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Terms modified by Month Study Selected AbstractsA Multicenter, 47-Month Study of Safety and Efficacy of Calcium Hydroxylapatite for Soft Tissue Augmentation of Nasolabial Folds and Other Areas of the FaceDERMATOLOGIC SURGERY, Issue 2007NEIL S. SADICK MD OBJECTIVES Each soft tissue filler product has its own unique profile in terms of adverse events. In this large-scale study, we investigated the safety profile of Radiesse, an injectable calcium hydroxylapatite (CaHA) implant, in treatment of nasolabial folds and other areas of the face. We also investigated the efficacy in a subset of the larger patient group. METHODS After obtaining informed consent from the subjects, researchers injected CaHA at two treatment centers into 113 patients (100 women and 13 men, ranging in age from 26 to 78 years) for a variety of facial aesthetic applications over a period of 47 months. Seventy-five patients had a single injection session; 38 had multiple sessions. Most patients (102) received 1.0 mL of CaHA per session; 12 received 2.0 mL per session. Typically, CaHA was administered with a 27-gauge 0.5- or 1 1/4-in. needle. RESULTS Safety. Of 113 patients, only 7 reported minor adverse events that were short-term and resolved within 1 month: transient ecchymosis (3), nongranulatomous submucosal nodules of the lip (2), and inflammation and edema (2). Efficacy. Efficacy ratings were performed for a subset of patients (n=41). On a scale of 1 to 5 (1=unsatisfactory; 5=excellent), the mean patient evaluation score for look and feel of the implant was 4.6; the mean physician scores for the look and feel of the implant were 4.5 and 4.6, respectively. During the 6-month follow-up visit, patients' mean ratings of the look and feel of the implant were 4.8 and 4.9, respectively. The physician's mean ratings for the look and feel of the implant were 4.5 and 4.9, respectively. CONCLUSIONS In our study, CaHA performed well, with a favorable safety profile, high patient satisfaction (90% of patients reported very good or excellent results), and good durability. We are especially pleased with the low incidence of adverse events coupled with the favorable responses from the patients themselves due to longevity of correction. [source] Rapid (partial) prescreening of cervical smears: the quality control method of choice?CYTOPATHOLOGY, Issue 4 2002D. BROOKE Rapid rescreening of all negative and inadequate smears is the quality control method of choice in the UK. The sensitivity of primary screening of laboratory and individual screeners are major indicators of screening quality and are dependent on the number of false negative smears found by rapid screening for their calculation. High sensitivity may indicate good quality primary screening or poor quality rapid review. Quantifiably high quality rapid rescreening is essential if these sensitivity figures are to be meaningful. A 12-month study was undertaken in routine practice using the prescreening mode to ascertain the sensitivity of rapid (partial) screening in our department . The final results of smears were compared with those of rapid prescreening. The calculated sensitivity ranged from 92,54% for high-grade abnormalities and 75,33% for all grades, revealing a wide range of performance between individual prescreeners. Rapid prescreening can identify individuals best suited to rapid screening in routine practice. By using these prescreeners only, the sensitivity of cervical screening could be raised. Rapid (partial) prescreening should be considered as the quality control method of choice. [source] Persistence and Improvement of Nasolabial Fold Correction with Nonanimal-Stabilized Hyaluronic Acid 100,000 Gel Particles/mL Filler on Two Retreatment Schedules: Results up to 18 Months on Two Retreatment SchedulesDERMATOLOGIC SURGERY, Issue 2008RHODA S. NARINS MD BACKGROUND Nonanimal-stabilized hyaluronic acid (NASHA) fillers are frequently used for facial soft tissue augmentation. Their long-term efficacy and the effects of different retreatment schedules are not well established. OBJECTIVE This is an 18-month interim analysis of a 30-month study to evaluate the efficacy and persistence of NASHA 100,000 gel particles/mL filler with two different retreatment schedules. METHODS This multicenter, randomized, evaluator-blinded study enrolled 75 patients with moderate to severe nasolabial folds. Patients were randomized to retreatment of one nasolabial fold at 4.5 months and the contralateral fold at 9 months after correction of both folds at the initial visit. RESULTS Wrinkle Severity Rating Scale scores improved significantly (p<.001) from baseline, with mean improvements ranging from 1.1 to 1.7 grades. Almost all patients (97%) responded satisfactorily, and the efficacy of the retreatment schedules did not differ significantly. Adverse events, primarily swelling and bruising, occurred in 33% of patients; none were serious. CONCLUSION The improvements seen after initial treatment with NASHA 100,000 gel particles/mL filler persisted for up to 18 months with one retreatment. The response was equivalent for retreatment at 4.5 and 9 months. [source] Laser Hair Removal with Alexandrite versus Diode Laser Using Four Treatment Sessions: 1-Year ResultsDERMATOLOGIC SURGERY, Issue 11 2001Sorin Eremia MD Background. Laser hair removal is the treatment of choice for hypertrichosis. The two most commonly used hair removal lasers are compared. Objective. To present the results of a comparative study examining the role of wavelength, fluence, spot size, pulse width, and cooling systems on long-term results after a series of four laser hair removal treatments using the 755 nm alexandrite and 800,810 nm diode lasers. Methods. The axillae of 15 untanned, type I,V patients were treated side by side four times at 4- to 6-week intervals with a 755 nm, 3-msec pulse width, cryogen spray-equipped alexandrite laser and an 800 nm, variable pulse width, cooled sapphire window-equipped diode laser. Each patient was pretested and treated with the maximum fluence tolerated at the largest spot size available for each laser (12 mm round/113 mm2 for the alexandrite and 9 mm for the diode). Results. Evaluations were done at 3, 6, 9, and 12 months after the last treatment. Twelve-month results with the alexandrite and diode lasers achieved 85% versus 84% hair reduction. The fact that tan avoidance was strictly followed permitted the use of relatively high fluences (25,30+ J/cm2) even in type IV patients. For most patients, four treatment sessions using high fluences (30,40 J/cm2) with relatively large spot sizes (12 mm round for the 755 nm alexandrite and 9 mm for the 800 nm diode) resulted in 12-month hair reductions in the 90% range. Conclusion. Both the alexandrite and diode lasers in this 12-month study produced excellent long-term hair reductions. [source] A reduction in severe hypoglycaemia in type 1 diabetes in a randomized crossover study of continuous intraperitoneal compared with subcutaneous insulin infusionDIABETES OBESITY & METABOLISM, Issue 11 2009A. Liebl Aim: Continuous intraperitoneal insulin infusion (CIPII) with the DiaPort system using regular insulin was compared to continuous subcutaneous insulin infusion (CSII) using insulin Lispro, to investigate the frequency of hypoglycemia, blood glucose control, quality of life, and safety. Methods: In this open, randomized, controlled, cross-over, multinational, 12-month study, 60 type 1 diabetic patients with frequent hypoglycemia and/or HbA1c > 7.0% with CSII were randomized to CIPII or CSII. The aim was to obtain the best possible blood glucose while avoiding hypoglycemia. Results: The frequency of any hypoglycemia was similar (CIPII 118.2 (SD 82.6) events / patient year, CSII 115.8 (SD 75.7) p = 0.910). The incidence of severe hypoglycemia with CSII was more than twice the one with CIPII (CIPII 34.8 events / 100 patient years, CSII 86.1, p = 0.013). HbA1c, mean blood glucose, and glucose fluctuations were not statistically different. Treatment-related severe complications occurred mainly during CIPII: port infections (0.47 events / patient year), abdominal pain (0.21 events / patient year), insulin underdelivery (0.14 events / patient year). Weight gain was greater with CSII (+ 1.5 kg vs. , 0.1 kg, p = 0.013), quality of life better with CIPII. Conclusions: In type 1 diabetes CIPII with DiaPort reduces the number of severe episodes of hypoglycemia and improves quality of life with no weight gain. Because of complications, indications for CIPII must be strictly controlled. CIPII with DiaPort is an alternative therapy when CSII is not fully successful and provides an easy method of intraperitoneal therapy. [source] Exploring New Frontiers: What Do Computers Contribute to Teaching Foreign Languages in Elementary School?FOREIGN LANGUAGE ANNALS, Issue 3 2002Joyce W. Nutta ABSTRACT: Two growing trends in foreign language education, the study of foreign languages in the elementary school (FLES) and the use of computer-assisted language learning (CALL), have been well researched independently but rarely in concert. This study compares the use of a print and multimedia program to teach Spanish to second through fifth graders from quantitative and qualitative perspectives. The experimental portion of the study showed that the achievement and proficiency of students using print or multimedia materials did not differ at posttest. However, a small but statistically significant difference in achievement emerged at the delayed test point in favor of the students who used the multimedia materials, although this finding is limited by participant attrition over the 13-month study. The qualitative portion of the study detected differences in language behavior, with the students who used multimedia spending more time to stop, check, and revise their language production, leading to greater precision in pronunciation and the use of larger chunks of language when repeating phrases. [source] Tolerability and Safety of Frovatriptan With Short- and Long-term Use for Treatment of Migraine and in Comparison With SumatriptanHEADACHE, Issue 2002Gilles Géraud MD Objective.,To evaluate the tolerability and safety of frovatriptan 2.5 mg in patients with migraine. Background.,Frovatriptan is a new, selective serotonin agonist (triptan) developed for the acute treatment of migraine. Dose range-finding studies identified 2.5 mg as the dose that conferred the optimal combination of efficacy and tolerability. Methods.,The tolerability and safety of frovatriptan 2.5 mg were assessed during controlled, acute migraine treatment studies, including a study that compared frovatriptan 2.5 mg with sumatriptan 100 mg, as well as a 12-month open-label study during which patients could take up to three doses of frovatriptan 2.5 mg within a 24-hour period. Safety and tolerability were assessed through the collection of adverse events, monitoring of heart rate and blood pressure performance of 12-lead electrocardiogram, hematology screen, and blood chemistry studies. Results.,In the short-term studies, 1554 patients took frovatriptan 2.5 mg and 838 took placebo. In the 12-month study, 496 patients treated 13 878 migraine attacks. Frovatriptan was well tolerated in the short- and long-term studies with 1% of patients in the short-term studies and 5% of patients in the long-term study withdrawing due to lack of tolerability. The incidence of adverse events was higher in the frovatriptan-treated patients than in the patients who took placebo (47% versus 34%) and the spectrum of adverse events was similar. When compared to sumatriptan 100 mg, significantly fewer patients taking frovatriptan experienced adverse events (43% versus 36%; P=.03) and the number of adverse events was lower (0.62 versus 0.91), there were also fewer adverse events suggestive of cardiovascular symptoms in the frovatriptan group. Analysis of the entire clinical database (n=2392) demonstrated that frovatriptan was well tolerated by the patients regardless of their age, gender, race, concomitant medication, or the presence of cardiovascular risk factors. No effects of frovatriptan on heart rate, blood pressure, 12-lead electrocardiogram, hematology screen, or blood chemistry were observed. No patient suffered any treatment-related serious adverse event. Conclusions.,Short- and long-term use of frovatriptan 2.5 mg was well tolerated by a wide variety of patients. Frovatriptan treatment produced an adverse events profile similar to that of placebo, and in a direct comparison study was better tolerated than sumatriptan 100 mg. [source] Water quality and Cryptosporidium distribution in an upland water supply catchment, Cumbria, UKHYDROLOGICAL PROCESSES, Issue 7 2007A. Sturdee Abstract Four micro-catchment (MC) areas were identified to represent the main terrain types of a remote, sparsely populated upland valley catchment of 18 km2 in Cumbria, UK. These were improved land with good grazing (IB), steeply sloping land with rough grazing (SG), wet moorland with sparse grazing (WM) and enclosed woodland that excluded livestock and deer (EW). Each MC contained the origin of a small stream that flowed into Swindale Beck, the river draining the valley. The water quality during the 14-month study, as judged by chemical and physical parameters, was excellent, but it could not be regarded as pristine because of the frequent presence of Cryptosporidium oocysts arising from livestock and wild mammal faeces. Oocysts (0·2,5·6 l,1) detected by genus-specific immunofluorescent antibody were found in 32% of 188 water samples tested: ranking order EW 44%, IB 34%, Beck 30%, SG and WM 26%. Similarly, oocysts were identified in 9·5% of 1730 faecal samples. Small wild mammals (28%), calves (15·7%) and lambs (8·1%) were the dominant sources, whereas adult livestock (1·8%) and large wild mammals (4·8%) were less important. Autumn showed the highest occurrence of oocysts for both water and faecal samples. No hydrological controls were found to have a significant impact on the occurrence or concentration of oocysts in the main river or in the MCs, suggesting that their presence is controlled by seasonal changes in pathogen prevalence in the animal reservoir. Copyright © 2006 John Wiley & Sons, Ltd. [source] Bone Mineral Density in Postmenopausal Breast Cancer SurvivorsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2001APRN, Janice J. Twiss PhD Purpose The overall purpose of this longitudinal 18-month study was to test the feasibility and effectiveness of a multicomponent intervention for prevention and treatment of osteoporosis. The purpose of this article is to describe the baseline bone mineral density (BMD) findings for 30 postmenopausal women and to compare these BMD findings to time since menopause, body mass index, and tamoxifen use. Data Sources Baseline data of BMD findings for 30 post-menopausal women, who have had a variety of treatments including surgery, adjuvant chemotherapy and or tamoxifen, and are enrolled in the 18-month longitudinal study. A demographic questionnaire and a three day dietary record were used to collect baseline data. Conclusions Eighty percent of the women with breast cancer history had abnormal BMDs at baseline (t-scores below -1.00 SD). Thinner women showed a greater risk for accelerated trabecular bone loss at the spine and hip. Implications for Practice These findings suggest the need for early BMD assessments and for aggressive health promotion intervention strategies that include a multifaceted protocol of drug therapy for bone remodeling, 1500 mg of daily calcium, 400 IU vitamin D and a strength weight training program that is implemented immediately following chemotherapy treatment and menopause in this high risk population of women. [source] Clinical Assessment of Ischemia-modified Albumin and Heart Fatty Acid,binding Protein in the Early Diagnosis of Non-ST-elevation Acute Coronary Syndrome in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 1 2010Sandrine Charpentier MD Abstract Objectives:, Heart fatty acid,binding protein (h-FABP) and ischemia-modified albumin (IMA) have recently been evaluated, but to the best of our knowledge, no study has reported an analysis of these two markers for the detection of early myocardial infarction and myocardial ischemia in a large cohort of consecutive patients presenting to an emergency department (ED). This study evaluates the diagnostic accuracy and the clinical utility of h-FABP and IMA for non-ST-segment elevation acute coronary syndrome (ACS) diagnosis in the first hour of management in an ED. Methods:, In a prospective 11-month study, 677 patients admitted to the ED with chest pain and suspected non-ST-segment elevation ACS were enrolled. On presentation, blood samples were obtained for the measurement of the biomarkers h-FABP (immunodetection with CardioDetect) and IMA (albumin cobalt-binding test). Two physicians, blinded to the results of the markers, independently categorized patients as having or not having non-ST-segment elevation ACS. Results:, Of the 677 patients who were prospectively recruited, non-ST-segment elevation ACS was diagnosed in 185 (27.3%). While IMA was not predictive of the ACS diagnosis (odds ratio [OR] = 1.23; 95% CI = 0.87 to 1.81), h-FABP was predictive of ACS diagnosis (OR = 4.65; 95% CI = 2.39 to 9.04) with specificity at 96.8% (95% CI = 95.4% to 98.1%) and sensitivity at 13.5% (95% CI = 10.9% to 16.1%). However, h-FABP did not add significant additional information to a predictive model that included the usual diagnostic tools for non-ST-elevation ACS management (p = 0.40). Conclusions:, In this study on a large cohort of patients admitted to an ED for chest pain, IMA and h-FABP did not provide valuable information for ACS diagnosis. ACADEMIC EMERGENCY MEDICINE 2010; 17:27,35 © 2010 by the Society for Academic Emergency Medicine [source] Atorvastatin in dyslipidaemia of the nephrotic syndromeNEPHROLOGY, Issue 2 2003Pedro VALDIVIELSO SUMMARY: The combined dyslipidaemia that accompanies the nephrotic syndrome increases the cardiovascular risk and appears to worsen long-term renal function. Our aim was to determine the efficacy and safety of 10 mg atorvastatin in the control of dyslipidaemia in these patients. We carried out a prospective, open, 6 month study of 10 patients with primary or secondary nephrotic syndrome (proteinuria >3.5 g/day, hypoalbuminaemia, oedema and hyperlipidaemia). The changes in lipids and plasma lipoproteins were measured, as well as the safety profile (transaminases, creatine phosphokinase, fibrinogen and antithrombin III activity) and parameters of renal function. The addition of 10 mg atorvastatin daily for 6 months resulted in a 41% reduction in low density lipoprotein (LDL) cholesterol and 31% in triglycerides (both P < 0.05), and a 15% increase in high density lipoprotein (HDL) cholesterol (NS). The drug was well tolerated and there was no change in the safety profile or deterioration in renal function. In fact, the levels of proteinuria fell in all but one patient (6.2 ± 2.6 vs 4.8 ± 2.5 g/24 h; P < 0.05). Atorvastatin, at the above dose, and for the time used proved to be a safe drug that effectively reduced dyslipidaemia in patients with nephrotic syndrome. [source] Evaluation of the environmental fate of thymol and phenethyl propionate in the laboratoryPEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 7 2008Dingfei Hu Abstract BACKGROUND: The natural monoterpenoid pesticides thymol and phenethyl propionate (PEP) are used indoors and outdoors, but their fate in the environment has not been reported. In order better to understand their impact on the environment, water metabolism and soil metabolism studies were conducted with thymol and PEP at a concentration of 10 µg g,1 in water and in soil under laboratory conditions. RESULTS: Dissipation half-lives of thymol and PEP were 16 and 5 days in water and 5 and 4 days in soil. 2-Phenylethanol and 2-(4-hydroxyphenyl)ethanol were detected as primary degradation products of PEP. Over time, a considerable volatilization loss of thymol, but not of phenethyl propionate, was found in the 1 month study under the experimental conditions used. Less than 6% of thymol and PEP were detected as bound residues, and less than 3% were mineralized during the 30 day study. CONCLUSION: In order to maximize the pesticidal effect, more attention should be paid to the temperature for thymol than for PEP when they are being applied, owing to the high volatility of the former. Thymol and PEP pose low risks to the ecosystem because of their rapid dissipation and low bound residues in the environment. Copyright © 2008 Society of Chemical Industry [source] Sexual behavior across ovarian cycles in wild black howler monkeys (Alouatta pigra): male mate guarding and female mate choiceAMERICAN JOURNAL OF PRIMATOLOGY, Issue 2 2009Sarie Van Belle Abstract We studied two multimale,multifemale groups of black howler monkeys (Alouatta pigra) during a 14-month study (June 2006,July 2007) in Palenque National Park, Mexico to evaluate the ways in which their sexual behavior changes across ovarian cycles. We analyzed 231 fecal samples, collected every 2.2±1.4 days from five females. For four females, estradiol and progesterone profiles revealed an average (±SE) cycle length of 18.3±1.4 days. Copulations occurred significantly more frequently during the periovulatory period (POP), defined as the estimated day of ovulation ±3 days (N=18). This was largely the result of cycling females soliciting sexual interactions during their POPs. Females directed their solicitations significantly more often toward "central" males of their group, who had close spatial associations with females at other times, compared with "noncentral" males, who did not associate closely with females. Central males rarely solicited sexual interactions, but instead monitored the females' reproductive status by sniffing their genitals, and maintained significantly closer proximity to females during their POPs, suggesting male mate guarding when conceptions are most likely to occur. Our findings indicate that the reproductive strategies of black howler central males and females coincide, highly skewing mating opportunities toward central males. Black howler females, however, occasionally choose to copulate with noncentral resident males or extra-group males during their POPs, undermining the ability of central males to monopolize all reproductive opportunities. Am. J. Primatol. 71:153,164, 2009. © 2008 Wiley-Liss, Inc. [source] Growth and reproductive performance of triploid and diploid blacklip abalone, Haliotis rubra (Leach, 1814)AQUACULTURE RESEARCH, Issue 2 2009Wenshan Liu Abstract Growth and reproduction of triploid and diploid blacklip abalone Haliotis rubra (Leach, 1814) were compared in a 30-month study. Triploidy was induced by inhibition of the second polar body formation using 6-dimethylaminopurine (6-DMAP) or cytochalasin B (CB). There were no significant differences in growth and survivorship between triploid and diploid abalone. However, triploid abalone had a more elongated shell and greater foot muscles than diploid abalone. A slightly curvilinear growth in shell length was conformed to all treatments. While diploid abalone had reached sexual maturity and spawned during the study, gonadal development and gamete maturation were abnormal in triploids. Female triploids lacked an apparent gonad at the macroscopic level but microscopic examination revealed that they had a thin layer of oogonia development. In contrast, male triploids were able to form similar-sized gonads to diploids during most of the reproductive period, but with brown-yellow discolouration and stalled gametogenesis at spermatocyte formation. Sex ratio of triploid abalone did not deviate from 1:1. With the onset of sexual maturation, growth and gonadal maturation occurred concurrently in diploid abalone, and there was no indication that growth of (diploid) abalone was reduced. [source] Effects of invasion of fire-free arid shrublands by a fire-promoting invasive alien grass (Pennisetum setaceum) in South AfricaAUSTRAL ECOLOGY, Issue 8 2009S. J. RAHLAO Abstract Arid shrublands in the Karoo (South Africa) seldom accumulate sufficient combustible fuel to support fire. However, as a result of invasion by an alien perennial grass (Pennisetum setaceum), they could become flammable. This paper reports on an experiment to assess the effects of fire following invasion by P. setaceum. We established 10 plots (5 × 10 m) separated by 2.5 m, and added grass fuel to five plots (5 and 10 tons ha,1 to alternate halves of the plot) leaving the remaining five plots as interspersed controls. Plots with fuel added were burnt, and fire behaviour was measured during the burns. Rates of fire spread were generally low (0.01,0.07 m s,1) and did not differ significantly between burn treatments. Mean fireline intensities were higher in the high compared with the low fuel treatments (894 and 427 kW m,1, respectively). We recorded plant species and their cover before and after burning on each of the plots. After 15 months of follow-up monitoring in the burn plots, only two species, the dwarf shrub (Tripteris sinuata) and the perennial herb (Gazania krebsiana) resprouted. Most individuals of other species were killed and did not reseed during the 15-month study. The mass of added fuel load (high or low) did not influence vegetation recovery rates after fire. Should future invasions by P. setaceum lead to similar fuel loads in these shrublands, inevitable fires could change the vegetation and may favour spread of the flammable grass. Our results have important implications for predicting the effects of invasive alien plants (especially grasses) on fire-free ecosystems elsewhere. The predicted impacts of fire may alter species composition, ultimately affecting core natural resources that support the Karoo economy. [source] The learning credit card: A tool for managing personal development,BRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY, Issue 2 2008Nick Rushby This is the report of a five month study, undertaken by Sundridge Park Training Technologies in association with Guildford Educational Services to assess the potential of smart card technology to support learning and the management of learning. The study had two strands,the state of the art of the technology and its potential for supporting, delivering and managing learning. In addition to a study of the literature and extensive discussions with people using smart cards, potential users of smart card and visionaries, the project team developed two illustrative systems using cards to store personal data relating to education and training. The term ,smart card' is often used loosely to describe three different types of card, each of which is similar in general shape and size to a traditional credit card. These are: memory cards, laser cards,and true smart cards incorporating a processor and memory. This study has been concerned with memory cards and smart cards. The focus for smart card applications has been predominantly financial: there are relatively few applications in education or training. A notable exception is the large scale project at the University of Bologna which uses smart cards to manage the progress and achievements of a large number of students in the Department of Electronics. The two illustrative systems provided valuable experience of using memory cards and smart cards in quasi-real education and training applications. They highlighted the problems of limited memory capacities and confirmed the high level of user acceptance reported by other trials. We can expect considerable advances in the technology of both memory cards and smart cards over the next months and years. The memory capacities of both types of cards will increase many-fold and the unit costs will fall as large quantities of cards are produced for financial applications. Education and training applications will benefit from this expanding market. The major surprise from the study was the level of interest in the work and the enthusiasm expressed by almost all of those who came to hear of it. The general level of awareness of smart card technology was found to be low. However, the requirement for a system which will enable individuals to manage and own their learning on an extended timescale was generally recognised. Some of the possible applications for smart cards and memory cards in education and training had emerged before the official start of the study and it is clear that the technology is potentially pervasive. The project team and those consulted identified a wide range of possible applications both in education and in training. These focussed on assessment, personal course planning and management, identification of relevant learning opportunities, and the ownership of learning. It was felt that, over the next few years, smart cards are very likely to be in common use as credit cards for financial applications. Therefore, their use for education and training should be planned now. The recommendations from the study are that: More detailed studies are needed to find out how smart cards and memory cards could be used by different organisations in a fully operational system; Standards should be established for smart card applications in education and training, similar to those governing financial applications; Applications should be developed after the standards have been established. To be convincing, these should take a case study approach with small pilot studies in a variety of contexts and must follow real needs rather than attempt to drive them; The case studies would then form the basis for a campaign to increase awareness of smart cards and their potential for education and training, together with a programme for building an infrastructure to support the proposed systems. The public sector should fund the task of developing standards and providing interfaces with existing educational systems and projects to demonstrate the feasibility of various applications. Since educational standards have a European dimension, the European Community may be a source of support for work in the area of standards. At the same time, private sector funding should be sought for skill development and career development systems in industry and in education. The Training Agency itself should consider the application of smart card technology to the control and management of the Youth Training Scheme (YTS). [source] Effects of Tai Chi and resistance training on cardiovascular risk factors in elderly Chinese subjects: a 12-month longitudinal, randomized, controlled intervention studyCLINICAL ENDOCRINOLOGY, Issue 6 2005G. Neil Thomas Summary Background, ,Tai Chi is rapidly gaining in popularity, worldwide. This study was performed to assess its impact on cardiovascular risk factors in comparison with resistance training exercises in elderly Chinese subjects. Methods, A total of 207 healthy elderly participants (65,74 years, 113/207 (55%) men) were randomly assigned to one of three intervention groups: (1) Tai Chi, three times/week for 1 h/session (n = 64); (2) resistance training exercise, three times/week for 1 h/session (n = 65); (3) usual level of physical activity control group (n = 78). Anthropometric measures, dual X-ray densitometry body composition, blood pressure, lipids, glycaemic and insulin sensitivity indices were measured at baseline and 12 months. Repeated-measures analysis of variance (anova) was used to assess the between-group changes using a last-observation-carried-forward intention-to-treat approach. Results, A total of 180 (87·0%) subjects completed the study. No significant changes were identified in the Tai Chi group compared to the resistance training or control group. Of the primary outcomes, only the improvement in the insulin sensitivity index differed, being significantly greater in the resistance training than in the control group [mean difference 0·018 (95% confidence interval ( CI) 0·000,0·037) mmol glucose/min, P = 0·02), and tending to be greater than in the Tai Chi group (mean difference 0·019 (95% CI 0·000,0·038) mmol glucose/min, P < 0·06). Conclusion, Tai Chi had no significant effect on any measure compared to the controls, whereas resistance training improved the insulin sensitivity index in this 12-month study. [source] Perceived criticism, marital interaction and relapse in unipolar depression,findings from a Korean sampleCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 5 2006Jung-Hye Kwon Perceived criticism by partner (PC) has been demonstrated to be a powerful predictor of depressive relapse. The purpose of this prospective 11-month study was to replicate this finding in an outpatient series of married women in Korea, but also to further explore the nature of PC in terms of qualities of the marital relationship and dysfunctional attitudes. The subjects consisted of 27 married female outpatients who had all been treated for major depression, but were in recovery at time of first contact or shortly after. All were interviewed at time 1 and then again after 11 months at time 2 to ascertain major depressive episode using the Korean version of SADS as well as completing the BDI. At first contact, questionnaire and interview assessments were used for marital quality and dysfunctional attitudes denoting dependency. There was a significant relationship between the single-item PC and depressive relapse at follow-up as predicted. This relationship was not enhanced by using the expanded item scale. PC and/or PC-E were significantly correlated with marital quality variables, specifically lack of emotional support from partner, negative interaction and dependence on partner. The study shows that perceived criticism by spouse is a predictor of depressive relapse in Korean outpatients and that this appears to reflect actual negative characteristics of the marital relationship as well as the depressed person's high dependence on the relationship. These results support the importance of improving marital interactions in preventing relapse in depression.,Copyright © 2006 John Wiley & Sons, Ltd. [source] Predictive Validity of a Computerized Emergency Triage ToolACADEMIC EMERGENCY MEDICINE, Issue 1 2007Sandy L. Dong MD Abstract Background Emergency department (ED) triage prioritizes patients on the basis of the urgency of need for care. eTRIAGE is a Web-based triage decision support tool that is based on the Canadian Triage and Acuity Scale (CTAS), a five level triage system (CTAS 1 = resuscitation, CTAS 5 = nonurgent). Objectives To examine the validity of eTRIAGE on the basis of resource utilization and cost as measures of acuity. Methods Scores on the CTAS, specialist consultations, computed-tomography use, ED length of stay, ED disposition, and estimated ED and hospital costs (if the patient was subsequently admitted to hospital) were collected for each patient over a six month period. These data were queried from a database that captures all regional ED visits. Correlations between CTAS score and each outcome were measured by using logistic regression models (categorical variables), univariate analysis of variance (continuous variables), and the Kruskal-Wallis analysis of variance (costs). A multivariate regression model that used cost as the outcome was used to identify interaction between the variables presented. Results Over the six month study, 29,524 patients were triaged by using eTRIAGE. When compared with CTAS level 3, the odds ratios for consultation, CT scan, and admission were significantly higher in CTAS 1 and 2 and were significantly lower in CTAS 4 and 5 (p < 0.001). When compared with CTAS levels 2,5 combined, the odds ratio for death in CTAS 1 was 664.18 (p < 0.001). The length of stay also demonstrated significant correlation with CTAS score (p < 0.001). Costs to the ED and hospital also correlated significantly with increasing acuity (median costs for CTAS levels in Canadian dollars: CTAS 1 =$2,690, CTAS 2 =$433, CTAS 3 =$288, CTAS 4 =$164, CTAS 5 =$139, and p < 0.001). Significant interactions between the data collected were found in a multivariate regression model, although CTAS score remained highly associated with costs. Conclusions Acuity measured by eTRIAGE demonstrates excellent predictive validity for resource utilization and ED and hospital costs. Future research should focus on specific presenting complaints and targeted resources to more accurately assess eTRIAGE validity. [source] | ||||||||||||||||