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Limited Use (limited + use)
Selected AbstractsLimited Use of Complementary and Alternative Medicine in Israeli Head and Neck Cancer PatientsTHE LARYNGOSCOPE, Issue 8 2005FACS, Yoav P. Talmi MD Abstract Hypothesis/Objective: The use of complementary or alternative medicine (CAM) is growing among cancer patients. A Medline search failed to reveal any dedicated report of CAM use specifically in patients with head and neck cancer (HNC). Study Design: Use of CAM was evaluated in a cohort of treated HNC patients. Methods: Patients treated for HNC were asked if they had used CAM since their diagnosis. Demographic data and data pertaining to mode of CAM, duration of treatment and effects were obtained. Results: One hundred forty-three patients (mean age 61 years) were included. Only nine patients (6.3%) reported using disease related CAM. This included acupuncture (4), Reiki (2), naturopathy (2), hypnosis (1), shiatsu (1), chiropractic treatment (1), homeopathy (1), and selenium (1). Conclusion: Contrary to the reported use, few of our HNC patients used CAM. Although this could be related to good caregiver-patient relationship, further studies in comparable populations are warranted to evaluate if this is a local or a pervading finding in head and neck cancer patients. [source] Early and Limited Use of Tacrolimus to Avoid Rejection in an Alemtuzumab and Sirolimus Regimen for Kidney Transplantation: Clinical Results and Immune MonitoringAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2009S. J. Knechtle Alemtuzumab induction with 60 days of tacrolimus treatment and continuous sirolimus treatment prevented acute rejection in nine of 10 consecutive renal allograft recipients. All patients are alive with a functioning kidney graft at 27,39 months of follow-up. Extensive immune monitoring was performed in all patients. Alloantibody detection, cytokine kinetics assay (CKA), and trans vivo delayed-type hypersensitivity (DTH) assay were performed every 6 months showing correlation with clinical evolution. Despite alloantibody presence in five patients, eight patients remain without the need for specific treatment and only sirolimus monotherapy in decreasing dosage. Four patients take only 1 mg sirolimus daily with levels of 3,4 ng/mL. One patient showed clinical signs of rejection at month 9 post-transplant, with slow increase in serum creatinine and histological signs of mixed cellular (endarteritis) and humoral rejection (C4d positivity in peritubular capillaries and donor-specific antibody (DSA)). In summary, the addition of tacrolimus therapy for 2 months to a steroid-free, alemtuzumab induction and sirolimus maintenance protocol limited the previously shown acute rejection development. Nevertheless, alloantibody was present in serum and/or C4d present on 1-year biopsy in half the patients. The combination of CKA and DSA monitoring or the performance of transvivo DTH correlated with immune status of the patients. [source] Ageing and unused capacity in Europe: is there an early retirement trap?ECONOMIC POLICY, Issue 59 2009Viola Angelini Summary We address the issue of how early retirement may interact with limited use of financial markets in producing financial hardship later in life, when some risks (such as long-term care) are not insured. We argue that the presence of financially attractive early retirement schemes in a world of imperfect financial and insurance markets can lead to an ,early retirement trap'. Indeed, Europe witnesses many (early) retired individuals in financial distress. In our analysis we use data on 10 European countries, which differ in their pension and welfare systems, in prevailing retirement age and in households' access to financial markets. We find evidence that an early retirement trap exists, particularly in some Southern and Central European countries: people who retired early in life are more likely to be in financial hardship in the long run. Our analysis implies that governments should stop making early retirement attractive, let retirees go back to work, improve access to financial markets and make sure long-term care problems are adequately insured. , Viola Angelini, Agar Brugiavini and Guglielmo Weber [source] Sample complexity reduction for two-dimensional electrophoresis using solution isoelectric focusing prefractionationELECTROPHORESIS, Issue 12 2008Matthew R. Richardson Abstract Despite its excellent resolving power, 2-DE is of limited use when analyzing cellular proteomes, especially in differential expression studies. Frequently, fewer than 2000 protein spots are detected on a single 2-D gel (a fraction of the total proteome) regardless of the gel platform, sample, or detection method used. This is due to the vast number of proteins expressed and their equally vast dynamic range. To exploit 2-DE unique ability as both an analytical and a preparative tool, the significant sample prefractionation is necessary. We have used solution isoelectric focusing (sIEF) via the ZOOM® IEF Fractionator (Invitrogen) to generate sample fractions from complex bacterial lysates, followed by parallel 2-DE, using narrow-range IPG strips that bracket the sIEF fractions. The net result of this process is a significant enrichment of the bacterial proteome resolved on multiple 2-D gels. After prefractionation, we detected 5525 spots, an approximate 3.5-fold increase over the 1577 spots detected in an unfractionated gel. We concluded that sIEF is an effective means of prefractionation to increase depth of field and improve the analysis of low-abundance proteins. [source] Comprehensive comparison of FISH, RT-PCR, and RQ-PCR for monitoring the BCR-ABL gene after hematopoietic stem cell transplantation in CMLEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2002Yoo-Jin Kim Abstract: The reverse transcriptase-polymerase chain reaction (RT-PCR) was compared with fluorescence in situ hybridization (FISH) and real-time quantitative RT-PCR (RQ-PCR) for minimal residual disease (MRD) monitoring in 266 post-transplant bone marrow samples from 78 patients with chronic myelogenous leukemia (CML). The sensitivities of FISH to BCR-ABL positive samples determined by first-round (1st) RT-PCR, second-round (2nd) RT-PCR, and RQ-PCR were 64.2%, 25.8%, and 20.7%, respectively. The BCR-ABL/ABL ratio by RQ-PCR had a mean of 0.000,13 in the 1st RT-PCR-negative samples and 1.42 in the 1st RT-PCR-positive samples (P<0.001), and means of 0.000,39 and 0.51 in the 2nd RT-PCR-negative and -positive samples (P< 0.001). The mean ratios of BCR-ABL/ABL by RQ-PCR were significantly different in N/N (1st/2nd RT-PCR) or N/P and P/P (P<0.001), but not in N/N and N/P, which showed that the discriminative power of RQ-PCR is confined to the 1st RT-PCR level. In this respect, monitoring of the 1st RT-PCR might be useful for estimating normalized BCR-ABL levels after transplantation. Nested RT-PCR was of limited use, as RQ-PCR quantified the BCR-ABL transcripts in 60 (91%) of 66 samples determined to be negative by 2nd RT-PCR. FISH was significantly correlated with RQ-PCR in FISH-positive samples (n=24, r=0.79, P=0.001). An increase of FISH preceded that of RQ-PCR in a few cases with molecular relapse. By analyzing a large number of samples post-transplant, we found that RQ-PCR might be the most useful assay for MRD monitoring; however, FISH and RT-PCR were found to be useful complementary tools. [source] Species-level effects more important than functional group-level responses to elevated CO2: evidence from simulated turvesFUNCTIONAL ECOLOGY, Issue 3 2004M. E. HANLEY Summary 1Using mixtures of 14 calcareous grassland plant species drawn from three functional groups, we looked at the effects of elevated atmospheric CO2 on contrasting levels of ecosystem performance (species, functional group and community). Experimental communities were subjected to ambient (,350 µmol mol,1) or elevated CO2 (,600 µmol mol,1) in controlled environments, with grazing simulated by clipping at monthly intervals for 546 days. 2We assessed the effect of elevated CO2 on plant performance by quantifying the productivity (biomass) and cover of component species. We also examined the effect of elevated CO2 on the vertical structure of the plant canopy. Elevated CO2 resulted in a significant increase in total community biomass only following nutrient addition. Within functional groups, non-leguminous forb species had significantly greater biomass and cover in elevated CO2 both before and after nutrient addition, although the effect was mainly due to the influence of one species (Centaurea nigra). Grasses, in contrast, responded negatively to elevated CO2, although again significant reductions in biomass and cover could mainly be ascribed to a single species (Brachypodium pinnatum). Legumes exhibited increased biomass and cover in elevated CO2 (the effects being particularly marked for Anthyllis vulneraria and Lotus corniculatus), but this response disappeared following nutrient addition. Vertical structure was little affected by CO2 treatment. 3We conclude that due to the idiosyncratic responses of individual species, the categorization of plants into broad functional groups is of limited use in guiding our understanding of the impacts of elevated atmospheric CO2 on plant communities. [source] A brief study of applications of the generalized reciprocal method and of some limitations of the methodGEOPHYSICAL PROSPECTING, Issue 5 2000Bengt Sjögren An analysis of the generalized reciprocal method (GRM), developed by Palmer for the interpretation of seismic refraction investigations, has been carried out. The aim of the present study is to evaluate the usefulness of the method for geotechnical investigations in connection with engineering projects. Practical application of the GRM is the main object of this study rather than the theoretical/mathematical aspects of the method. The studies are partly based on the models and field examples presented by Palmer. For comparison, some other refraction interpretation methods and techniques have been employed, namely the ABC method, the ABEM correction method, the mean-minus-T method and Hales' method. The comparisons showed that the results, i.e. the depths and velocities determined by Palmer, are partly incorrect due to some errors and misinterpretations when analysing the data from field examples. Due to the limitations of the GRM, some of which are mentioned here, stated by Palmer in his various publications, and other shortcomings of the method (e.g. the erasing of valuable information), the GRM must be regarded as being of limited use for detailed and accurate interpretations of refraction seismics for engineering purposes. [source] Dynamic macroecology on ecological time-scalesGLOBAL ECOLOGY, Issue 1 2010Jonathan A. D. Fisher ABSTRACT Aim, The discipline of macroecology is increasingly being regarded as an effective vehicle for the evaluation of recent population- to ecosystem-level responses to widespread human and environmental influences. However, due to the prevalent use of time-averaged and cumulative data in macroecological analyses, the majority of the patterns that emerge from research in this field can be regarded as static. Here we review the application of dynamic macroecological analyses to changes in relationships between macroecological variables on seasonal to decadal scales. We illustrate the strength of this perspective for documenting changing patterns and testing hypotheses related to these dynamics on ecological time-scales. Location, Studies were compiled and reviewed from terrestrial and aquatic ecosystems. Methods, We review examples of temporal changes in macroecological patterns driven by recent anthropogenic influences and environmental change. Results, The dynamic nature of macroecological patterns on ecological time-scales has been revealed in recent years across a wide range of ecosystems, largely through the development, maintenance and analysis of biotic and environmental monitoring time series. The resultant analyses complement examinations of dynamics over evolutionary time and have similarly revealed that static portrayals can conceal important temporal dynamics that underlie the patterns of interest. As a consequence, static depictions, resting as they do on comparative analyses in which the validity of space-for-time substitutions is assumed, may be of limited use for testing hypotheses related to the mechanisms underlying the patterns revealed and, by extension, the development of reliable predictions of future states. Main conclusions, Recent dynamic macroecological analyses have demonstrated the utility of combined spatial and temporal replication, and have contributed to hypothesis testing related to the mechanistic processes underlying changes in macroecological patterns on ecological time-scales. We suggest four specific avenues of future research to further the development and application of temporal approaches on similar time-scales within the field of macroecology. [source] ,We didn't know it would get that bad': South Asian experiences of dementia and the service responseHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2003Alison Bowes BA PhD Abstract The aim of the present paper was to examine some views and experiences of dementia among older South Asian people, as well as their families and carers, and to explore central issues of service support. Data were collected in Scotland through interviews with 11 professionals working with South Asian people with dementia, and four case studies of South Asian people with a diagnosis of dementia, as well as their families and carers. The case studies demonstrated overwhelmingly negative experiences of dementia, with poor quality of life, desperate needs for support, lack of access to appropriate services, little knowledge of dementia, and isolation from community and family life. The interviews with professionals described a strong demand for services, a need to develop awareness and knowledge about dementia in South Asian communities, and a need to promote more culturally sensitive, individually responsive services. Similarities between South Asian people and the non-South Asian population include stress on carers, increasing isolation, problematic diagnostic practices, lack of knowledge and demand for service support. Differences include limited use of non-National Health Service (NHS) support, dealing with later stages of dementia at home, particularly negative views about residential care, culturally based attitudinal differences and use of the term ,dementia' in English as neutral rather than stigmatising. The present authors suggest that there is little knowledge and experience of dementia in South Asian communities, as well as restricted access to appropriate services, despite the efforts of voluntary sector and NHS special projects. There is demand for services, especially at home. Services need to develop individual responsiveness for effective working in a diverse society. [source] Presentation and comments on EU legislation related to food industries,environment interactions: sustainable development, and protection of nature and biodiversity , genetically modified organismsINTERNATIONAL JOURNAL OF FOOD SCIENCE & TECHNOLOGY, Issue 7 2006Ioannis S. Arvanitoyannis Summary The European Union (EU) legislation regarding sustainable development moves along two distinct lines: the impact of industries (food industries included) on the environment (release of gases and green house effect and the effect of cultivating genetically modified organisms (GMOs) on the environment. EU voted three communications [COM(2002)524, COM(2003)301, COM(2004)38] in an attempt to set an action plan based on technologies to manage pollution, by promoting less polluting and less resource-intensive products and services and ways to manage resources more efficiently. As such environment-friendly technologies pervade practically all economic activities and sectors it is anticipated that they will reduce effectively energy and resource consumption thereby creating fewer emissions and less waste. As regards the cultivation and/or importing of GMOs, EU legislation was based on two directives (E.U. 90/219/EEC, E.U. 2001/18/EC) and four regulations [Regulation (EC) No. 258/97, Regulation (EC) No. 1830/2003, Regulation (EC) No. 1830/2003 and Regulation (EC) No. 1946/2003]. The directives aimed at adopting measures for limited use of GM micro-organisms, making the procedure for granting consent to the deliberate release and placing on the market of GMOs more efficient and more transparent, making GMO labelling compulsory and thereby enhancing GMOs traceability along the entire food chain. [source] Overview of DVB-RCS+M and its developmentINTERNATIONAL JOURNAL OF SATELLITE COMMUNICATIONS AND NETWORKING, Issue 3-4 2010Harald Skinnemoen Abstract The use of DVB-S and DVB-RCS for conducting two-way communications from small satellite terminals has become well established in Europe and elsewhere. During the development of DVB-RCS the possibility of limited use for satellite terminals that were moving was considered in January 2004 and incorporated into the Guideline document associated with the Standard in April 2005. It was noted, however, that this matter could be addressed further as a future development. This paper addresses the steps that have been taken since then to realize this objective. During the last few years, it has been shown that the DVB-S2/DVB-RCS specifications are good candidate baselines for the efficient implementation of broadband services to mobile users. Results of these studies were gathered in a study mission report from the TM-RCS ad hoc group. It was demonstrated that both forward and return channel waveforms are impacted by the mobile usage, and should be addressed in the scope of an update of the DVB-RCS standard. Technical analysis identified that DVB-RCS, as it had been originally designed for fixed satellite services, provided most of the features required by mobile applications above 5,GHz, and could be turned into a competitive solution with a few carefully crafted modifications. Subsequent activities within the TM-RCS Group have led to an efficient and robust standard that incorporates mobility more definitely into version 1.5.1 of the DVB-RCS specifications, along with appropriate detailed ,Guidelines' documentation giving expanded description of the standard and its use and application. Copyright © 2009 John Wiley & Sons, Ltd. [source] Phototactic responses of larvae from the marine sponges Neopetrosia proxima and Xestospongia bocatorensis (Haplosclerida: Petrosiidae)INVERTEBRATE BIOLOGY, Issue 2 2010Rachel Collin Abstract. Previous studies suggest that phototaxis in sponge larvae is generated by the bending of a tuft of long posterior cilia (LPC). The photoresponsiveness of these cilia is often assayed by examining their reaction to sudden changes in light intensity. Here, we document and describe the larvae of the tropical marine sponges Neopetrosia proxima and Xestospongia bocatorensis and examine the phototactic behavior of their larvae. Both species brood ovoid, tufted parenchymella larvae, clearly countering an earlier hypothesis that all petrosid sponges are oviparous. Larvae of N. proxima were positively phototactic and settled after 2 d, while larvae of X. bocatorensis were negatively phototactic and settled in as little as 4 h. In both species, LPC quickly responded to changes in the light intensity. When the light intensity is reduced, the larvae of N. proxima fold the cilia inwards immediately without beating, then flare them outwards, beating for a few seconds, and then gradually return to the neutral position while continuing to beat. In contrast, the larvae of X. bocatorensis flare the cilia outwards when the light intensity is reduced and fold them inwards when the light intensity is increased. Comparisons with reported ciliary responses to light for other species demonstrate that these responses do not show the hypothesized one-to-one correspondence with phototactic behaviors and are, therefore, of limited use in explaining the mechanisms that coordinate larval swimming. [source] Unpacking the concept of patient satisfaction: a feminist analysisJOURNAL OF ADVANCED NURSING, Issue 3 2005Sheila A. Turris MSN RN Aim., The aim of this paper is to present a feminist critique of the concept of patient satisfaction. Background., Fiscal restraint, health care restructuring, shifting demographics, biomedical technological advances, and a significant shortage of health care professionals are stretching health care systems across North America to the breaking point. A simultaneous focus on consumerism and health service accountability is placing additional pressure on the system. The concept of patient satisfaction, with roots in the consumer movement of the 1960s, has both practical and political relevance in the current health care system and is commonly used to guide research related to consumer experiences of health care. Because the quality of health care encounters may lead to treatment-seeking delays, patient satisfaction research may be an effective vehicle for addressing this public health issue. However, there is wide agreement that patient satisfaction is an under-theorized concept. Using current conceptualizations of patient satisfaction, we end up all too often producing a checklist approach to ,achieving' patient satisfaction, rather than developing an understanding of the larger issues underlying individual experiences of health care. We focus on the symptoms rather than the problems. Discussion., Without further theoretical refinement, the results of research into patient satisfaction are of limited use. To push forward theoretical development we might apply a variety of theoretical lenses to the analysis of both the concept and the results of patient satisfaction research. Feminism, in particular, offers a perspective that may provoke further refinement of patient satisfaction as a concept. Conclusions., Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care. [source] Recovery of bird populations after clearfelling of tall open eucalypt forest in Western AustraliaJOURNAL OF APPLIED ECOLOGY, Issue 5 2001M.R. Williams Summary 1Increasing concern over the sustainable management of forested landscapes and the extent of forest clearance world-wide has led to a growing interest in the impacts of logging and associated habitat disturbance on biodiversity. 2We conducted an experimental study of the impact of clearfelling on birds of the karri Eucalyptus diversicolor forest in south-west Western Australia over a 17-year period, and a retrospective study of both clearfelled and naturally regenerated karri stands aged from 0 to 146 years. 3One-third of species still had significantly reduced abundance 14 years after disturbance ceased, although all affected species made limited use of regenerating forest. 4Multivariate analysis of changes in bird community structure showed that the effects of disturbance were still evident 14 years after clearfelling. Clearfelling may also have produced some temporary changes in community structure in adjacent unlogged forest. 5Species richness and total abundance of birds declined by 58% and 96%, respectively, in the first year after clearfelling, and 14 years after logging were still 17% and 55% below levels in adjacent undisturbed forest. During this early successional phase both measures increased as a simple function of stand age. Species richness of regrowth reached that of old-growth at 30,50 years and total abundance of all bird species in regrowth was similar to that of old-growth after approximately 70 years. 6Several bird species offer potential as indicators of the ecological sustainability of karri forest management. These species nest in large hollows in standing live trees (two cockatoo species) or have been slow to recolonize immature regrowth karri forests (six species). 7Post-hoc power analysis showed that even the long-term and intensive sampling employed in this study failed to detect declines in abundance of less than 80,90% for most bird species. For many uncommon species, trying to estimate changes in abundance is problematic and likely to require replication which is difficult to achieve in field situations where logged and unlogged forests are compared. Despite this, the present study identified some key impacts of forest clearfelling on bird communities, with implications both for the consequences of clearfelling of forests and the criteria for sustainable forest management. [source] Why is there discordant diversity in sengi (Mammalia: Afrotheria: Macroscelidea) taxonomy and ecology?AFRICAN JOURNAL OF ECOLOGY, Issue 1 2009Galen B. Rathbun Abstract The seventeen species of sengis or elephant-shrews form a well-defined clade of mammals endemic to Africa that occupy the extremes of terrestrial habitats, from coastal deserts to montane forests. Because of their isolation on Africa soon after the break-up of Gondwanaland, theoretically sengis initially evolved with little competition from other placental radiations. Their life history features include myrmecophagy, saltatorial gaits, no or limited use of nests, social monogamy, small litters of precocial young and absentee maternal care of neonates. These traits together are unique to the Macroscelidea and represent a wedding of features usually associated with either small antelopes or anteaters. Combined, these features define an adaptive syndrome that presumably has been relatively immune to competition from contemporary mammals, partially due to phylogenetic inertia. Yet paradoxically, the syndrome is well suited to a wide range of terrestrial habitats, resulting in low taxonomic diversity. Because of their unusual phylogeny and low species diversity, conservation interest is high for those sengis with relatively low densities in fragmented forests. Résumé Les 17 espèces de sengis (musaraignes éléphants) forment un clade bien déterminé de mammifères endémiques d'Afrique, qui occupe des habitats terrestres extrêmes allant de déserts côtiers à des forêts de montagne. En raison de leur isolement sur le continent africain très vite après la scission du Gondwana, les sengis ont théoriquement évolué au départ sans qu'il existe beaucoup de compétition avec les radiations d'autres placentaires. Les caractéristiques de leur histoire incluent de la myrmécophagie, des déplacements par bonds, un usage de nids limité, voire inexistant, la monogamie sociale, de petites portées de jeunes précoces et l'inexistence de soins maternels pour les nouveau-nés. Toutes ces caractéristiques sont uniques pour les Macroscélidés et représentent un regroupement de caractéristiques d'habitude associées à de petites antilopes ou à des fourmiliers. Combinées, ces caractéristiques définissent un syndrome d'adaptation qui, sans doute, fut relativement protégé de toute compétition avec des mammifères contemporains, à cause, en partie, de l'inertie phylogénétique. Mais, paradoxalement, ce syndrome est bien adaptéà une vaste gamme d'habitats terrestres, ce qui n'entraîne donc qu'une faible diversité taxonomique. En raison de leur phylogenèse inhabituelle et de la faible diversité entre ces espèces, l'intérêt de la conservation est considérable pour ces sengis dont la densité, dans des forêts fragmentées, est relativement faible. [source] A critical view of how nursing has defined spiritualityJOURNAL OF CLINICAL NURSING, Issue 12 2009Janice Clarke Aims., To offer a detailed discussion of the issue of ,lack of critique' in the literature on spirituality in nursing. The discussion will include the limited use of sources from theology and religious studies and the demand to separate spirituality and religion and will go on to examine the consequences of the resulting approach. The drive for unique knowledge to further professionalisation and the demands of inclusiveness are suggested as possible reasons for the development of the current model. The dangers and pitfalls of definition are explored. The paper suggests that theology could provide insights into explaining spirituality. Background., The last four decades have seen a proliferation of definitions of spirituality in the nursing literature. Recently, in response to their own concerns and prompts from outside the ,spirituality' community authors have suggested that we revisit this literature with a more critical stance. This paper is in response to that suggestion. During the course of a PhD supervised from a department of practical theology I have critically analysed the literature from several perspectives and this paper is one result of that review. Design., Literature review. Methods., Critical reflection on how spirituality has been defined. Conclusion., The lack of critique has produced a bias in the literature towards broad, generic, existential definitions which, together with the intentional divorce from religion and theology have led to definitions which have the tendency to result in a type of spiritual care which is indistinguishable from psychosocial care, hard to explain to patients and difficult to put into practice. Relevance to clinical practice., The acceptance of a diverse range of understandings of spirituality and a greater focus on practical ways of using it in nursing care are the direction the profession should be moving into. [source] Situating Internet Use: Information-Seeking Among Young Women with Breast CancerJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 3 2010Ellen Balka In recent years considerable attention has been focused on the potential of the Internet as a means of health information delivery that can meet varied health information needs and empower patients. In this article, we explore utilization of the Internet as a means of health information consumption amongst young women with breast cancer who were known Internet users. Focusing on a population known to be competent at using the Internet allowed us to eliminate the digital divide as a possible explanation for limited use of the Internet for health information-seeking. Ultimately, this allowed us to demonstrate that even in this Internet savvy population, the Internet is not necessarily an unproblematic means of disseminating health care information, and to demonstrate that the huge amount of health care information available does not automatically mean that information is useful to those who seek it, or even particularly easy to find. Results from our qualitative study suggest that young women with breast cancer sought information about their illness in order to make a health related decision, to learn what would come next, or to pursue social support. Our respondents reported that the Internet was one source of many that they consulted when seeking information about their illness, and it was not the most trusted or most utilized source of information this population sought. [source] Using interpubic distance for sexing manakins in the fieldJOURNAL OF FIELD ORNITHOLOGY, Issue 1 2010Chase D. Mendenhall ABSTRACT Field methods for determining the sex of birds are often limited due to morphometric overlap between sexes, intermediate plumages, seasonality, and reliance on subjective age classification. Interpubic distance, characterized in birds as the distance between the distal ends of the pubic bones, has not been formally tested as a method for determining the sex of birds, despite references among parrot breeders and the frequent use of analogous measurements in mammals. We developed a harmless and easily performed field method for measuring interpubic distance in studies involving bird capture, and compared the interpubic distances of known sex White-ruffed Manakins (Corapipo altera), Orange-collared Manakins (Manacus aurantiacus), and Blue-crowned Manakins (Lepidothrix coronata) to evaluate the possible use of this measurement to determine sex. Using interpubic distance ranges based on 85% confidence intervals where overlap existed between sexes, the sex of 92.8,100% of all manakins in our study was accurately determined with no misclassification. Interpubic distance performed better than plumage-based methods that sexed 74.0% of all individuals and misclassified 1.5%. Using linear discriminant analysis, we developed classification equations that allowed us to accurately determine the sex of all individuals with 100% accuracy using mass and interpubic distance. Additionally, we compared the interpubic distances of female White-ruffed Manakins to evaluate the potential to determine age and reproductive status. Despite an apparent relationship between interpubic distance, age and reproductive status, we concluded that interpubic distance has limited use for determining age and reproductive status due to extensive overlap (31.6,100%), but shows potential in other applications. Based on these results, we endorse the use of interpubic distance to determine the sex of manakins. We encourage further study to develop additional classification equations using different morphometric measurements and to test the efficacy of interpubic distance to determine sex in other bird species. RESUMEN Los métodos del campo para distinguir el sexo de aves son limitados a causa de traslapes de medidas mórfometricas extremas entre sexos, plumajes intermedios, diferencias temporales y/o dependencia en clasificación sujeto de la edad. Distancia interpúbica, caracterizada en aves como la distancia entre los puntos distales de los huesos púbicos, no ha sido formalmente probada como un método para distinguir el sexo de las aves, a pesar de referencias por criadores de loros y uso de métodos similares en mamíferos. Diseñamos un método del campo rápido y sencillo que no tiene riesgo del daño para sacar la distancia interpúbica en estudios que capturan aves. Comparamos la distancia interpúbica de individuos de sexo conocido de Corapipo altera, Manacus aurantiacus, y Lepidothrix coronata para probar el método. Clasificamos correctamente el sexo de 92.8,100% de todos los individuos en este estudio por rangos determinados a través de intérvalos de confianza de 85%. La distancia interpúbica funcionó mejor que un método basado en plumaje, el cual que distinguió el sexo correcto de 74.0% pero falló en clasificar el sexo de 1.5% de los individuos estudiados. Usamos el análisis de discriminación linear para determinar el poder predictivo de la distancia interpúbica, longitud del ala y masa e hicimos ecuaciones de clasificación que distinguieron sexo con un 100% de éxito usando solo masa y distancia interpúbica. Además, comparamos distancia interpúbica de las hembras de C. altera para evaluar el potencial de distinguir edad y estadio reproductivo. A pesar de existir una conexión entre distancia interpúbica, edad y estadio reproductivo, concluimos que la distancia interpúbica es limitada en el contexto de distinguir edad y estadio reproductivo por traslape extensivo (31.6,100%), pero muestra potencial en otras aplicaciones. Basados en estos resultados recomendamos el uso de distancia interpúbica como un método para distinguir sexo de pipridos. Recomendamos más investigación para crear otras ecuaciones de clasificación usando medidas mórfometricas diferentes y probar la eficacia de la distancia interpúbica para distinguir el sexo de otras especies de aves. [source] ORIGINAL ARTICLE: Use of 3D imaging and awareness of GEC-ESTRO recommendations for cervix cancer brachytherapy throughout Australia and New ZealandJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2010S Van Dyk Abstract Introduction:, A 2005 survey of practices indicated limited use of three-dimensional (3D) imaging modalities and planning methods in cervix cancer brachytherapy in Australia and New Zealand. However, advancing technologies and published recommendations are influencing change. This survey aims to identify both changes in practice and awareness and uptake of Groupe European de Curietherapie of the European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations. Methods:, A survey was emailed to all radiotherapy departments with brachytherapy facilities. Twenty departments practise brachytherapy for cancer of the cervix. The survey consisted of five questions enquiring about use and type of 3D imaging; rate of reimaging and replanning; and contouring, prescribing and reporting practices. Results:, A 100% response rate was obtained. Sixty-five per cent of departments use 3D CT imaging to plan brachytherapy insertions. Thirty per cent of departments use two-dimensional (2D) x-rays. Four departments (20%) use a combination of imaging modalities including CT, ultrasound and MRI. Sixty-five per cent of departments reimage and replan for each insertion. Four departments (20%) contour, prescribe dose and report treatment according to GEC-ESTRO recommendations. Conclusions:, There has been a marked increase in the use of 3D imaging and awareness of GEC-ESTRO recommendations. Implementation and reporting of image-based gynaecological brachytherapy is strongly dependent on local resources and infrastructure. [source] An in vitro study of the reliability of DIAGNOdent® measurementsJOURNAL OF ORAL REHABILITATION, Issue 9 2004J Kühnisch summary, Aim of this in vitro study was to assess the reliability of measurements by a laser fluorescence technique for occlusal caries detection. Four dentists using four DIAGNOdent® devices (Dds) according to manufacturer's instructions examined 80 carefully cleaned extracted molars with non-cavitated occlusal lesions. Inter- and intra-examiner reproducibility were calculated using Lin's intra-class correlation coefficient (ICCLin) and the limits of agreement by Bland and Altman (Comp Biol Med 1990;20:337). An excellent intra-examiner reproducibility was found for all dentists (ICCLin 0·93,0·98). The inter-examiner reliability was proved to be good and excellent (ICCLin 0·74,0·98). By reason of the registered lower mean fluorescence values of dentist 3 compared with his/her colleagues all these measurements were excluded from further calculations. Differences between Dd instruments were not evident. When the values of the Dd were categorized according to the treatment related cut-off limits a substantial reproducibility was found in the range of 0,14 (ICCLin 0·66; DIFF 4·0/,3·5) and >30 (ICCLin 0·6% of all Dd measurements were reproduced in the range 15,30 (ICCLin 0·16; DIFF 8·1/,7·3). The results suggest that dentists should be trained before using Dd. The low reliability in the interval of 15-30 could indicate a limited use for a longitudinal caries monitoring on pits and fissures; further research should be focused on this clinically important interval. [source] Linking program implementation and effectiveness: Lessons from a pooled sample of welfare-to-work experimentsJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 4 2003Howard S. Bloom This paper addresses the question: How does implementation influence the effectiveness of mandatory welfare-to-work programs? Data from three large-scale, multi-site random assignment experiments were pooled; quantitative measures of program implementation were constructed; and multilevel statistical modeling was used to examine the relationship between program implementation and effects on short-term client earnings. Individual-level data were analyzed for 69,399 sample members and group-level implementation data were analyzed for 59 local programs. Findings indicate that, other things being equal, earnings effects are increased by: an emphasis on quick client employment, an emphasis on personalized client attention, staff caseloads that do not get too large, and limited use of basic education. Findings also show that mandatory welfare-to-work programs can be effective for many types of people, and that focusing on clients who are especially job-ready (or not) does not have a consistent influence on a program's effectiveness. © 2003 by the Association for Public Policy Analysis and Management [source] A mixed motive approach to lobbying: applying game theory to analyse the impact of co-operation and conflict on perceived lobbying successJOURNAL OF PUBLIC AFFAIRS, Issue 2 2006Freya Aitken-Turff This study was motivated by the apparent discrepancy between guidance for public relations best practice using co-operation and collaboration to resolve conflict, and the potential to use the positive elements of conflict and competition to lobby more effectively. Game theory matrix was applied to nine lobbying campaigns, and used narrative analysis to identify themes of co-operation, conflict, and mixed motive lobbying in the transcripts. The primary research identified that: Conflict, co-operation and mixed-motive lobbying were apparent in all the case studies. Mixed motive lobbying was unattainable between organizations with diametrically opposed interests and this may limit its application. A further obstacle to mixed motive strategies is the high level of resources it uses. The numerical game theory matrix used in this study was of limited use, however, the conceptual framework the theory provided was effective at modelling conflict and co-operation strategies. Formal co-operative alliances were common in the sample. Smaller coalitions appeared to be more effective than the larger ones. Those engaged in high conflict campaigns perceived themselves to be more effective than those engaged in lower conflict campaigns, however, this would need to be examined more exhaustively to establish causality. Copyright © 2006 John Wiley & Sons, Ltd. [source] How project approach influences adoption of SWC by farmers, examples from southern MaliLAND DEGRADATION AND DEVELOPMENT, Issue 5 2006F. Bodnár Abstract Choices in project approach affect the continuation of soil and water conservation (SWC) after project withdrawal, and thus the sustainability and cost effectiveness of the project. A SWC project was carried out in southern Mali between 1986 and 1998. Its features were the promotion of cheap and simple SWC measures, a participatory village extension approach with limited use of incentives, and the incorporation of the SWC programme in an existing Malian extension service. By 2000, farmers in half the 5000 villages in southern Mali had been trained in SWC. By 2002, erosion-control measures had been installed in 94,per,cent of the villages in southern Mali by 46,per,cent of the farmers and in 15,per,cent of the fields. Though external donor support has stopped, farmer adoption is steadily continuing and spreading to untargeted villages. Copyright © 2006 John Wiley & Sons, Ltd. [source] Describing clinical teachers' characteristics and behaviours using critical incidents and repertory gridsMEDICAL EDUCATION, Issue 7 2006Praminthra Chitsabesan Context, Completion of a rating questionnaire is the method used most frequently to evaluate a teacher's performance. Questionnaires that largely assess ,high-inference' teaching characteristics, such as ,enthusiasm' and ,friendliness', require the observer to make a judgement about the teacher but do not describe what the teacher actually did and so have limited use in providing feedback. Measures of ,low-inference' teaching behaviours (i.e. those that are concrete and observable), such as frequency, amount or types of verbal interaction, do not demonstrate how these are linked to good teaching. Objectives, To describe high-inference teacher characteristics and define the associated low-inference behaviours. Methods, A purposive sample of consultants, postgraduate and undergraduate students, nurse lecture practitioners and patients were selected for semistructured interviews using repertory grids and critical incidents to elicit preferred characteristics and behaviours of clinical teachers. Interviews were audiotaped, transcribed and then content-analysed using a framework to pair teachers' characteristics and their behaviours. Results, We identified a variety of preferred high-inference characteristics and their associated observable and recordable low-inference behaviours. Discussion, We carried out a study that included all participants in clinical teaching and found that participants differed in their preferred characteristics and behaviours. It is important for future research to look at behaviours interdependently, rather than alone, and to take into account the evidence that participants tend to infer characteristics rather than think in terms of behaviours. This information will be used to inform the development of a formative tool for evaluating clinical teaching. [source] Technically Speaking: Transforming Language Learning through Virtual Learning Environments (MOOs)MODERN LANGUAGE JOURNAL, Issue 2 2001Silke Von Der Emde Though MOOs (multiple user domains object-oriented) have found a limited use in some language courses, their potential for transforming the language learning classroom has not been fully recognized or valued. In Fall 1998 and 1999, the authors teamed up to teach the first language course conducted almost entirely using a MOO and involving a 7-week exchange between students learning German at an American college and advanced students of English at a German university. Drawing on their experiences, the authors systematically map out the tremendous pedagogical benefits to using a MOO for language learning: a student-centered learning environment structured by such objectives as peer teaching, autonomous learning principles, intellectually rich content-based instruction, individualized learning, and play. In addition to offering a model for the successful integration of technology into the classroom, this article suggests how MOOs can help achieve the long-sought goal of securely anchoring intermediate or even elementary language learning back into the liberal arts curriculum. [source] A comparison of techniques for assessing dispersal behaviour in gundis: revealing dispersal patterns in the absence of observed dispersal behaviourMOLECULAR ECOLOGY, Issue 15 2008KAREN J NUTT Abstract Knowledge of the dispersal status of group members is important to understanding how sociality may have evolved within a species. I assessed the effectiveness of four techniques for elucidating dispersal behaviour in a rock-dwelling rodent (Ctenodactylus gundi) with small group sizes (2,10 animals): genetic parentage assignment, haplotype data and kinship analyses, assignment testing, and F -statistics. The first two methods provided the greatest insight into gundi dispersal behaviour. Assignment testing and F -statistics proved of limited use for elucidating fine-scale dispersal, but could detect large-scale patterns despite low sex-biased dispersal intensity (1.9 : 1) because of moderate genetic differentiation among groups (FST = 0.10). Findings are discussed in light of current dispersal theory. In general, gundi dispersal is plastic, and seems to be dependent on body weight (for males), group composition, and scale of analysis (total dispersal events recorded within the population were almost twice the immigration rate into the population). Most groups were comprised of a single matriline and one immigrant male. Immigrant rather than philopatric males bred with group females. Dispersal among groups was male-biased, but dispersal or philopatry could occur by either sex. During a drought, both sexes delayed dispersal and cooperative social units formed. Whether such behaviour resulted directly from the drought or not remains unclear, however, since comparative information was not available from nondrought years. Combining fine-scale analyses with information on large-scale patterns provided substantial insight into gundi dispersal behaviour despite the limited movement of animals during a drought, and may prove useful for elucidating dispersal behaviour in other social animals. [source] A practice survey on vasopressor and inotropic drug therapy in Scandinavian intensive care unitsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2003A. Oldner Background: This practice survey was performed to analyse the indications for use of vasopressor/inotropic drugs, preferred drugs and doses as well as concomitant monitoring and desired haemodynamic target values in Scandinavian ICUs. An internet-based reporting system was implemented. Methods: A total of 223 ICUs were identified in the Scandinavian countries and invited to participate in a one-day point-prevalence study. An internet-based database was constructed and a practice survey protocol designed to identify haemodynamic monitoring, indications for vasopressor/inotropic drug-therapy, fluids used for volume loading, pretreatment circulatory state, actual and targeted haemodynamic variables. Patients were eligible for the study if on vasopressor/inotropic drug-therapy for more than 4 h. Results: A total of 114 ICUs participated. A total of 114 adult patients matched the inclusion criteria. Sixty-seven per cent of the patients had received vasopressor/inotropic drug-treatment for >24 h and 32% received more than one drug. Arterial hypotension (92%) and oliguria (50%) were most common indications. Fluid loading prior to therapy was reported in 87% of patients. Dopamine (47%) and noradrenaline (44%) were the most commonly used drugs followed by dobutamine (24%). No other drug exceeded 6%. Non-catecholamine drugs were rarely used even in cardiac failure patients. Invasive arterial pressure was monitored in 95% of patients, pulmonary artery catheters were used in 19%. Other cardiac output monitoring techniques were used in 8.5% of the patients. Conclusion: Dopamine and noradrenaline seem to be the most commonly used inotropic/vasopressor drugs in Scandinavia. Traditional indications for inotropic/vasopressor support as hypotension and oliguria seem to be most common. Invasive monitoring was used in almost all patients, whereas a limited use of pulmonary artery catheters was noted. The internet-based reporting system proved to be an efficient tool for data collection. [source] Traumatic axonal injury: practical issues for diagnosis in medicolegal casesNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 2 2000J. F. Geddes In the 25 years or so after the first clinicopathological descriptions of diffuse axonal injury (DAI), the criterion for diagnosing recent traumatic white matter damage was the identification of swollen axons (,bulbs') on routine or silver stains, in the appropriate clinical setting. In the last decade, however, experimental work has given us greater understanding of the cellular events initiated by trauma to axons, and this in turn has led to the adoption of immunocytochemical methods to detect markers of axonal damage in both routine and experimental work. These methods have shown that traumatic axonal injury (TAI) is much more common than previously realized, and that what was originally described as DAI occupies only the most severe end of a spectrum of diffuse trauma-induced brain injury. They have also revealed a whole field of previously unrecognized white matter pathology, in which axons are diffusely damaged by processes other than head injury; this in turn has led to some terminological confusion in the literature. Neuropathologists are often asked to assess head injuries in a forensic setting: the diagnostic challenge is to sort out whether the axonal damage detected in a brain is indeed traumatic, and if so, to decide what , if anything , can be inferred from it. The lack of correlation between well-documented histories and neuropathological findings means that in the interpretation of assault cases at least, a diagnosis of ,TAI' or ,DAI' is likely to be of limited use for medicolegal purposes [source] Clinical Predictors of Defibrillation Thresholds with an Active Pectoral Pulse Generator Lead SystemPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 4 2002DENICE M. HODGSON HODGSON, D.M., et al.: Clinical Predictors of Defibrillation Thresholds with an Active Pectoral Pulse Generator Lead System. Active pectoral pulse generators are used routinely for initial ICD placement because they reduce DFTs and simplify the implantation procedure. Despite the common use of these systems, little is known regarding the clinical predictors of defibrillation efficacy with active pulse generator lead configurations. Such predictors would be helpful to identify patients likely to require higher output devices or more complicated implantations. This was a prospective evaluation of DFT using a uniform testing protocol in 102 consecutive patients with an active pectoral can and dual coil transvenous lead. For each patient, the DFT was measured with a step-down protocol. In addition, 34 parameters were assessed including standard clinical echocardiographic and radiographic measures. Multivariate stepwise regression analysis was performed to identify independent predictors of the DFT. The mean DFT was 9.3 ± 4.6 J and 93% (95/102) of patients had a DFT , 15 J. The QRS duration, interventricular septum thickness, left ventricular mass, and mass index were significant but weak (R < 0.3) univariate predictors of DFT. The left ventricular mass was the only independent predictor by multivariate analysis, but this parameter accounted for < 5% of the variability of DFT measured (adjusted R2= 0.047, P = 0.017). The authors concluded that an acceptable DFT (< 15 J) is observed in > 90% of patients with this dual coil and active pectoral can lead system. Clinical factors are of limited use for predicting DFTs and identifying those patients who will have high thresholds. [source] Seizures in children after kidney transplantation: Has the risk changed and can we predict who is at greatest risk?PEDIATRIC TRANSPLANTATION, Issue 5 2008Lorie D. Hamiwka Abstract:, Children undergoing kidney transplantation are at increased risk for symptomatic seizures with a previously reported incidence of approximately 20%. Little data exist to help predict which children may be at risk. We retrospectively reviewed all children who underwent kidney transplantation evaluation at our center between October 1993 and August 2007 and identified 41 children who had an EEG prior to transplant. Demographic data as well as the following were collected: immunosuppressive medications, developmental status, history of seizures, family history of seizures, post-transplant seizures and EEG results. EEGs were classified as normal or abnormal. Prior to transplantation, one child had a history of febrile seizures and six experienced afebrile seizures. Nine (22%) children identified had an abnormal EEG prior to transplant. In eight cases the EEG was non-epileptiform and in one case was epileptiform. Abnormal EEGs did not correlate with a family history of seizures. Delayed development was noted in seven children and was not associated with an epileptiform EEG. Following kidney transplantation, no child experienced a seizure. Our single center study suggests that current rates of seizures following kidney transplantation are lower than previously reported and that routine EEG as part of the pretransplant evaluation in these children is of limited use to predict those at risk. 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