Home About us Contact
|
Home About us Contact | ||
|
|
||
Least Common (least + common)
Selected AbstractsIdiopathic myelofibrosis: pathogenesis to treatmentHEMATOLOGICAL ONCOLOGY, Issue 2 2006John T Reilly Abstract Idiopathic myelofibrosis (IMF) is the least common of the chronic myeloproliferative disorders and carries the worst prognosis with a median survival of 4 years. It is a clonal haematopoietic stem-cell disorder and, although the pathogenesis remains unclear, approximately 50% of cases are known to possess an activating JAK2 V617F mutation. In contrast, the characteristic stromal proliferation is a reactive, or secondary, event that results from the aberrant release of a variety of growth factors from megakaryocytes and monocytes. Treatment for most cases is supportive, although androgens, recombinant erythropoietin, steroids and thalidomide are effective modalities for the amelioration of anaemia. Myelosuppression, splenectomy and irradiation are valuable therapeutic modalities for specific clinical situations. Prognostic scores are available to aid the identification of cases for whom bone marrow transplantation should be considered. Recently, the use of reduced intensity conditioning has resulted in prolonged survival and lower transplant-related mortality. This review summarises the recent advances in the disease's pathogenesis and discusses the role of the various therapeutic options. Copyright © 2006 John Wiley & Sons, Ltd. [source] On Being a Lone DissenterJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 9 2005Donald Granberg Asch's (1956) research on group pressure to conform implied that it is difficult to be a lone dissenter. Extending this to the analysis of voting patterns in the U.S. Supreme Court's 1953-2001 terms, it was found that of 4,178 decisions, the 8-1 split was the least common (10%). Unanimous decisions were most common (35%), followed by 5-4 splits (21%), 6-3 splits (20%), and 7-2 splits (14%). Large differences were found among the 29 Justices serving during this period as to how often they were lone dissenters, led by Justice William Douglas, who issued lone dissents on about 6% of the decisions on which he voted. [source] Symptoms and signs of temporomandibular disorders and oral parafunctions among Saudi childrenJOURNAL OF ORAL REHABILITATION, Issue 12 2003N. M. A. Farsi summary, This study aimed to record the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunctions among Saudi children. A questionnaire and a clinical examination of signs and symptoms of TMD were performed on 1940 stratified randomly selected schoolchildren. The sample was divided into three groups, 505 with primary, 737 with mixed and 734 with permanent dentition. The prevalence of TMD signs was found to be 20·7% and the most common sign of TMD was joint sounds (11·8%). The second most common sign was restricted mouth opening (5·3%). Muscle and temporomandibular joint (TMJ) pain as well as deviation upon jaw opening appeared infrequently. TMJ sounds were significantly increasing with age (P < 0·05). TMD symptoms as reported by the parents were evident in 24·2% of the returned questionnaires (1113). The most common symptoms were headache (13·6%) and pain on chewing (11·1%). The incidence of headache was found to be significantly increasing from primary to permanent dentition (P < 0·01). No sex difference in the prevalence of any symptom was reported. Nail biting was the most common oral parafunction (27·7%) while bruxism was the least common (8·4%). All parafunctions except bruxism were significantly related to age. Cheek biting and thumb sucking were reported more in females than in males. The importance of a screening examination for symptoms and signs of TMD should not be overlooked in the clinical assessment of the pediatric patient. [source] Challenges in multisource feedback: intended and unintended outcomesMEDICAL EDUCATION, Issue 6 2007Joan Sargeant Context, Multisource feedback (MSF) is a type of formative assessment intended to guide learning and performance change. However, in earlier research, some doctors questioned its validity and did not use it for improvement, raising questions about its consequential validity (i.e. its ability to produce intended outcomes related to learning and change). The purpose of this qualitative study was to increase understanding of the consequential validity of MSF by exploring how doctors used their feedback and the conditions influencing this use. Methods, We used interviews with open-ended questions. We purposefully recruited volunteer participants from 2 groups of family doctors who participated in a pilot assessment of MSF: those who received high (n = 25) and those who received average/lower (n = 44) scores. Results, Respondents included 12 in the higher- and 16 in the average/lower-scoring groups. Fifteen interpreted their feedback as positive (i.e. confirming current practice) and did not make changes. Thirteen interpreted feedback as negative in 1 or more domains (i.e. not confirming their practice and indicating need for change). Seven reported making changes. The most common changes were in patient and team communication; the least common were in clinical competence. Positive influences upon change included receiving specific feedback consistent with other sources of feedback from credible reviewers who were able to observe the subjects. These reviewers were most frequently patients. Discussion, Findings suggest circumstances that may contribute to low consequential validity of MSF for doctors. Implications for practice include enhancing procedural credibility by ensuring reviewers' ability to observe respective behaviours, enhancing feedback usefulness by increasing its specificity, and considering the use of more objective measures of clinical competence. [source] | ||||||||||