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Long Delays (long + delay)
Selected AbstractsChanges in a rat facial muscle after facial nerve injury and repairMUSCLE AND NERVE, Issue 9 2001Davor Jergovi Abstract This study describes changes in a rat facial muscle innervated by the mandibular and buccal facial nerve branches 4 months after nerve injury and repair. The following groups were studied: (A) normal controls; (B) spontaneous reinnervation by collateral or terminal sprouting; (C) reinnervation after surgical repair of the mandibular branch; and (D) chronic denervation. The normal muscle contained 1200 exclusively fast fibers, mainly myosin heavy chain (MyHC) IIB fibers. In group B, fiber number and fiber type proportions were normal. In group C, fiber number was subnormal. Diameters and proportions of MyHC IIA and hybrid fibers were above normal. The proportion of MyHC IIB fibers was subnormal. Immediate and delayed repair gave similar results with respect to the parameters examined. Group D rats underwent severe atrophic and degenerative changes. Hybrid fibers prevailed. These data suggest that spontaneous regeneration of the rat facial nerve is superior to regeneration after surgical repair and that immediacy does not give better results than moderate delay with respect to surgical repair. Long delays are shown to be detrimental. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1202,1212, 2001 [source] Do early interviews affect children's long-term event recall?APPLIED COGNITIVE PSYCHOLOGY, Issue 7 2004Margaret-Ellen Pipe The present study examined the effects of the timing of an initial interview on children's recall of an event over delays of 1 and 2 years. Fifty-five children who had originally participated in a novel event when they were between 5- and 6-years old and had been interviewed about it following either short (1 week or less) or long (1 or 6 month) delays were re-interviewed 1 and 2 years after the original experience. An additional 20 children not interviewed prior to the 1-year interview were included as a no-prior-interview control group. Long delays to the initial interview led to better open-ended recall at the 1-year delay than short delays to initial interview or no prior interview. However, initial interviews that followed short delays had a greater impact on children's responses to specific questions. The results suggest that prior interview history is an important consideration when examining the effects of long delays on children's event reports, and that the effects of the timing of an initial interview depend on the nature of the information recalled. Copyright © 2004 John Wiley & Sons, Ltd. [source] Selective lesions of basal forebrain cholinergic neurons produce anterograde and retrograde deficits in a social transmission of food preference task in ratsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 6 2002Anna Vale-Martínez Abstract We examined the performance of Long-Evans rats with 192 IgG-saporin lesions of the medial septum/vertical limb of the diagonal band (MS/VDB) or nucleus basalis magnocellularis/substantia innominata (NBM/SI), which removed cholinergic projections mainly to hippocampus or neocortex, respectively. We studied the effects of these lesions on anterograde and retrograde memory for a natural form of hippocampal-dependent associative memory, the social transmission of food preference. In a study of anterograde memory, MS/VDB lesions did not affect the immediate, 24-h or 3-week retention of the task. In contrast, NBM/SI lesions severely impaired immediate and 24-h retention. In a study of retrograde memory in which rats acquired the food preference 5 days or 1 day before surgery and they were tested 10,11 days after surgery, MS/VDB-lesioned rats showed striking memory deficits for the preference acquired at a long delay (5 days) before surgery, although all lesioned rats exhibited poorer retention on both retest sessions than on their pretest performance. Subsequent testing of new anterograde learning in these rats revealed no disrupting effects of lesions on a standard two-choice test. When rats were administered a three-choice test, in which the target food was presented along with two more options, NBM/SI-lesioned rats were somewhat impaired on a 24-h retention test. These results provide evidence that NBM/SI and MS/VDB cholinergic neurons are differentially involved in a social memory task that uses olfactory cues, suggesting a role for these neurons in acquisition and consolidation/retrieval of nonspatial declarative memory. [source] Neandertals, competition, and the origin of modern human behavior in the LevantEVOLUTIONARY ANTHROPOLOGY, Issue 4 2003John J. Shea Abstract The East Mediterranean Levant is a small region, but its paleoanthropological record looms large in debates about the origin of modern humans and the fate of the Neandertals. For most of the twentieth century, the Levantine paleoanthropological record supported models of continuity and evolutionary transition between Neandertals and early modern humans. Recent advances in radiometric dating have challenged these models by reversing the chronological relationship between Levantine Neandertals and early modern humans. This revised chronostratigraphy for Levantine Middle Paleolithic human fossils raises interesting questions about the evolutionary relationship between Neandertals and early modern humans. A reconsideration of this relationship moves us closer to understanding the long delay between the origin of morphologically modern-looking humans during the Middle Paleolithic (>130 Kyr) and the adaptive radiation of modern humans into Eurasia around the time of the transition from the Middle to Upper Paleolithic (50 to 30 Kyr). [source] Role of reserve carbohydrates in the growth dynamics of Saccharomyces cerevisiae,FEMS YEAST RESEARCH, Issue 8 2004Vincent Guillou Abstract The purpose of this study was to explore the role of glycogen and trehalose in the ability of Saccharomyces cerevisiae to respond to a sudden rise of the carbon flux. To this end, aerobic glucose-limited continuous cultures were challenged with a sudden increase of the dilution rate from 0.05 to 0.15 h,1. Under this condition, a rapid mobilization of glycogen and trehalose was observed which coincided with a transient burst of budding and a decrease of cell biomass. Experiments carried out with mutants defective in storage carbohydrates indicated a predominant role of glycogen in the adaptation to this perturbation. However, the real importance of trehalose in this response was veiled by the unexpected phenotypes harboured by the tps1 mutant, chosen for its inability to synthesize trehalose. First, the biomass yield of this mutant was 25% lower than that of the isogenic wild-type strain at dilution rate of 0.05 h,1, and this difference was annulled when cultures were run at a higher dilution rate of 0.15 h,1. Second, the tps1 mutant was more effective to sustain the dilution rate shift-up, apparently because it had a faster glycolytic rate and an apparent higher capacity to consume glucose with oxidative phosphorylation than the wild type. Consequently, a tps1gsy1gsy2 mutant was able to adapt to the dilution rate shift-up after a long delay, likely because the detrimental effects from the absence of glycogen was compensated for by the tps1 mutation. Third, a glg1,glg2, strain, defective in glycogen synthesis because of the lack of the glycogen initiation protein, recovered glycogen accumulation upon further deletion of TPS1. This recovery, however, required glycogen synthase. Finally, we demonstrated that the rapid breakdown of reserve carbohydrates triggered by the shift-up is merely due to changes in the concentrations of hexose-6-phosphate and UDPglucose, which are the main metabolic effectors of the rate-limiting enzymes of glycogen and trehalose pathways. [source] Monitoring indicators of health care quality by means of a hospital register of tumoursJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2008Maximino Redondo MD PhD Abstract Rationale, Hospital registers of tumours provide, on a continuous basis, information on differences in patterns of neoplasias and the results of the treatment strategies employed. Objective, In view of the scant publications on measures of health care quality in hospital tumour registers, the aim of our paper is to present the outcome of a study to monitor the results related to health care quality in oncology. Methods, Data are presented for cases recorded at the Hospital Costa del Sol over a period of 8 years. The sources of information are fundamentally the patient's medical record and the database of the Pathology Department. Results, A high proportion of patients (mean 50%, range 45,68%) were admitted to the hospital by the Emergency Department; there was a notably long delay between the appearance of the first symptoms and the occasion of the first hospital visit (median 65 days; range 60,75 days). Particularly striking was the corresponding delay for breast cancer patients, in most cases superior to 3 months. As was the case for the percentage of admissions by the Emergency Department, most of the indicators evaluated in this study present a significant improvement compared with the initial years of the Hospital Register of Tumours. Thus, non anatomic-pathological diagnoses represented around 7% (range 3,13%), while 43% of patients (range 28,57%) were given adjuvant treatment in the form of radiation therapy or chemotherapy. In 40% of cases (range 20,50%), the tumour stage was included in the clinical record by the doctor who was treating the patient (in the remaining cases, these data were recorded by the Tumour Registry); the date of appearance of the first symptoms was included in the medical record in 65% of cases (range 54,80%). According to the stage classification, the following 5-year survival rates were recorded: (I) 98%, (II) 94%, (III) 69% and (IV) 39% for breast cancer; (I) 93%, (II) 83%, (III) 68% and (IV) 12% for cancer of the colon; and (I) 100%, (II) 94%, (III) 79% and (IV) 53% for prostate cancer. Conclusion, The high percentage of patients admitted by the Emergency Department and the long delay between the appearance of the first symptoms reflect the deficient attention paid to this problem by patients and by primary health care services. Our results suggest that the Hospital Register of Tumours could constitute an excellent tool for monitoring the quality of health care systems for oncological patients. [source] Screening Tablets for DOB Using Surface-Enhanced Raman Spectroscopy,JOURNAL OF FORENSIC SCIENCES, Issue 5 2007Steven E. J. Bell Ph.D. Abstract:, 2,5,-Dimethoxy-4-bromoamphetamine (DOB) is of particular interest among the various "ecstasy" variants because there is an unusually long delay between consumption and effect, which dramatically increases the danger of accidental overdose in users. Screening for DOB in tablets is problematic because it is pharmacologically active at 0.2,3 mg, which is c. 50 times less than 3,4-methylenedioxy-N-methylamphetamine (MDMA) and makes it more difficult to detect in seized tablets using conventional spot tests. The normal Raman spectra of seized DOB tablets are dominated by the bands of the excipient with no evidence of the drug component. Here we report the first use of on-tablet surface-enhanced Raman spectroscopy (SERS) to enhance the signal from a low concentration drug. Raman studies (785-nm excitation) were carried on series of model DOB/lactose tablets (total mass c. 400 mg) containing between 1 mg and 15 ,g of DOB and on seized DOB tablets. To generate surface-enhanced spectra, 5 ,L of centrifuged silver colloid was dispensed onto the upper surface of the tablets, followed by 5 ,L of 1.0 mol/dm3 NaCl. The probe laser was directed onto the treated area and spectra accumulated for c. 20 sec (10 sec × 2). It was found that the enhancement of the DOB component in the model tablets containing 1 mg DOB/tablet and in the seized tablets tested was so large that their spectra were completely dominated by the vibrational bands of DOB with little or no contribution from the unenhanced lactose excipient. Indeed, the most intense DOB band was visible even in tablets containing just 15 ,g of the drug. On-tablet surface-enhanced Raman spectroscopy is a simple method to distinguish between low dose DOB tablets and those with no active constituent. The fact that unique spectra are obtained allows identification of the drug while the lack of sample preparation and short signal accumulation times mean that the entire test can be carried out in <1 min. [source] The influence of morphine on the absorption of paracetamol from various formulations in subjects in the supine position, as assessed by TDx measurement of salivary paracetamol concentrationsJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 10 2003Julia M. Kennedy ABSTRACT The aim of this study was to determine the influence of the type of paracetamol formulation on the rate of absorption when subjects are in the supine position, with or without taking concomitant morphine. Two groups of healthy volunteers were used, who were in the fasting state and remained in the supine position during the study. One group took 1500 mg of paracetamol on three occasions as conventional tablets, dispersible tablets or a suspension in a randomized crossover design. Seventeen saliva samples per subject were obtained (time zero to 360 min post-dose), which were then centrifuged and kept at ,20°C prior to analysis. The second group repeated the study following four doses of morphine syrup (10 mg 4 hourly) in the 12 h preceding paracetamol ingestion. In this phase of the study, paracetamol absorption from suspension was not investigated. A TDx assay was used to determine salivary paracetamol concentrations. The tmax for conventional tablets when taken concomitantly with morphine was 160 (+81) min compared to 51 (+58) min for subjects not taking morphine. For dispersible tablets the tmax in the morphine group was 14 (+9) min compared to 15 (+12) min without morphine. The results suggest that patients who are confined to bed and taking morphine will have an unacceptably long delay between taking conventional paracetamol tablets and the paracetamol reaching therapeutic plasma concentrations. Conversely, there is little effect on the absorption of dispersible paracetamol under the same conditions. [source] Small bowel tumours: a 10 year experience in four sydney teaching hospitalsANZ JOURNAL OF SURGERY, Issue 9 2004David S. Rangiah Background: Small bowel tumours are uncommon and can have a long delay prior to diagnosis. The present study aims to compare the use of computed tomography (CT) and contrast small bowel series (SBS) in their diagnosis and to outline the clinical features of small bowel tumours. Methods: A retrospective, case note study was conducted between 1990 and 2000 in four Sydney teaching hospitals. The data collected included clinical features, investigations and tumour characteristics. Results: One hundred and sixty-six people with small bowel tumours were identified (91 malignant; 75 benign). Malignant tumours consisted of adenocarcinomas (31%), carcinoid tumours (12%), lymphomas (7%) and leiomyosarcomas (5%). Benign tumours consisted of adenomas (22%), hamartomas (13%), leiomyomas (4%), inflammatory polyps (4%) and hyperplastic polyps (2%) and a benign schwannoma (1%). Adenocarcinomas were mainly located in the duodenum (P < 0.001) and carcinoid tumours in the ileum (P < 0.001). Malignant tumours were associated with a higher proportion of symptoms (P < 0.01), signs (P < 0.001) and episodes of small bowel obstruction (P < 0.01). Abdominal CT scans demonstrated a greater sensitivity (87.7%) than SBS (72.9%) with a slightly improved sensitivity when both investigations were used (89.3%). Abdominal ultrasound had a lower sensitivity than both of the above investigations of 65%. Gastroduodenoscopy had a sensitivity of 90% for diagnosing duodenal tumours. Operative procedures were performed on 92 patients with a preoperative diagnosis made in 77%. Metastatic spread of malignant tumours was evident in 46%. The sites of spread were to lymph nodes (23%), liver (21%) and distant locations (2%) at diagnosis. Conclusions: Malignant small bowel tumours are more likely to produce symptoms and signs than benign tumours, particularly caused by small bowel obstruction. Abdominal CT is the best radiological investigation for small bowel tumours and has a slight complimentary effect with SBS in improving the chances of detection. Gastroduodenoscopy remains the best investigation of duodenal tumours. [source] Drawing facilitates children's reports of factual and narrative information: implications for educational contextsAPPLIED COGNITIVE PSYCHOLOGY, Issue 7 2009Julien Gross In the present study, we examined the effect of drawing on children's reports of an educational event. Five- and 6-year-old children visited a local museum and were interviewed either 1,2 days or 7 months later. After each delay, half of the children were asked to tell about what they had learned during their visit to the museum and the other half were given the opportunity to draw while telling. All children were also given a standard comprehension test, covering material that the museum staff considered to be most relevant to the visit. When tested after a short delay, children who drew while talking reported more factual and more narrative information than children who did not draw. When tested after a long delay, drawing only enhanced children's reports of narrative information. After both delays, children's verbal descriptions of the event exceeded their scores on the comprehension test. These data have important practical implications for the educational value of museum visits and suggest a new method of assessing children's learning in educational contexts. Copyright © 2008 John Wiley & Sons, Ltd. [source] Is bipolar disorder overdiagnosed among patients with substance abuse?BIPOLAR DISORDERS, Issue 6 2007Christopher Stewart Background:, Bipolar illness is frequently misdiagnosed. Several studies have focused on the underdiagnosis of this condition and the frequent long delay in its recognition. However, the illness is difficult to diagnose and many of its symptoms are shared by other conditions. In order to determine the accuracy of the diagnosis of bipolar illness among subjects with substance abuse, we carried out a study in patients with a previous diagnosis of bipolar disorder (BD) and known history of substance abuse or dependence, who were currently engaged in treatment for substance abuse. Methods:, Individuals participating in a community-based substance treatment program and who had a previous diagnosis of BD were invited to undergo a structured clinical interview for diagnosis performed by a psychiatrist. In addition to the interview, previous hospital records were reviewed whenever possible. Diagnosis was made following strict DSM-IV criteria. Results:, Only 9 of 21 (42.9%) subjects met diagnostic criteria for BD. Seven were BD type II and two were BD I. Conclusions:, Bipolar disorder is frequently misdiagnosed following strict DSM-IV criteria. Among subjects with substance abuse, it may be overdiagnosed by psychiatrists. [source] Analysis and use of FMRI response delaysHUMAN BRAIN MAPPING, Issue 2 2001Ziad S. Saad Abstract In this study, we implemented a new method for measuring the temporal delay of functional magnetic resonance imaging (fMRI) responses and then estimated the statistical distribution of response delays evoked by visual stimuli (checkered annuli) within and across voxels in human visual cortex. We assessed delay variability among different cortical sites and between parenchyma and blood vessels. Overall, 81% of all responsive voxels showed activation in phase with the stimulus while the remaining voxels showed antiphase, suppressive responses. Mean delays for activated and suppressed voxels were not significantly different (P < 0.001). Cortical flat maps showed that the pattern of activated and suppressed voxels was dynamically induced and depended on stimulus size. Mean delays for blood vessels were 0.7,2.4 sec longer than for parenchyma (P < 0.01). However, both parenchyma and blood vessels produced responses with long delays. We developed a model to identify and quantify different components contributing to variability in the empirical delay measurements. Within-voxel changes in delay over time were fully accounted for by the effects of empirically measured fMRI noise with virtually no measurable variability associated with the stimulus-induced response itself. Across voxels, as much as 47% of the delay variance was also the result of fMRI noise, with the remaining variance reflecting fixed differences in response delay among brain sites. In all cases, the contribution of fMRI noise to the delay variance depended on the noise power at the stimulus frequency. White noise models significantly underestimated the fMRI noise effects. Hum. Brain Mapping 13:74,93, 2001. © 2001 Wiley-Liss, Inc. [source] Studying the relation between temporal reward discounting tasks used in populations with ADHD: A factor analysisINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2010Anouk Scheres Abstract Background: This study aimed at investigating the relationship between tasks that have been used in attention deficit hyperactivity disorder (ADHD) to measure choices between smaller immediate and larger delayed rewards: real and hypothetical temporal discounting tasks, and single-choice paradigms. Methods: Participants were 55 undergraduate psychology students. Tasks included a real and hypothetical version of a temporal discounting (TD) task with choices between a large reward (10 cents) after delays up to 60 seconds, and smaller immediate rewards (2,8 cents); two versions of a hypothetical temporal discounting task with choices between a large reward ($100) after delays up to 120 months, and smaller immediate rewards ($1,$95); a Choice Delay Task with choices between one point now and two points after 30 seconds (one point is worth five cents). Results: Correlation analyses showed that the real and the hypothetical TD tasks with 10 cents were very strongly associated. However, the hypothetical TD tasks with $100 did not correlate with either the real or the hypothetical TD task with 10 cents. Principal component analysis extracted two components: one for small amounts and short delays, and a second one for large rewards and long delays. Conclusions: Temporal reward discounting is not a uniform construct. Functional brain imaging research could shed more light on unique brain activation patterns associated with different forms of temporal reward discounting. Copyright © 2010 John Wiley & Sons, Ltd. [source] Experiences of diagnosis and treatment among people with multiple sclerosisJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2008Rhiannon G. Edwards MSc Abstract Rationale, aims and objectives, The aim of this qualitative study was to examine patients' experiences of being diagnosed with multiple sclerosis (MS), the information that they were given at this time, subsequent treatment and its impact on their lives. Method, Data were collected through semi-structured interviews with 24 people with MS. The use of interviews allowed participants' experiences to be explored in depth. Participants were recruited by the MS Society through membership details and through a press release in a local newspaper. Telephone interviews lasted between 30 and 60 minutes, were tape-recorded and transcribed verbatim. Data were analysed using thematic content analysis. Results, The majority of participants were female (n = 17), with ages ranging from 35 to 72 years. Disease duration ranged from 1 to 37 years. Many participants' diagnosed before and after 2000 had experienced long delays in diagnosis. At the point of diagnosis, participants had to make sense of and understand their diagnosis often with insufficient support. Some participants expressed anger about the way they had been given their diagnosis. Many felt they had not received sufficient information about their illness at this time and had responded by conducting their own searches for information to satisfy this need. Conclusion, Improving the way in which doctors communicate with patients experiencing diagnostic delay and at the point of diagnosis deserves further study, in order to avoid later adjustment problems. [source] Practical aspects of ROESY experiments for identification of bound waters in the cyclic tetrasaccharideMAGNETIC RESONANCE IN CHEMISTRY, Issue 12 2005Kazuo Furihata Abstract ROESY pulse sequences are presented and evaluated to identify bound waters in the cyclic tetrasaccharide. The first experiment incorporated the double-pulsed field gradient spin-echo (DPFGSE) for selective water excitation at the initial portion of the pulse sequence. Although long, shaped pulses were used in DPFGSE to achieve the highly selective excitation of water resonance that is very close to resonances of the cyclic tetrasaccharide, the approach was not effective because of the loss of sensitivity. Concomitant use of long delays and moderate length of shaped pulses in the portion of DPFGSE gained more sensitivity. A simple approach incorporating spin-echo with long delays instead of DPFGSE also afforded a sensitive spectrum. Practical aspects of these ROESY experiments are illustrated using the cyclic tetrasaccharide cyclo -{,6}-,- D -Glcp -(1,3)-,- D -Glcp -(1,6)-,- D -Glcp -(1,3)-,- D -Glcp -(1,). Copyright © 2005 John Wiley & Sons, Ltd. [source] A prospective study of severe hypoglycemia and long-term spatial memory in children with type 1 diabetesPEDIATRIC DIABETES, Issue 2 2004Tamara Hershey Abstract:, In a previous retrospective study, severe hypoglycemia (SH) was associated with decreased long-term spatial memory in children with type 1 diabetes mellitus (T1DM). In this study, we tested the hypothesis that prospectively ascertained SH would also be associated with decreased spatial long-term memory over time. Children with T1DM (n = 42) and sibling controls (n = 25) performed a spatial delayed response (SDR) task with short and long delays and other neuropsychological tests at baseline and after 15 months of monitoring. Extreme glycemic events and other medical complications were recorded prospectively during follow-up. Fourteen T1DM children experienced at least one episode of SH during the follow-up period (range = 1,5). After controlling for long-delay SDR performance at baseline, age, gender, and age of onset, the presence of SH during the prospective period was statistically associated with decreased long-delay SDR performance at follow-up (semipartial r = ,0.38, p = 0.017). This relationship was not seen with short-delay SDR or with verbal or object memory, attention, or motor speed. These results, together with previously reported data, support the hypothesis that SH has specific, negative effects on spatial memory skills in T1DM children. [source] Implementing a strategy-driven performance measurement system for an applied research groupTHE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 3 2002Christoph H. Loch Although most companies recognize the importance of R&D for future competitiveness, they often struggle to assess its contribution to the organization. Performance measurement in R&D is particularly difficult because (1) effort levels may not be observable, (2) project success is uncertain, influenced by uncontrollable factors, and (3) success can be assessed only after long delays, or it accrues to other units of the organization. Based on existing literature on the problem, we developed a performance measurement system for the process technology research group of an industrial company. This measurement system systematically supported the business strategy. Moreover, the measures were adjusted for different project profiles: short-versus long term, hardware versus software, routine support services versus breakthrough ideas and knowledge development. The contribution of this article is a description of the process of developing and implementing a comprehensive performance measurement system in a company, based on previous performance management research, and supporting the company's strategy. It is noteworthy that the system was implemented in a research group (as opposed to development), where the measurement problems are the most severe. [source] Delays in discharge of vascular surgical patients: a prospective auditANZ JOURNAL OF SURGERY, Issue 6 2010Senarath Edirimanne Abstract Aim:, To quantify delays in discharge for vascular surgical patients and identify causes of such delays. Methods:, A prospective audit of delays in discharge of vascular surgical admissions over a 6-month period was performed. Expected date and time of discharge was compared with actual date and time of discharge. Day-case patients, patients who died during admission and patients not under the direct care of the vascular team were excluded. Results:, There were 99 elective and 51 acute admissions accounting for 729 hospital bed days. The median (range) age was 72 years (21,92) and 94% of patients were living independently in the community. Forty-seven percent of patients were discharged on the planned day and time, 21% on the planned day but at a later-than-predicted time and 32% were delayed by more than 1 day. Delays identified in this audit accounted for 135 bed days. Fifteen percent of delays were due to causes that can be improved by internal organization (e.g. delayed paperwork). The majority of the delays (85%) were due to external factors such as lack of rehabilitation beds or lack of placement facilities in nursing homes. Elderly patients and acute admissions were more likely to have long delays in discharge. Conclusion:, Delays in discharge of vascular surgical patients use a lot of acute surgical bed days. Strategies to prevent delays in discharge should include not only improving internal organization and early identification and referral of patients who require rehabilitation/placement but also increased funding for such essential non-acute services. [source] Primary hyperparathyroidism: Referral patterns and outcomes of surgeryANZ JOURNAL OF SURGERY, Issue 3 2002Richard S. Flint Background: Parathyroidectomy has long been established as an effective treatment for primary hyperparathyroidism (HPT). Methods: A 15-year retrospective audit was made by surgeons at North Shore Hospital, Auckland, of 33 patients with primary HPT who had parathyroidectomy. Results: There were 22 females and 11 males, ranging in age from 18 to 77 years (median 63 years). Initial diagnosis was predominantly by a general practitioner (72%), who invariably referred to a physician. Referral to surgery was made by general physicians (55%), endocrinologists (33%) and geriatricians (6%). Delay between diagnosis and referral for surgery ranged from 8 days to 10 years (median 7 months), and exceeded 2 years in 24% of patients. Twenty-eight (85%) were symptomatic: 13 (39%) had renal symptoms, 13 (39%) had bone disease, 10 (31%) had gastrointestinal complaints, seven (21%) had psychiatric illnesses and six (18%) had fatigue. The high incidence of symptoms was matched by high biochemical values (mean serum cal- cium level 2.97 mmol/L), and large parathyroid glands (mean weight 2001 mg). Twenty-nine patients (88%) had single adenomas, two (6%) had chief cell hyperplasia and two (6%) had carcinoma. Thirty-one (94%) were cured of their primary HPT. Conclusions: Parathyroidectomy is a safe and effective treatment for primary HPT but depends upon referral from non-surgical clinicians. A large proportion of patients have long delays before their surgery, and the group selected for surgery is referred with severe disease. [source] Do early interviews affect children's long-term event recall?APPLIED COGNITIVE PSYCHOLOGY, Issue 7 2004Margaret-Ellen Pipe The present study examined the effects of the timing of an initial interview on children's recall of an event over delays of 1 and 2 years. Fifty-five children who had originally participated in a novel event when they were between 5- and 6-years old and had been interviewed about it following either short (1 week or less) or long (1 or 6 month) delays were re-interviewed 1 and 2 years after the original experience. An additional 20 children not interviewed prior to the 1-year interview were included as a no-prior-interview control group. Long delays to the initial interview led to better open-ended recall at the 1-year delay than short delays to initial interview or no prior interview. However, initial interviews that followed short delays had a greater impact on children's responses to specific questions. The results suggest that prior interview history is an important consideration when examining the effects of long delays on children's event reports, and that the effects of the timing of an initial interview depend on the nature of the information recalled. Copyright © 2004 John Wiley & Sons, Ltd. [source] Rethinking Caretaker Conventions for Australian GovernmentsAUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 3 2001Glyn Davis Australia has well-established conventions for caretaker governments. These conventions regulate how a government should operate once an election is called, and have been documented for some decades. Yet the current conventions date from an era when elections usually produced clear and immediate results. Can our caretaker conventions cope with the emerging reality of indecisive elections and long delays before a new government is confirmed? This paper canvasses the state of Australia's caretaker conventions and offers suggestions for an expanded, contemporary code. [source] Neoadjuvant chemoradiotherapy for operable oesophageal carcinoma: preliminary results from SheffieldBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2001I. McL. Background: Surgical resection is the mainstay of treatment for potentially curable oesophageal carcinoma but the long-term survival rate remains 10,20 per cent. Neoadjuvant administration of chemoradiotherapy (NCR) may improve these values. In this study the authors reviewed their preliminary experience with NCR in Sheffield. Methods: Twenty-five patients with potentially resectable oesophageal carcinoma embarked on a regimen of NCR, with resection planned 4,6 weeks later. Chemotherapy incorporated two cycles of intravenous cis -platinum and 5-fluorouracil with external-beam radiotherapy administered synchronously (30,45 Gy). Results: Twenty-two of the 25 patients suffered side-effects from NCR, including one death, and seven patients failed to complete NCR as planned. The median interval from diagnosis to surgery was 121 days. Twelve out of 24 patients had significant postoperative complications, including two deaths. Seven patients had a complete histological response to NCR (three out of 15 for adenocarcinoma, four out of nine for squamous carcinoma). Conclusion: The complete histological response rate to NCR in these patients compares favourably with previous studies, as does the postoperative mortality, but this was at the expense of substantial morbidity and was associated with long delays from diagnosis to operation. At present it is not possible to predict which patients will respond favourably to NCR and whether they will benefit with improved survival. © 2001 British Journal of Surgery Society Ltd [source] | |||||||||||||||||||||||||||||||