. Nagel Abstract A density-adapted three-dimensional radial projection reconstruction pulse sequence is presented which provides a more efficient k -space sampling than conventional three-dimensional projection reconstruction sequences. The gradients of the density-adapted three-dimensional radial projection reconstruction pulse sequence are designed such that the averaged sampling density in each spherical shell of k -space is constant. Due to hardware restrictions, an inner sphere of k -space is sampled without density adaption. This approach benefits from both the straightforward handling of conventional three-dimensional projection reconstruction sequence trajectories and an enhanced signal-to-noise ratio (SNR) efficiency akin to the commonly used three-dimensional twisted projection imaging trajectories. Benefits for low SNR applications, when compared to conventional three-dimensional projection reconstruction sequences, are demonstrated with the example of sodium imaging. In simulations of the point-spread function, the SNR of small objects is increased by a factor 1.66 for the density-adapted three-dimensional radial projection reconstruction pulse sequence sequence. Using analytical and experimental phantoms, it is shown that the density-adapted three-dimensional radial projection reconstruction pulse sequence allows higher resolutions and is more robust in the presence of field inhomogeneities. High-quality in vivo images of the healthy human leg muscle and the healthy human brain are acquired. For equivalent scan times, the SNR is up to a factor of 1.8 higher and anatomic details are better resolved using density-adapted three-dimensional radial projection reconstruction pulse sequence. Magn Reson Med, 2009. © 2009 Wiley-Liss, Inc. [source] The molecular scanner in microscope modeRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 22 2006Stefan L. Luxembourg The combination of microscope mode matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) with protein identification methodology: the molecular scanner, was explored. The molecular scanner approach provides improvement of sensitivity of detection and identification of high-mass proteins in microscope mode IMS. The methodology was tested on protein distributions obtained after separation by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS-PAGE). High-quality, high-spatial-resolution ion images were recorded on a TRIFT-II ion microscope after gold coating of the MALDI sample preparation on the poly(vinylidenedifluoride) capture membranes. The sensitivity of the combined method is estimated to be 5 pmol. The minimum amount of sample consumed, needed for identification, was estimated to be better than 100 fmol. Software tools were developed to analyze the spectral data and to generate broad mass range and single molecular component microscope mode ion images and single mass-to-charge ratio microprobe mode images. Copyright © 2006 John Wiley & Sons, Ltd. [source] Vitamin contents of eggs that produce larvae showing a high survival rate in the Japanese eel Anguilla japonicaAQUACULTURE RESEARCH, Issue 11 2009Hirofumi Furuita Abstract This paper describes the relationship between the egg vitamin concentrations and the egg quality in the Japanese eel Anguilla japonica. No notable relation was found between any vitamin and the fertilization rate. Hatching and survival rates of larvae, however, significantly increased with an elevated level of egg vitamin C (VC). In contrast to VC, the relation between vitamins E (VE) and A (VA) concentrations and survival rate showed a clear peak, with a reduced survival rate at both higher and lower vitamin concentrations. The ratio of VE to lipid or highly unsaturated fatty acid (HUFA) in eggs positively correlated with hatching and survival rates of larvae. High-quality (HQ) eggs were determined as eggs that produced larvae having a survival rate higher than 80% at 8 days post hatch, and low-quality (LQ) eggs were determined as eggs that did not hatch. The level of VC of HQ was significantly higher than LQ. The results of this study suggest that HQ eggs, which produce larvae having a high survival rate, must have high levels of VC and VE/HUFA ratio and contain optimum levels of VA and VE in Japanese eel. [source] Health Care Supply Chain Design: Toward Linking the Development and Delivery of Care Globally,DECISION SCIENCES, Issue 2 2009Kingshuk K. Sinha ABSTRACT This article is motivated by the gap between the growing demand and available supply of high-quality, cost-effective, and timely health care, a problem faced not only by developing and underdeveloped countries but also by developed countries. The significance of this problem is heightened when the economy is in recession. In an attempt to address the problem, in this article, first, we conceptualize care as a bundle of goods, services, and experiences,including diet and exercise, drugs, devices, invasive procedures, new biologics, travel and lodging, and payment and reimbursement. We then adopt a macro, end-to-end, supply chain,centric view of the health care sector to link the development of care with the delivery of care. This macro, supply chain,centric view sheds light on the interdependencies between key industries from the upstream to the downstream of the health care supply chain. We propose a framework, the 3A-framework, that is founded on three constructs,affordability, access, and awareness,to inform the design of supply chain for the health care sector. We present an illustrative example of the framework toward designing the supply chain for implantable device,based care for cardiovascular diseases in developing countries. Specifically, the framework provides a lens for identifying an integrated system of continuous improvement and innovation initiatives relevant to bridging the gap between the demand and supply for high-quality, cost-effective, and timely care. Finally, we delineate directions of future research that are anchored in and follow from the developments documented in the article. [source] Service Personnel, Technology, and Their Interaction in Influencing Customer Satisfaction,DECISION SCIENCES, Issue 1 2006Craig M. Froehle ABSTRACT Managing both the technologies and the personnel needed for providing high-quality, multichannel customer support creates a complex and persistent operational challenge. Adding to this difficulty, it is still unclear how service personnel and these new communication technologies interact to influence the customer's perceptions of the service being provided. Motivated by both practical importance and inconsistent findings in the academic literature, this exploratory research examines the interaction of media richness, represented by three different technology contexts (telephone, e-mail, and online chat), with six customer service representative (CSR) characteristics and their influences on customer satisfaction. Using a large-sample customer survey data set, the article develops a multigroup structural equation model to analyze these interactions. Results suggest that CSR characteristics influence customer service satisfaction similarly across all three technology-mediated contexts. Of the characteristics studied, service representatives contribute to customer satisfaction more when they exhibit the characteristics of thoroughness, knowledgeableness, and preparedness, regardless of the richness of the medium used. Surprisingly, while three other CSR characteristics studied (courtesy, professionalism, and attentiveness) are traditionally believed to be important in face-to-face encounters, they had no significant impact on customer satisfaction in the technology-mediated contexts studied. Implications for both practitioners and researchers are drawn from the results and future research opportunities are discussed. [source] A Comparison of Four Mohs Tissue Preparation Methods Using Porcine SkinDERMATOLOGIC SURGERY, Issue 9 2010FRCPC, WILLIAM LEAR MD OBJECTIVE Mohs surgery relies on high-quality, rapid tissue preparation and processing. This study evaluated four currently performed tissue preparation and processing methods for speed of processing and depth of cut into the tissue block to achieve a complete high-quality section. METHODS The following four methods were tested: cryoEMBEDDER, float, heat sink, and slide. Standardized specimens of porcine skin were used to ensure uniformity. We measured the time required for a technician to flatten, embed, and cut to the first complete section of each specimen. Additionally, we measured the depth in microns required to cut into an embedded specimen to achieve a complete section. RESULTS There were advantages and disadvantages of each method, and our findings suggest that the heat sink and float methods are more time efficient but that the slide and cryoEMBEDDER methods require less cutting into the specimen to obtain a complete section. The cryoEMBEDDER device used in this study was loaned by cryoEMBEDDER (Salt Lake City, Utah). [source] Wilkhahn: A tradition of the cutting edgeDESIGN MANAGEMENT REVIEW, Issue 2 2002Brigitte Wolf Under the personal leadership of Fritz Hahne, Wilkhahn has created a niche for itself and earned a global reputation for designing high-quality, classically modern furniture that is both elegant and functional. In a rich overview of this German firm, Brigitte Wolf explores the business objectives, the work ethic, the design principles, the social and environmental values and, of course, the products and architecture that are the hallmark of this remarkable company. [source] Technology and innovation in the psychosocial treatment of methamphetamine use, risk and dependenceDRUG AND ALCOHOL REVIEW, Issue 3 2008FRANCES J. KAY-LAMBKIN Abstract Issues. The dramatic increase in methamphetamine use has led to the urgent need for high-quality, effective treatments and management strategies for methamphetamine use problems to be developed and disseminated. Although some evidence exists for the use of psychological, pharmacological and other approaches to treatment for problematic methamphetamine use, other evidence suggests that many methamphetamine users do not access these treatment options due to a range of individual and service-level barriers. Approach. A review of available research literature was undertaken to identify treatment strategies for methamphetamine users, which overcome the problems associated with treatment access for this important target group and involve technological and other innovative approaches. Key Findings. Several approaches to addressing problematic methamphetamine use have been suggested, including assertive engagement strategies, flexibility in the provision of treatment and retention strategies and use of a multi-focused intervention package, such as stepped care, perhaps including new technologies as alternatives or supplements to face-to-face-delivered treatments. No research currently exists to examine the possible benefit of these strategies for people with methamphetamine use problems. Implications. The use of stepped-care intervention packages has the potential to address many of the current challenges faced by both clinicians and clients in treating methamphetamine use problems. Conclusions. Although promising, these approaches require further attention and research effort, particularly among the specific group of methamphetamine users. [source] Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatmentADDICTION, Issue 10 2010Hendrik G. Roozen ABSTRACT Aims Many individuals with substance use disorders are opposed to seeking formal treatment, often leading to disruptive relationships with concerned significant others (CSOs). This is disturbing, as untreated individuals are often associated with a variety of other addiction-related problems. Community Reinforcement and Family Training (CRAFT) provides an option to the more traditional treatment and intervention approaches. The objective of this systematic review was to compare CRAFT with the Alcoholics Anonymous/Narcotics Anonymous (Al-Anon/Nar-Anon) model and the Johnson Institute intervention in terms of its ability to engage patients in treatment and improve the functioning of CSOs. Methods The electronic databases PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Library were consulted. Four high-quality randomized controlled trials were identified, with a total sample of 264 CSOs. Data were synthesized to quantify the effect with 95% confidence intervals, using the random effects model. Results CRAFT produced three times more patient engagement than Al-Anon/Nar-Anon [relative risk (RR) 3.25, 95% confidence interval (CI) 2.11,5.02, P < 0.0001; numbers needed to treat (NNT) = 2] and twice the engagement of the Johnson Institute intervention (RR 2.15, 95% CI 1.28,3.62, P = 0.004; NNT = 3). Overall, CRAFT encouraged approximately two-thirds of treatment-resistant patients to attend treatment, typically for four to six CRAFT sessions. CSOs showed marked psychosocial and physical improvements whether they were assigned to CRAFT, Al-Anon/Nar-Anon or the Johnson Institute intervention within the 6-month treatment window. Conclusion CRAFT has been found to be superior in engaging treatment-resistant substance-abusing individuals compared with the traditional programmes. [source] A low-leakage sample plug injection scheme for crossform microfluidic capillary electrophoresis devices incorporating a restricted cross-channel intersectionELECTROPHORESIS, Issue 15 2008Chin-Lung Chang Abstract This study develops a crossform CE microfluidic device in which a single-circular barrier or a double-circular barrier is introduced at the cross-channel intersection. Utilizing a conventional crossform injection scheme, it is shown that these barriers reduce sample leakage and deliver a compact sample band into the separation channel, thereby ensuring an enhanced detection performance. A series of numerical and experimental investigations are performed to investigate the effects of the barrier type and the barrier ratio on the flow streamlines within the microchannel and to clarify their respective effects on the sample leakage ratio and sample plug variance during the injection process. The results indicate that a single-circular barrier injector with a barrier ratio greater than 20% and a double-circular barrier injector with a barrier ratio greater than 40% minimize the sample leakage ratio and produce a compact sample plug. As a result, both injectors have an excellent potential for use in high-quality, high-throughput chemical analysis procedures and in many other applications throughout the micro-total analysis systems field. [source] Determination of load spectra for durability approval of car drive linesFATIGUE & FRACTURE OF ENGINEERING MATERIALS AND STRUCTURES, Issue 12 2002B. OELMANN ABSTRACT Knowledge of the significan and representative load spectra is one important requirement for a high-quality, quick durability life approval of vehicle components on a test rig or by calculation. The way that such load spectra can be derived from measurements is demonstrated in this paper by the example of a passenger car drive line. The paper includes a brief introduction followed by an outline of the objectives. The proposed approach will then be illustrated and the results will be presented. Examples of applications will be shown and an outlook for further activities presented. [source] Mechanical Buckling: Mechanics, Metrology, and Stretchable ElectronicsADVANCED FUNCTIONAL MATERIALS, Issue 10 2009Dahl-Young Khang Abstract Mechanical buckling usually means catastrophic failure in structural mechanics systems. However, controlled buckling of thin films on compliant substrates has been used to advantage in diverse fields such as micro-/nanofabrication, optics, bioengineering, and metrology as well as fundamental mechanics studies. In this Feature Article, a mechanical buckling model is presented, which sprang, in part, from the buckling study of high-quality, single-crystalline nanomaterials. To check the mechanical-buckling phenomenon down to the nano-/molecular scale, well-aligned single-walled carbon nanotube arrays and cross linked carbon-based monolayers are transferred from growth substrate onto elastomeric substrate and then they are buckled into well-defined shapes that are amenable to quantitative analysis. From this nano- or molecular-scale buckling, it is shown that the mechanical moduli of nanoscale materials can easily be determined, even using a model based on continuum mechanics. In addition, buckling phenomena can be utilized for the determination of mechanical moduli of organic functional materials such as poly(3-hexylthiophene) (P3HT) and P3HT/6,6-phenyl-C61 -butyric acid methyl ester (PCBM) composite, which are widely used for organic transistors and organic photovoltaics. The results provide useful information for the realization of flexible and/or stretchable organic electronics. Finally, the fabrication and applications of "wavy, stretchable" single-crystal Si electronics on elastomeric substrates are demonstrated. [source] Epitaxial Graphene Growth by Carbon Molecular Beam Epitaxy (CMBE)ADVANCED MATERIALS, Issue 37 2010Jeongho Park A novel growth method (carbon molecular beam epitaxy (CMBE)) has been developed to produce high-quality and large-area epitaxial graphene. This method demonstrates significantly improved controllability of the graphene growth. CMBE with C60 produces AB stacked graphene, while growth with the graphite filament results in non-Bernal stacked graphene layers with a Dirac-like electronic structure, which is similar to graphene grown by thermal decomposition on SiC (000-1). [source] Bottom-Imprint Method for VSS Growth of Epitaxial Silicon Nanowire Arrays with an Aluminium CatalystADVANCED MATERIALS, Issue 46 2009Zhang Zhang A bottom-imprint method to fabricate high-quality Si [100] nanowire arrays is described (see figure). This new approach combines the functions of a highly ordered anodic aluminum oxide (AAO) template that acts as both a stamp and a template. Vertically aligned, Al-catalyzed Si nanowire (NW) arrays are grown epitaxially on the Si substrate with a narrow size distribution. [source] Ordered High-Density Si [100] Nanowire Arrays Epitaxially Grown by Bottom Imprint MethodADVANCED MATERIALS, Issue 27 2009Zhang Zhang A novel bottom imprint method to fabricate high-quality Si [100] nanowire arrays is demonstrated. This new approach combines the functions of a high-ordering AAO template as a stamp and template simultaneously. By the protective polymer layer in the hot imprint, the vertical 40,nm Si nanowire arrays grow epitaxially on the Si substrate with a narrow size distribution [source] Medical management of left-sided ulcerative colitis and ulcerative proctitis: Critical evaluation of therapeutic trialsINFLAMMATORY BOWEL DISEASES, Issue 10 2006Miguel Regueiro MD Abstract Background: The goal of this work was to critically evaluate the published studies on the treatment of ulcerative proctitis (UP) and left-sided ulcerative colitis (L-UC). The results of this review provided the content for the accompanying treatment guidelines, Clinical Guidelines for the Medical Management of Left-sided Ulcerative Colitis and Ulcerative Proctitis: Summary Statement. Methods: All English language articles published between 1995 and September 2005 were identified through a comprehensive literature search using OVID and PubMed. The quality of the data supporting or rejecting the use of specific therapies was categorized by a data quality grading scale. An "A+" grade was assigned to treatment supported by multiple high-quality randomized controlled trials with consistent results, whereas a "D" grade was given to therapy supported only by expert opinion. The therapeutic efficacy of a treatment was defined by its success in treating UP and L-UC compared with placebo. A medication was ranked as "excellent" if it was specifically studied for UP and L-UC and had consistently positive results compared with placebo or another agent. Quality and efficacy scores were agreed on by author consensus. Results: For the acute treatment of UP or L-UC, the rectally administered corticosteroids and mesalazine (5-ASA), either alone or in combination with oral 5-ASAs, are the most effective therapy: evidence quality, A+; efficacy, excellent. Only rectally administered 5-ASA received an A+/excellent rating for maintenance of remission. Infliximab received an A+ grade for induction and maintenance of remission but only a "good" rating because the studies were performed in all UC, not specifically UP or L-UC. Conclusions: This critical evaluation of treatment provides a "report card" on medications available for the management of patients with UP and L-UC. The guidelines should provide a useful reference and supplement for physicians treating UC patients. [source] Evaluation of one- and two-equation low- Re turbulence models.INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 12 2003Axisymmetric separating, Part I, swirling flows Abstract This first segment of the two-part paper systematically examines several turbulence models in the context of three flows, namely a simple flat-plate turbulent boundary layer, an axisymmetric separating flow, and a swirling flow. The test cases are chosen on the basis of availability of high-quality and detailed experimental data. The tested turbulence models are integrated to solid surfaces and consist of: Rodi's two-layer k,, model, Chien's low-Reynolds number k,, model, Wilcox's k,, model, Menter's two-equation shear-stress-transport model, and the one-equation model of Spalart and Allmaras. The objective of the study is to establish the prediction accuracy of these turbulence models with respect to axisymmetric separating flows, and flows of high streamline curvature. At the same time, the study establishes the minimum spatial resolution requirements for each of these turbulence closures, and identifies the proper low-Mach-number preconditioning and artificial diffusion settings of a Reynolds-averaged Navier,Stokes algorithm for optimum rate of convergence and minimum adverse impact on prediction accuracy. Copyright © 2003 John Wiley & Sons, Ltd. [source] Evaluation of one- and two-equation low- Re turbulence models.INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 12 2003Part II, Vortex-generator jet, diffusing S-duct flows Abstract This second segment of the two-part paper systematically examines several turbulence models in the context of two flows, namely a vortex flow created by an inclined jet in crossflow, and the flow field in a diffusing S-shaped duct. The test cases are chosen on the basis of availability of high-quality and detailed experimental data. The tested turbulence models are integrated to solid surfaces and consist of: Rodi's two-layer k,, model, Wilcox's k,, model, Menter's two-equation shear,stress-transport model, and the one-equation model of Spalart and Allmaras. The objective of the study is to establish the prediction accuracy of these turbulence models with respect to three-dimensional separated flows with streamline curvature. At the same time, the study establishes the minimum spatial resolution requirements for each of these turbulence closures, and identifies the proper low-Mach-number preconditioning and artificial diffusion settings of a Reynolds-averaged Navier,Stokes algorithm for optimum rate of convergence and minimum adverse impact on prediction accuracy. Copyright © 2003 John Wiley & Sons, Ltd. [source] Systematic review of the effectiveness of integrated care pathways: what works, for whom, in which circumstances?INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2009Davina Allen RGN BA(Hons) PhD Abstract Aim, Integrated care pathways (ICP) are management technologies which formalise multidisciplinary team-working and enable professionals to examine their roles and responsibilities. ICPs are now being implemented across international healthcare arena, but evidence to support their use is equivocal. The aim of this study was to identify the circumstances in which ICPs are effective, for whom and in what contexts. Methods, A systematic review of high-quality randomised controlled trials published between 1980 and 2008 (March) evaluating ICP use in child and adult populations in the full range of healthcare settings. Results 1For relatively predictable trajectories of care ICPs can be effective in supporting proactive care management and ensuring that patients receive relevant clinical interventions and/or assessments in a timely manner. This can lead to improvements in service quality and service efficiency without adverse consequences for patients. 2ICPs are an effective mechanism for promoting adherence to guidelines or treatment protocols thereby reducing variation in practice. 3ICPs can be effective in improving documentation of treatment goals, documentation of communication with patients, carers and health professionals. 4ICPs can be effective in improving physician agreement about treatment options. 5ICPs can be effective in supporting decision-making when they incorporate a decision-aide. 6The evidence considered in this review indicates that ICPs may be particularly effective in changing professional behaviours in the desired direction, where there is scope for improvement or where roles are new. 7Even in contexts in which health professionals are already experienced with a particular pathway, ICP use brings additional beneficial effects in directing professional practice in the desired direction. 8ICPs may be less effective in bringing about service quality and efficiency gains in variable patient trajectories. 9ICPs may be less effective in bringing about quality improvements in circumstances in which services are already based on best evidence and multidisciplinary working is well established. 10Depending on their purpose, the benefits of ICPs may be greater for certain patient subgroups than others. 11We do not know whether the costs of ICP development and implementation are justified by any of their reported benefits. 12ICPs may need supporting mechanisms to underpin their implementation and ensure their adoption in practice, particularly in circumstances in which ICP use is a significant change in organisational culture. 13ICP documentation can introduce scope for new kinds of error. Conclusions, ICPs are most effective in contexts where patient care trajectories are predictable. Their value in settings in which recovery pathways are more variable is less clear. ICPs are most effective in bringing about behavioural changes where there are identified deficiencies in services; their value in contexts where inter-professional working is well established is less certain. None of the studies reviewed included an economic evaluation and thus it is not known whether their benefits justify the costs of their implementation. [source] Extemporaneous product use in paediatric patients: a systematic reviewINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2008Ms Jennifer A Giam pharmacist, postgraduate student Objective To identify the relative extent of extemporaneous product use reported in the paediatric population and the implications for pharmacy practice. Method A systematic literature review was undertaken to identify the prevalence of extemporaneous product use in paediatric patients including those studies examining both ,off-label' and unlicensed medicine use from which extemporaneous products were separately identified and compared to licensed drug use. Key findings Twenty studies were identified and evaluated in which extemporaneous products prepared by a pharmacy or licensed manufacturer could be identified. Although prescribing of unlicensed drugs and licensed drugs used ,off-label' occurs more frequently in younger children and for more serious conditions, the use of extemporaneous products is consistent across all age groups and therapeutic areas. Studies using pharmacy dispensing records identified details of extemporaneous products more accurately than studies using prescribing records. Despite efforts to improve the availability of suitable licensed medicine products for children, extemporaneously prepared products are still needed to ensure that optimal drug therapy is available to children in accurate and effective doses and dosage forms. Conclusions Paediatric patients have a continuing need for extemporaneously prepared medicines when suitable dose forms are unavailable from manufacturers. Pharmacists require access to stability, compatibility and formulation information, as well as appropriate training to ensure patients are supplied with high-quality, safe and effective preparations. [source] Developing an advanced nurse practitioner service in emergency care: attitudes of nurses and doctorsJOURNAL OF ADVANCED NURSING, Issue 3 2006Miriam Griffin MSc RGN PGCSNP Aim., This paper reports a study to determine the attitudes of nurses, doctors and general medical practitioners towards the development of an advanced nurse practitioner service within an emergency department. Background., The role of advanced nurse practitioner in emergency care has emerged in a number of countries, and has brought with it confusion about titles, role boundaries, clinical accountability and educational requirements. Initially, the role resulted from a need for healthcare professionals to provide a service to the increased numbers of patients presenting to hospital with less urgent problems. Since then, the service has evolved to one where nurse practitioners provide high-quality and cost-effective care to persons who seek help for non-urgent, urgent or emergent conditions in a variety of emergency care settings. However, little research could be identified on the attitudes of relevant nursing and medical staff towards the development of this role. Methods., A questionnaire survey was carried out, and a 29-item Likert rating scale was developed to measure attitudes. Along with some demographic variables, two open-ended questions were added to allow respondents to elaborate on what they perceived as benefits and difficulties associated with an advanced nurse practitioner service. All general practitioners, emergency nurses and emergency doctors in one health board in the Republic of Ireland were targeted, and 25 emergency nurses, 13 emergency doctors and 69 general practitioners were approached to take part. Data were collected in February 2004. Findings., An overall response rate of 74·8% was achieved. All respondents were positive towards the development of an advanced nurse practitioner service, with general practitioners being less positive. The principal differences appeared between general practitioners and hospital emergency care staff. Conclusion., There is a need for a multidisciplinary approach to the planning of advanced nurse practitioner services. To achieve multiprofessional acceptance, an accredited and standardized education programme is required, and this must address existing role boundaries. [source] Spring Cereals for Forage and Grain Production in a Cool Maritime ClimateJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 1 2003A. G. Todd Abstract Newfoundland's climate is marginal for agricultural production. The availability of locally grown cereal grain and high-quality forage are major limitations to successful animal agriculture in this region. Here, our overall objective was to compare several spring cereal species for both annual forage and grain production in Newfoundland's cool Maritime climate. Several varieties of barley (Hordeum vulgare L.), wheat (Triticum aesitivum L.), oats (Avena sativa L.) and pea (Pisum sativum L.),cereal mixtures for forage yield and quality, as well as grain yield and maturity, were compared in field trials on the east and west coasts in both 1999 and 2000. Barley headed earliest, yielded greatest forage dry matter, had lowest forage protein and acid detergent fibre (ADF) percentages, and had neutral detergent fibre (NDF) mean values greater than those of pea,cereal mixtures, but less than those of oats and wheat. Forage harvested from pea,cereal mixtures was similar to that of barley for yield, ADF and NDF, while P and protein percentage were much greater. Barley matured 10,15 days earlier than both wheat and oats. In general terms, all three spring cereals exhibited similar grain yield potential. Oats tillered less, but compensated by producing more kernels spike,1. Days to maturity for cereal grains in western Newfoundland were roughly similar to those reported for the Maritime provinces of Canada. Yield and maturity results for both forage and grain production suggest that eastern Newfoundland is a unique agro-ecoregion in North America, and agronomic recommendations specific to other regions may not be applicable in this region. [source] Mentoring: A Key Strategy to Prepare the Next Generation of Physicians to Care for an Aging AmericaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2009Heidi K. White MD Mentoring is an important instructional strategy that should be maximally used to develop the next generation of physicians who will care for a growing population of frail older adults. Mentoring can fulfill three specific purposes: (1) help learners choose an area of specialty, (2) help fellows and new faculty navigate advancement in the academic environment, and (3) help new physicians enter a local medical community and develop a high-quality, professionally rewarding, financially viable practice that meets the needs of older adults. The components and process of mentoring are reviewed. Current and potential mechanisms to promote mentoring for the specific purpose of increasing the quality and quantity of physicians available to care for the older adult population are discussed. [source] Caring for Older Americans: The Future of Geriatric MedicineJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue S6 2005American Geriatrics Society Core Writing Group of the Task Force on the Future of Geriatric Medicine In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate palliative care. Geriatric medicine has developed new models of care, advanced the treatment of common geriatric conditions, and advocated for the health and health care of older persons. Nevertheless, at the beginning of the 21st century, the health care of older persons is at a crossroads. Despite the substantial progress that geriatric medicine has made, much more remains to be done to meet the healthcare needs of our aging population. The clinical, educational, and research approaches of the 20th century are unable to keep pace and require major revisions. Maintaining the status quo will mean falling further and further behind. The healthcare delivery and financing systems need fundamental redesign to improve quality and eliminate waste. The American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has identified five goals aimed at optimizing the health of older persons: ,,To ensure that every older person receives high-quality, patient-centered health care ,,To expand the geriatrics knowledge base ,,To increase the number of healthcare professionals who employ the principles of geriatric medicine in caring for older persons ,,To recruit physicians and other healthcare professionals into careers in geriatric medicine ,,To unite professional and lay groups in the effort to influence public policy to continually improve the health and health care of seniors Geriatric medicine cannot accomplish these goals alone. Accordingly, the Task Force has articulated a set of recommendations primarily aimed at the government, organizations, agencies, foundations, and other partners whose collaboration will be essential in accomplishing these goals. The vision described in this document and the accompanying recommendations are only the broad outline of an agenda for the future. Geriatric medicine, through its professional organizations and its partners, will need to mobilize resources to identify and implement the specific steps that will make the vision a reality. Doing so will require broad participation, consensus building, creativity, and perseverance. The consequences of inaction will be profound. The combination of a burgeoning number of older persons and an inadequately prepared, poorly organized physician workforce is a recipe for expensive, fragmented health care that does not meet the needs of our older population. By virtue of their unique skills and advocacy for the health of older persons, geriatricians can be key leaders of change to achieve the goals of geriatric medicine and optimize the health of our aging population. Nevertheless, the goals of geriatric medicine will be accomplished only if geriatricians and their partners work in a system that is designed to provide high-quality, efficient care and recognizes the value of geriatrics. [source] Effect of High Pressure Pasteurization on Bacterial Load and Bioactivity of Echinacea PurpureaJOURNAL OF FOOD SCIENCE, Issue 7 2010Xiu-Min Chen Abstract:, High hydrostatic pressure (HHP) technology was applied to organic Echinacea purpurea (E. purpurea) roots and flowers to determine the feasibility of using this technology for cold herb pasteurization, to produce microbiologically safe and shelf-stable products for the natural health products (NHPs) industry. HHP significantly (P < 0.01) reduced microbial contamination in both roots and flowers without affecting the phytochemical retention of chicoric and chlorogenic acids, and total alkamide contents. The antioxidant activity of E. purpurea methanol-derived extracts, evaluated in both chemical (2,2,-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) [ABTS] and oxygen radical absorption capacity [ORAC] assay) and in cell culture models (RAW264, 7 macrophage, H2O2 -induced intracellular oxidation, and lipopolysaccharide [LPS]-induced nitric oxide production), was not adversely affected by the application of HHP at both 2 and 5 min at 600 mPa. Furthermore, HHP did not affect the capacity of E. purpurea extracts to suppress nitric oxide production in LPS-activated macrophage cells. Therefore, our results show that HHP is an effective pasteurization process treatment to reduce microbial-contamination load while not adversely altering chemical and bioactive function of active constituents present in organic E. purpurea. Practical Application:, Our study reports for the first time, the effectiveness of using high hydrostatic pressure (HHP) technology pressure to pasteurize E. purpurea root and flower, and the comparative retention of bioactive phytochemicals. Therefore, this technique can be used in food and natural health product industries to produce high-quality, microbiologically safe, and shelf-stable products. [source] Temporal Changes in Brain Volume and Cognition in a Randomized Treatment Trial of Vascular DementiaJOURNAL OF NEUROIMAGING, Issue 1 2001Joseph P. Broderick MD ABSTRACT Objective. To measure changes in brain and ischemic volume over time by magnetic resonance imaging (MRI) as part of a randomized treatment trial of vascular dementia. Methods. Participants who met criteria for vascular dementia underwent comprehensive neurological and neuropsychological testing on entrance, during, and at completion of the 1-year study. For those centers who had easily available MRI, MRI of the brain was to be performed on entry and completion of the study. Image analysis was performed on all balanced and T2-weighted MR films to determine ventricular, sulcal, ischemic, and hemispheric brain volumes. Results. Of the 105 patients who met the criteria for vascular dementia, 40 had a baseline MRI study that met protocol requirements and was of excellent image quality. The baseline ventricular volume in these 40 patients with high-quality MR correlated with most measures of cognitive and behavioral function, including the total Alzheimer's Disease Assessment Score (ADAS) (r= 0.51, P= .0024), as well as activities of daily living (r= 0.61, P= .0002). The baseline ischemic brain volume correlated well only with the gait and postural stability scale (r= 0.74, P= .009). Of the 40 participants, 25 had MRI studies at baseline and at completion of the study that were comparable and of excellent image quality. For these 25 patients, the mean ventricular volumes increased by 9% over the study year (P= .001) and the mean ischemic brain volume increased by 18% (P= .01). Temporal changes in the sulcal and nonischemic brain volume did not reach significance. None of the 14 clinical score measures changed significantly between baseline and completion of the study in these 25 patients. Conclusion. In summary, ventricular volume correlated well with cognitive measures in patients with vascular dementia and was a more sensitive marker for change during the study year than the clinical scales used in this study. This study also points out the practical limitations of brain imaging as a surrogate measure of clinical outcome in multicenter randomized treatment trials of brain disease. [source] Historical instrumental climate data for Australia,quality and utility for palaeoclimatic studies,JOURNAL OF QUATERNARY SCIENCE, Issue 7 2006Neville Nicholls Abstract The quality and availability of climate data suitable for palaeoclimatic calibration and verification for the Australian region are discussed and documented. Details of the various datasets, including problems with the data, are presented. High-quality datasets, where such problems are reduced or even eliminated, are discussed. Many climate datasets are now analysed onto grids, facilitating the preparation of regional-average time series. Work is under way to produce such high-quality, gridded datasets for a variety of hitherto unavailable climate data, including surface humidity, pan evaporation, wind, and cloud. An experiment suggests that only a relatively small number of palaeoclimatic time series could provide a useful estimate of long-term changes in Australian annual average temperature. Copyright © 2006 John Wiley & Sons, Ltd. [source] TIEBOUT DYNAMICS: NEIGHBORHOOD RESPONSE TO A CENTRAL-CITY/SUBURBAN HOUSE-PRICE DIFFERENTIAL,JOURNAL OF REGIONAL SCIENCE, Issue 4 2007Paul Thorsnes ABSTRACT We take advantage of an unusual natural experiment,a high-quality 1920s subdivision split neatly in half by a central-city/suburban boundary,to study the response over 30 years to the relative decline in the quality of central-city services since the 1960s. As expected, a large sale price differential opens in the 1960s. Demographic characteristics are nevertheless similar across the boundary. Survey data indicate Tiebout sorting: the central city side attracts households who prefer alternatives to suburban public schools. Children attend parochial and public "magnet" schools. A neighborhood association supplements municipal services. Rigid service district boundaries inhibit closure of the house-price differential. [source] | |||||||||||||||||||||||||||||||||||||