Home About us Contact
|
Home About us Contact | ||
|
|
||
Likely Benefit (likely + benefit)
Selected AbstractsPrediction rules for computed tomography in the dementia assessment: do they predict clinical utility of CT?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2003Kelly A. Condefer Abstract Neuroimaging is widely employed in the dementia assessment in refining clinical decision-making. However, with rising interest in cost-effective medical practice, efforts have been made in the literature to define clinical prediction rules that select for a subgroup of patients who would most likely benefit from neuroimaging. This short study examined the ability of a group of published clinical predictors to identify patients whose diagnoses or management would be influenced by CT scan results. The study finds that none of the published predictors bears a significant relationship to actual influence of CT scans in a group of memory clinic patients, highlighting the need for the development of clinical predictors for neuroimaging that will impact patient care. Copyright © 2003 John Wiley & Sons, Ltd. [source] Antiplatelet Therapy: Anti-Ischemic Benefits versus Bleeding RiskJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2008C. MICHAEL GIBSON M.D., F.A.C.C. Balance between efficacy and safety is a major concern in therapeutic interventions of patients with acute coronary syndromes. Identifying and managing the risks that may negatively affect this balance can potentially minimize the incidence of morbidity and/or mortality among patients with acute coronary syndromes. Unstable angina and non-ST-elevation myocardial infarction are potentially life-threatening disorders and a major cause of hospitalization and emergency medical care. At the time of presentation, the use of algorithms that provide reasonable assessment of a patient's risk of cardiovascular events, such as the Thrombolysis in Myocardial Infarction risk score, can help clinicians identify which patients will most likely benefit from a specific strategy. The ultimate goal of treatment for non-ST-elevation myocardial infarction is to reduce short- and long-term morbidity and mortality, as well as salvage myocardial cells and cardiac function. Pharmacologic intervention with antiplatelet and/or antithrombotic agents has proven to be effective in achieving this goal in numerous outcome studies. However, clinicians must balance anti-ischemic efficacy with the need to minimize the risk of serious bleeding complications (e.g., hemorrhage). Issues related to safety include timing of the dose, duration of infusion, drug compatibility, errors in estimating a patient's weight and/or age, failure to adjust the dosage based upon renal function, and errors in drug preparation. [source] Use of the Internet by parents of paediatric patientsJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9 2006Brynn K Wainstein Aim: We aimed to determine the rate of Internet use for obtaining medical information by health-care patients at a tertiary paediatric hospital, whether the Internet may influence patients' attitudes to health-care services and health-care providers and whether patients would prefer the assistance of a professional informatics officer. Methods: An anonymous questionnaire randomly distributed to 450 subjects at Sydney Children's Hospital, Sydney, Australia. Results: A total of 294 (65%) questionnaires were returned. Overall Internet use for medical information was 64% (189/294). Most (97%; 183/189) respondents reported ,wanting to know more' as the reason they sought information on the Internet. Eighty-eight per cent (167/189) of respondents reported that they trust their doctor more than the Internet. Twenty-one per cent (39/189) had presented their doctor with information about which he/she was unaware and 18% (34/189) had altered a health-care decision because of information found on the Internet. The Internet had influenced questions asked of doctors in 83% (156/189). Eighty-six per cent (252/294) of all respondents were in favour of professional assistance to obtain medical information. Conclusion: A large number of patients use the Internet to find information that influences their attitudes to health care. The services of a medical informatics professional would likely benefit both patients and doctors. [source] Customising an antibody leukocyte capture microarray for systemic lupus erythematosus: Beyond biomarker discoveryPROTEOMICS - CLINICAL APPLICATIONS, Issue 2 2010Joshua W. K. Ho Abstract Systemic lupus erythematosus (SLE) is a complex autoimmune disease that has heterogeneous clinical manifestation with diverse patterns of organ involvement, autoantibody profiles and varying degrees of severity of disease. Research and clinical experience indicate that different subtypes of SLE patients will likely benefit from more tailored treatment regimes, but we currently lack a fast and objective test with high enough sensitivity to enable us to perform such sub-grouping for clinical use. In this article, we review how proteomic technologies could be used as such an objective test. In particular, we extensively review many leukocyte surface markers that are known to have an association with the pathogenesis of SLE, and we discuss how these markers can be used in the further development of a novel SLE-specific antibody leukocyte capture microarray. In addition, we review some bioinformatics challenges and current methods for using the data generated by these cell-capture microarrays in clinical use. In a broader context, we hope our experience in developing a disease specific cell-capture microarray for clinical application can be a guide to other proteomic practitioners who intend to extend their technologies to develop clinical diagnostic and prognostic tests for complex diseases. [source] Molecular targeted therapies for diffuse large B-cell lymphoma based on apoptosis profiles,THE JOURNAL OF PATHOLOGY, Issue 5 2010Saskia AGM Cillessen Abstract Diffuse large B-cell lymphoma (DLBCL) is the most common type of adult non-Hodgkin lymphoma and is treated with chemotherapy in combination with rituximab. Despite this aggressive therapy, the disease is fatal in 30,40% of patients. Inhibition of the apoptosis signalling pathways is strongly related to response to chemotherapy and eventual clinical outcome. In order to survive, lymphoma cells depend on disruption of the apoptosis pathway by mutations in apoptosis inducing genes or by continuous expression of anti-apoptotic proteins. The development of molecules targeting these apoptosis inhibitors provides a very promising opportunity to specifically target tumour cells without toxicity to non-malignant cells in DLBCL patients. Sensitivity for most of these antagonists can be predicted based on biological markers, suggesting the possibility of pre-defining patients who will most likely benefit from these targeted therapies. Experimental therapies aimed at restoring the upstream apoptosis pathway or targeting apoptosis inhibitors are currently being tested in clinical trials and are expected to be effective particularly in chemotherapy-refractory DLBCL, providing hope for patients who are refractory to current therapies. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] Opportunities for enhanced collaboration within the data assimilation communityTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 613 2005Dennis McLaughlin Abstract Recent advances in sensor technology, telecommunications and computation open up new possibilities for the application of data assimilation concepts across the Earth sciences. As a result, the data assimilation community is expanding beyond meteorology and oceanography to include representatives from climatology, hydrology, atmospheric chemistry, ecology and other disciplines. This development offers new opportunities for collaboration between the operational and research sides of the community. Opportunities exist not only in traditional forecasting applications, but also in areas such as reanalysis, model diagnosis, development of new model parametrizations, and observing-system design. Disciplinary scientists from outside the traditional data assimilation community are starting to appreciate that data assimilation can provide an integrated view of earth processes over a range of time and space scales. Operational data assimilation groups have special expertise and capabilities that are needed by newcomers to the field. If the scope of the operational community expands to include a wider range of applications, the entire field will likely benefit from new ideas, new resources, and increased visibility and recognition. Copyright © 2005 Royal Meteorological Society [source] Restoring prairie pothole wetlands: does the species pool concept offer decision-making guidance for re-vegetation?APPLIED VEGETATION SCIENCE, Issue 2 2006Susan M. Galatowitsch Anon. (2004) Abstract Question: Do regional species pools, landscape isolation or on-site constraints cause plants from different guilds to vary in their ability to colonize restored wetlands? Location: Iowa, Minnesota, and South Dakota, USA. Methods: Floristic surveys of 41 restored wetlands were made three and 12 years after reflooding to determine changes in local species pools for eight plant guilds. The effect of landscape isolation on colonization efficiency was evaluated for each guild by plotting local species pools against distance to nearby natural wetlands, and the relative importance of dispersal vs. on-site constraints in limiting colonization was explored by comparing the local species pools of restored and natural wetlands within the region. Results: Of the 517 wetland plant taxa occurring in the region, 50% have established within 12 years. The proportion of the regional species pool represented in local species pools differed among guilds, with sedge-meadow perennials, emergent perennials and floating/submersed aquatics least represented (33-36%) and annual guilds most represented (74-94%). Colonization-to-extinction ratios suggest that floating/submersed aquatics have already reached a species equilibrium while sedge-meadow and emergent perennials are still accumulating species. Increasing distance to nearest wetlands decreased the proportion of the regional species pool present in local pools for all guilds except native annuals and woody plants. The maximum proportion predicted, assuming no distance constraint, was comparable to the lowest-diversity natural wetlands for most perennial guilds, and also lower than what was achieved in a planted, weeded restoration. Conclusions: A biotic constraints seem to limit the colonization of floating/submersed aquatics into natural or restored wetlands, whereas all other guilds are potentially constrained by dispersal or biotic factors (i.e. competition from invasive species). Using species pools to evaluate restoration progress revealed that immigration potential varies considerably among guilds, that local species richness does not necessarily correspond to immigration limitations, and that some guilds (e.g. sedge-meadow perennials) will likely benefit more than others from being planted at restoration sites. [source] Antenatal Perineal Massage for Reducing Perineal TraumaBIRTH, Issue 2 2006M.M. Beckmann Background:, Perineal trauma following vaginal birth can be associated with significant short- and long-term morbidity. Antenatal perineal massage has been proposed as one method of decreasing the incidence of perineal trauma. Objectives:, To assess the effect of antenatal perineal massage on the incidence of perineal trauma at birth and subsequent morbidity. Search strategy:, We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 January 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2005), PubMed (1966 to January 2005), EMBASE (1980 to January 2005) and reference lists of relevant articles. Selection criteria:, Randomised and quasi-randomised controlled trials evaluating any described method of antenatal perineal massage undertaken for at least the last four weeks of pregnancy. Data collection and analysis:, Both review authors independently applied the selection criteria, extracted data from the included studies and assessed study quality. We contacted study authors for additional information. Main results:, Three trials (2434 women) comparing digital perineal massage with control were included. All were of good quality. Antenatal perineal massage was associated with an overall reduction in the incidence of trauma requiring suturing (three trials, 2417 women, relative risk (RR) 0.91 (95% confidence interval (CI) 0.86 to 0.96), number needed to treat (NNT) 16 (10 to 39)). This reduction was statistically significant for women without previous vaginal birth only (three trials, 1925 women, RR 0.90 (95% CI 0.84 to 0.96), NNT 14 (9 to 35)). Women who practised perineal massage were less likely to have an episiotomy (three trials, 2417 women, RR 0.85 (95% CI 0.75 to 0.97), NNT 23 (13 to 111)). Again this reduction was statistically significant for women without previous vaginal birth only (three trials, 1925 women, RR 0.85 (95% CI 0.74 to 0.97), NNT 20 (11 to 110)). No differences were seen in the incidence of 1st or 2nd degree perineal tears or 3rd/4th degree perineal trauma. Only women who have previously birthed vaginally reported a statistically significant reduction in the incidence of pain at three months postpartum (one trial, 376 women, RR 0.68 (95% CI 0.50 to 0.91) NNT 13 (7 to 60)). No significant differences were observed in the incidence of instrumental deliveries, sexual satisfaction, or incontinence of urine, faeces or flatus for any women who practised perineal massage compared with those who did not massage. Authors' conclusions:, Antenatal perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage. *** The preceding report is an Abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464,780X). The Cochrane Database of Systematic Reviews 2006 Issue 1. Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [source] Transgenic fish: an evaluation of benefits and risksFISH AND FISHERIES, Issue 2 2000N. Maclean Transgenic fish have many potential applications in aquaculture, but also raise concerns regarding the possible deleterious effects of escaped or released transgenic fish on natural ecosystems. In this review the potential applications of transgenic fish are considered, the probable benefits reviewed, the possible risks to the environment identified and the measures which might be taken to minimize these risks are evaluated. Growth trials of transgenic fish have already been carried out in outdoor facilities and some of these are discussed in the light of possible risks and benefits. Regarding the hazards associated with release or escape, whilst there is some evidence to suggest that transgenic fish may be less fit compared to their wild counterparts, there is insufficient evidence to say that this will be true in all cases. Using mathematical models, we have attempted to predict the magnitude of the genetic effects in a range of different scenarios. A number of possible containment techniques are considered, amongst which containment by sterility is probably the most promising. This can be engineered either by triploidy or by transgenic methods. The conclusions include a tabulated balance sheet of likely benefits and risks, with appropriate weighting. [source] Mutual, non-profit or public interest company?ANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 2 2002An evaluation of options for the ownership, control of water utilities The purpose of this paper is to evaluate various organizational models for the ownership and control of natural monopolies , specifically the infrastructure of water and sewage provision in England and Wales. First, it summarizes recent discussion of who should own water assets in Britain. The paper notes the opportunity that has arisen for increased consumer involvement, and examines the relative merits of three models that have been suggested as alternatives: a non-profit trust or company, a public interest company, and a consumer mutual. Five criteria are suggested for evaluating the merits of each type: its ability to safeguard the interests of the most important stakeholder, the consumer; avoid the necessity for a heavy regulatory regime; incentivize management to manage efficiently but without ,producer capture'; raise capital relatively cheaply; and resist pressures to demutualize. The paper agrees with the recent paper in this Journal by Morse (2000) that, in theory, the consumer mutual has advantages. It draws on Hansmann's work that suggests consumer ownership of water would be less costly than investor-ownership, providing there are no large conflicts of interest between different types of consumer. Hansmann's thesis is expanded to consider the likely benefits from wider member participation, and the hidden costs of not taking members into account. It then tests out whether customers would be motivated in practice to be active members, introducing a theoretical model of what motivates members of co-operatives and mutuals to participate. The conclusions are that provided managers and board members are committed to encouraging member participation, the consumer mutual model would work well. It would need only light regulation, would avoid producer capture, and would be able to raise capital fairly easily, both from money markets and from members. It would need legislation to prevent it from being demutualized at some time in the future. However, if a participatory corporate culture cannot be guaranteed, or if there is a risk of decline of participation over time, other options such as a non-profit trust or a public interest company would be less risky. [source] The potential of L-band SAR for quantifying mangrove characteristics and change: case studies from the tropicsAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 3 2007Richard M. Lucas Abstract 1.The Japan Aerospace Exploration Agency's (JAXA) Advanced Land Observing Satellite (ALOS) L-band Phased Array Synthetic Aperture Radar (PALSAR), launched successfully in January 2006, will provide new data sets for coastal ecosystems mapping and change monitoring at local to global scales. 2.To evaluate L-band capability for mangrove applications, data acquired by the NASA airborne SAR (AIRSAR) and Japanese Earth Resources Satellite (JERS-1 SAR) over sites in Australia, French Guiana and Malaysia were used to demonstrate benefits for mapping extent and zones, retrieving biomass and structural attributes (e.g. height), and detecting change. 3.The research indicates that mapping is most effective where mangroves border non-forested areas and where differences in structure, as a function of species, growth stage and biomass distributions, occur between zones. 4.Using L-band SAR, biomass can be retrieved up to ,100,140 Mg ha,1, although retrieval is complicated by a noticeable decrease in L-band backscattering coefficient within higher (,>200 Mg ha,1) biomass stands, particularly those with extensive prop root systems. 5.Change detection through multi-temporal comparison of data proved useful for mapping deforestation/regeneration and mangrove dynamics associated with changing patterns of sedimentation. 6.The research highlights the likely benefits and limitations of using ALOS PALSAR data and supports JAXA's Kyoto & Carbon (K&C) Initiative in promoting the use of these data for regional mangrove assessment. Copyright © 2007 John Wiley & Sons, Ltd. [source] | ||||||||||||||||