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Kinds of Options Available Selected AbstractsA SANCTUARY IN POST-CONFLICT SPACE: THE BAPTIST CHURCH AS A ,MIDDLE OPTION' IN BANOVINA, CROATIAGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 1 2009Reinhard Henkel ABSTRACT. One of the observable aspects of social change during the transition period in most post-socialist countries is the revival of religion. The resurgence of churches has accompanied national revival and in some countries it is also connected to a growing post-socialist nationalism. This article focuses on the development of different ,,transnational', religious options in an area of ethnic conflict by presenting a case study of the post-war growth of the Baptist Church in the Banovina region in Croatia, close to the Bosnian border. Research results are based on halfstructured interviews with church representatives and members. The research shows that there has been a considerable post-war expansion of the Baptist Church in the Banovina region, and that it is mainly ethnic Serbs and people from mixed marriages who have joined the Church. Many of them have a background as communists. For them, neither the Catholic Church, which is regarded as a Croatian church, nor the Serbian Orthodox Church are viable religious options. Instead, there are three factors that make the ,Baptist option' attractive. First, it is grounded in the historical tradition of the Baptist Church in this region and on memories and myths activated in the war and post-war periods. Second, the Baptist Church has made a middle transnational option available in an ethnically mixed area. As such it attracts those who are searching for a niche of neutrality in an ethnically strongly divided region characterized by conflict. Third, the considerable humanitarian work and help of organizations related to the Baptist Church during and after the war not only added in the eyes of many people in need to its image elements of existential shelter, but also brought the Church out of the shadows and made it more ,visible', thereby improving its former reputation as an obscure sect. [source] Fulminant hepatic failure: Wilson's disease or autoimmune hepatitis?PEDIATRIC TRANSPLANTATION, Issue 1 2005Implications for transplantation Abstract:, Fulminant hepatic failure (FHF) accounts for 10,15% of pediatric liver transplants in the USA annually. Because the onset of FHF may be the first presentation of Wilson's disease (WD) and autoimmune hepatitis (AIH) in previously asymptomatic adolescents, determination of the etiology of FHF is critical as treatment and prognosis differ between these two entities. Patients with AIH may be salvaged by medical treatment. On the contrary, liver transplantation is currently the only life saving therapeutic option available for patients with WD who present with fulminant liver failure. To establish the diagnosis of WD and AIH in the setting of FHF remains challenging for diagnosticians and decisions regarding liver transplantation may be necessary before a diagnosis is firmly established. We report a previously asymptomatic patient who presented with FHF and clinical and laboratory features suggestive of both WD and AIH and who underwent successful therapeutic liver transplantation before the diagnosis of WD could be confirmed. [source] Morphological and ecological responses to a conservation translocation of powan (Coregonus lavaretus) in ScotlandAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 3 2010E. C. Etheridge Abstract 1.The establishment of refuge populations has become a common management tool for threatened fish species in recent years, yet the effects of translocation are not fully understood in a conservation context. 2.This paper examines the hypothesis that phenotypic changes have occurred during the formation of two refuge populations of the nationally rare powan (a freshwater fish species) which were established in Loch Sloy and Carron Valley Reservoir in Scotland. 3.Significant differences in head morphology, size and growth between the founder and refuge populations and between the two refuge populations were demonstrated. These changes are probably due to a combination of founder effects, intense selection and phenotypic plasticity. These changes can undermine the rationale behind the establishment of refuge populations. 4.The results call into question the usefulness of translocation as a conservation measure; however, there are times when this is the only viable management option available. The future of translocation and the validity of establishing refuge populations for powan conservation are discussed. Copyright © 2010 John Wiley & Sons, Ltd. [source] The impact of aphicide drenches on Micromus tasmaniae (Walker) (Neuroptera: Hemerobiidae) and the implications for pest control in lettuce cropsAUSTRALIAN JOURNAL OF ENTOMOLOGY, Issue 3 2006Peter G Cole Abstract, The recent arrival of lettuce aphid (Nasonovia ribis-nigri (Mosley) ) in Australia has resulted in a pesticide-based protection program based upon seedling drenches of imidacloprid being promoted by many advisory agencies and accepted by growers as the only option available. This has caused concern about potential for incompatibility with existing integrated pest management programs for other pests in lettuce. Two neonicotinoid insecticides, imidacloprid (Confidor 200SC) and thiamethoxam (Actara), were applied to lettuce seedlings by drenching. A model aphid (Macrosiphum euphorbiae (Thomas) ), used because N. ribis-nigri was not present in mainland Australia at that time, was periodically released onto the seedlings over 10 weeks. The effects of imidacloprid and thiamethoxam on larvae of predatory brown lacewings (Micromus tasmaniae (Walker) ) which fed on the aphids were measured over 10 weeks by bioassay. Imidacloprid applied at a rate of 11 mL active ingredient (ai) per 1000 seedlings and thiamethoxam applied at 0.5 g ai per 1000 seedlings were highly toxic to M. tasmaniae that consumed aphids from the seedlings for up to 4 weeks after application. A 1/10 rate of imidacloprid (1.1 mL ai per 1000 seedlings) caused moderate toxicity for 3 weeks, and was then harmless to M. tasmaniae. Thiamethoxam and the high rate of imidacloprid caused almost complete mortality of aphids for about 6 weeks after application, and the low rate of imidacloprid displayed similarly high activity for about 3 weeks. [source] Local authorities, climate change and small and medium enterprises: identifying effective policy instruments to reduce energy use and carbon emissionsCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 3 2008Jaryn Bradford Abstract This paper discusses potential policy options available to local and municipal authorities, to achieve reductions in energy usage and greenhouse gas (GHG) emissions from small and medium-sized enterprises (SMEs). Researchers conducted surveys with 112 SMEs, and the results have been used to disaggregate the category of ,SME' into sub-sectors based on industrial sector, two measurements of employee size and annual turnover. A statistical analysis identifies key characteristics and behaviours of the sub-sectors of firms and discusses the type of policy measure these groups of SMEs would probably respond to. The key results of the research indicate that categories of firms differ in terms of energy use behaviours, internal constraints and attitudes toward possible policy options. The paper presents a ,policy matrix' to represent the most and least likely policy options to achieve energy savings from different categories of SMEs. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source] So You Want to Be a Dermasurgeon: How to Get Training or Choose a FellowshipDERMATOLOGIC SURGERY, Issue 9 2006MURAD ALAM MD BACKGROUND There are many routes to obtaining training in dermasurgery. OBJECTIVE The objective is to discuss some considerations that may guide selection of dermasurgery training. METHODS Current training options are reviewed. RESULTS Some considerations that may guide selection of type of dermasurgery training include: (1) individual temperament; (2) the subtype of dermasurgery in which training is desired (Mohs, cosmetic surgery, laser); (3) family and geographic factors; (4) preference for private practice versus academic career; and (5) proportion of future practice to be devoted to dermasurgery. CONCLUSIONS There are a growing number of training choices for budding dermasurgeons, with multiple options available for each set of particular circumstances. [source] Democratization and State Feminism: Gender Politics in Africa and Latin AmericaDEVELOPMENT AND CHANGE, Issue 3 2002Ihejirika, Philomina E. Okeke This article addresses the link between state feminism and democratization in the global South. The authors use the contrasting cases of Chile and Nigeria to show some of the factors that encourage women to exploit the opportunities presented by transitions to democracy, and link the outcome of state feminism to the strategies and discourses available to women during democratization. Based on evidence from the cases analysed, the authors propose that the strategic options available to women are shaped by at least three factors: (1) the existence of a unified women's movement capable of making political demands; (2) existing patterns of gender relations, which influence women's access to arenas of political influence and power; and (3) the content of existing gender ideologies, and whether women can creatively deploy them to further their own interests. State feminism emerged in Chile out of the demands of a broad,based women's movement in a context of democratic transition that provided feminists with access to political institutions. In Nigeria, attempts at creating state feminism have consistently failed due to a political transition from military to civilian rule that has not provided feminists with access to political arenas of influence, and the absence of a powerful women's movement. [source] The metabolic syndrome and schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009J. M. Meyer Objective:, To summarize the accumulated data on metabolic syndrome prevalence in patients with schizophrenia, examine evidence for a biological contribution of the mental illness to metabolic risk and review novel options available for management of prediabetic states. Method:, A Medline search using metabolic syndrome, insulin resistance and insulin sensitivity cross-referenced with schizophrenia was performed on articles published between 1990 and May 2008. Results:, Recent evidence indicates that schizophrenia increases predisposition towards metabolic dysfunction independent of environmental exposure. Both fasting and non-fasting triglycerides have emerged as important indicators of cardiometabolic risk, while metformin, thiazolidinediones and GLP-1 modulators may prove promising tools for managing insulin resistance. Conclusion:, Because of lifestyle, disease and medication effects, schizophrenia patients have significant risk for cardiometabolic disease. Routine monitoring, preferential use of metabolically neutral antipsychotics and lifestyle education are critical to minimizing risk, with a possible role for antidiabetic medications for management of insulin resistant states that do not respond to other treatment strategies. [source] Glycaemic goals in patients with type 2 diabetes: current status, challenges and recent advancesDIABETES OBESITY & METABOLISM, Issue 6 2010K. Khunti Recommendations for the management of type 2 diabetes include rigorous control of blood glucose levels and other risk factors, such as hypertension and dyslipidaemia. In clinical practice, many patients do not reach goals for glycaemic control. Causes of failure to control blood glucose include progression of underlying pancreatic , -cell dysfunction, incomplete adherence to treatment (often because of adverse effects of weight gain and hypoglycaemia) and reluctance of clinicians to intensify therapy. There is increasing focus on strategies that offer potential to improve glycaemic control. Structured patient education has been shown to improve glycaemic control and other cardiovascular risk factors in people with type 2 diabetes. Payment of general practitioners by results has been shown to improve glycaemic control. New classes of glucose-lowering agents have expanded the treatment options available to clinicians and patients and include the dipeptidyl peptidase 4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. These new classes of therapy and other strategies outlined above could help clinicians to individualize treatment and help a greater proportion of patients to achieve long-term control of blood glucose. [source] Food Security in Protracted Crises: Building More Effective Policy FrameworksDISASTERS, Issue 2005Margarita Flores This paper considers the principal elements that underpin policy frameworks for supporting food security in protracted crisis contexts. It argues that maintaining the food entitlements of crisis-affected populations must extend beyond interventions to ensure immediate human survival. A ,policy gap' exists in that capacities for formulating policy responses to tackle the different dimensions of food insecurity in complex, fluid crisis situations tend to be weak. As a result, standardised, short-term intervention designs are created that fall short of meeting the priority needs of affected populations in the short and long term and only partially exploit the range of policy options available. The paper discusses key attributes of agency frameworks that could support more effective policy processes to address longer term as well as immediate food security needs. Additionally, it points to some main challenges likely to be encountered in developing such frameworks and, with the participation of beneficiaries, translating them into effective action. [source] BIODIVERSITY RESEARCH: Conserving macroinvertebrate diversity in headwater streams: the importance of knowing the relative contributions of , and , diversityDIVERSITY AND DISTRIBUTIONS, Issue 5 2010Amber Clarke Abstract Aim, We investigated partitioning of aquatic macroinvertebrate diversity in eight headwater streams to determine the relative contributions of , and , diversity to , diversity, and the scale dependence of , and , components. Location, Great Dividing Range, Victoria, Australia. Methods, We used the method of Jost (Ecology, 2007, 88, 2427,2439) to partition , diversity into its , and , components. We undertook the analyses at both reach and catchment scales to explore whether inferences depended on scale of observation. Results, We hypothesized that , diversity would make a large contribution to the , diversity of macroinvertebrates in our dendritic riverine landscape, particularly at the larger spatial scale (among catchments) because of limited dispersal among sites and especially among catchments. However, reaches each had relatively high taxon richness and high , diversity, while , diversity made only a small contribution to , diversity at both the reach and catchment scales. Main conclusions, Dendritic riverine landscapes have been thought to generate high , diversity as a consequence of limited dispersal and high heterogeneity among individual streams, but this may not hold for all headwater stream systems. Here, , diversity was high and , diversity low, with individual headwater stream reaches each containing a large portion of , diversity. Thus, each stream could be considered to have low irreplaceability since losing the option to use one of these sites in a representative reserve network does not greatly diminish the options available for completing the reserve network. Where limited information on individual taxonomic distributions is available, or time and money for modelling approaches are limited, diversity partitioning may provide a useful ,first-cut' for obtaining information about the irreplaceability of individual streams or subcatchments when establishing representative freshwater reserves. [source] Review of bupropion for smoking cessationDRUG AND ALCOHOL REVIEW, Issue 2 2003ROBYN RICHMOND Abstract The advent of bupropion hydrochloride sustained release (Zyban) has heralded a major change in the options available for smoking cessation pharmacotherapy. Bupropion is a selective re-uptake inhibitor of dopamine and noradrenalin which prevents or reduces cravings and other features of nicotine withdrawal. Bupropion is a useful oral and non-nicotine form of pharmacotherapy for smoking cessation. For this review a total of 221 papers were reviewed plus poster presentations. This review examines in detail original clinical trials on efficacy, categorised according to whether they were acute treatment trials in healthy smokers; studies in specific populations such as people with depression, chronic obstructive pulmonary disease (COPD) or cardiovascular disease; or relapse prevention studies. Overall, these studies in varying populations comprising over four thousand subjects, showed bupropion consistently produces a positive effect on smoking cessation outcomes. The evidence highlights the major public health role that bupropion has in smoking cessation. The methodological issues of published clinical trials reporting one year outcomes were examined in detail including: completeness of follow-up; loss to follow-up; intention to treat analysis; blindness of assessment; and validation of smoking status. The review discusses contraindications, adverse effects, dose and overdose, addictive potential, and the role of bupropion in reducing cessation-related weight gain. Bupropion combined with or compared to other pharmacotherapies (nicotine patch; nortriptyline) is considered. Impressive evidence exists for the use of bupropion in smoking cessation among difficult patients who are hard-core smokers such as those with cardiovascular disease, chronic obstructive pulmonary disease (COPD) and depression. Bupropion reduces withdrawal symptoms as well as weight gain and is effective for smoking cessation for people with and without a history of depression or alcoholism. Serious side effects of bupropion use are rare. The major safety issue with bupropion is risk of seizures (estimated at approximately 0.1%) and it should not be prescribed to patients with a current seizure disorder or any history of seizures. In clinical trials of bupropion for smoking cessation no seizures were reported. Allergic reactions occur at a rate of approximately 3% and minor adverse effects are common including dry mouth and insomnia. [source] A randomized controlled trial of an internet-based intervention for alcohol abusersADDICTION, Issue 12 2009John A. Cunningham ABSTRACT Objective Misuse of alcohol imposes a major public health cost, yet few problem drinkers are willing to access in-person services for alcohol abuse. The development of brief, easily accessible ways to help problem drinkers who are unwilling or unable to seek traditional treatment services could therefore have significant public health benefit. The objective of this project is to conduct a randomized controlled evaluation of the internet-based Check Your Drinking (CYD) screener ( http://www.CheckYourDrinking.net). Method Participants (n = 185) recruited through a general telephone population survey were assigned randomly to receive access to the CYD, or to a no-intervention control group. Results Follow-up rates were excellent (92%). Problem drinkers provided access to the CYD displayed a six to seven drinks reduction in their weekly alcohol consumption (a 30% reduction in typical weekly drinking) at both the 3- and 6-month follow-ups compared to a one drink per week reduction among control group respondents. Conclusions The CYD is one of a growing number of internet-based interventions with research evidence supporting its efficacy to reduce alcohol consumption. The internet could increase the range of help-seeking options available because it takes treatment to the problem drinker rather than making the problem drinker come to treatment. [source] Epigenetic therapy in myelodysplastic syndromesEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2010Caterina Musolino Abstract The wide spectrum of clonal hematopoietic disorders that fall under the broad diagnostic category of myelodysplastic syndromes (MDS) consist of a family of bone marrow malignancies , with ineffective, inadequate, and dysplastic hematopoiesis, and with an increased risk of life-threatening infections, bleeding, and progression to acute myeloid leukemia (AML) , that are characterized by a deep heterogeneity on the clinical, biologic and prognostic level. The intrinsic complexity of this group of disorders and the frequent association with one or more comorbidities have limited for many years the number of effective treatment options available: most patients are, indeed, still managed by supportive care measures, with just a minority of them being eligible for allogeneic stem cell transplantation, which is still the only potentially curative modality. In the last two decades, the progressively better understanding of MDS biology has shown how an abnormal epigenetic modulation might play a crucial part in the pathogenesis and in the process of biologic evolution of these disorders. Moreover, pharmacological agents that target the so-called epigenome have shown a significant clinical activity for diverse hematologic malignancies, including MDS. The aim of this review is to highlight recent developments within the context of current knowledge of MDS and its altered epigenetic regulation and to recall the experimental steps that have brought to the clinical development and application of epigenetic modifiers, such as azacytidine and decitabine, trying to explain the biologic rationale for their use in this setting. [source] Liberalized capital markets, state autonomy, and European monetary unionEUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 2 2003Erik Jones The conventional wisdom is that capital market integration and now monetary union have limited the options available to macroeconomic policy makers in Europe. The question considered here, therefore, is why many prominent Europeans insist that monetary union is a rational response to capital market integration. Monetary union eliminates exchange rate volatility , but only at a cost in terms of tightening the constraints on macroeconomic policy. Using a combination of macroeconomic theory and (descriptive) statistical analysis of European performance, I find that: capital market integration has increased macroeconomic flexibility through a mitigation of the current account constraint; European states have combined macroeconomic policies in a manner that has taken advantage of greater flexibility on the current account; the cost of such flexibility in terms of the impact of financial volatility on the real economy manifests differently in different countries; and monetary union both enhances flexibility on the current account and mitigates financial volatility. [source] Contemporary Models of Youth Development and Problem Prevention: Toward an Integration of Terms, Concepts, and ModelsFAMILY RELATIONS, Issue 1 2004Stephen Small Over the past several years, increased interest in preventing youth problems and promoting healthy youth development has led youth and family practitioners, policy makers, and researchers to develop a wide range of approaches based on various theoretical frameworks. Although the growth in guiding frameworks has led to more complex models and a greater diversity in the options available to scholars and practitioners, the lack of an integrative conceptual scheme and consistent terminology has led to some confusion in the field. Here, we provide an overview of three approaches to youth development and problem prevention, critically examine their strengths and weaknesses, and offer some elaborations to help clarify, extend, and integrate the models. We conclude by discussing some general implications for researchers, practitioners, and policy makers. [source] Mobile phones, communities and social networks among foreign workers in SingaporeGLOBAL NETWORKS, Issue 3 2009ERIC C. THOMPSON Abstract Transnational mobility affects both high-status and low-income workers, disrupting traditional assumptions of the boundedness of communities. There is a need to reconfigure our most basic theoretical and analytical constructs. In this article I engage in this task by illustrating a complex set of distinctions (as well as connections) between ,communities' as ideationally constituted through cultural practices and ,social networks' constituted through interaction and exchange. I have grounded the analysis ethnographically in the experiences of foreign workers in Singapore, focusing on domestic and construction workers from the Philippines, Indonesia, Thailand and Bangladesh. I examine the cultural, social and communicative role that mobile phones play in the lives of workers who are otherwise constrained in terms of mobility, living patterns and activities. Mobile phones are constituted as symbol status markers in relationship to foreign workers. Local representations construct foreign workers as users and consumers of mobile telephony, reinscribing ideas of transnational identities as well as foreignness within the context of Singapore. Migrant workers demonstrate a detailed knowledge of the various telephony options available, but the desire to use phones to communicate can overwhelm their self-control and lead to very high expenditures. The research highlights the constraints , as well as possibilities , individuals experience as subjects and agents within both social and cultural systems, and the ways in which those constraints and possibilities are mediated by a particular technology , in this case, mobile phones. [source] The recent declines of farmland bird populations in Britain: an appraisal of causal factors and conservation actionsIBIS, Issue 4 2004Ian Newton In this paper, the main aspects of agricultural intensification that have led to population declines in farmland birds over the past 50 years are reviewed, together with the current state of knowledge, and the effects of recent conservation actions. For each of 30 declining species, attention is focused on: (1) the external causes of population declines, (2) the demographic mechanisms and (3) experimental tests of proposed external causal factors, together with the outcome of (4) specific conservation measures and (5) agri-environment schemes. Although each species has responded individually to particular aspects of agricultural change, certain groups of species share common causal factors. For example, declines in the population levels of seed-eating birds have been driven primarily by herbicide use and the switch from spring-sown to autumn-sown cereals, both of which have massively reduced the food supplies of these birds. Their population declines have been associated with reduced survival rates and, in some species, also with reduced reproductive rates. In waders of damp grassland, population declines have been driven mainly by land drainage and the associated intensification of grassland management. This has led to reduced reproductive success, as a result of lowered food availability, together with increased disturbance and trampling by farm stock, and in some localities increased nest predation. The external causal factors of population decline are known (with varying degrees of certainty) for all 30 species considered, and the demographic causal factors are known (again with varying degrees of certainty) for 24 such species. In at least 19 species, proposed causal factors have been tested and confirmed by experiment or by local conservation action, and 12 species have been shown to benefit (in terms of locally increased breeding density) from options available in one or more agri-environment schemes. Four aspects of agricultural change have been the main drivers of bird population declines, each affecting a wide range of species, namely: (1) weed-control, mainly through herbicide use; (2) the change from spring-sown to autumn-sown cereal varieties, and the associated earlier ploughing of stubbles and earlier crop growth; (3) land drainage and associated intensification of grassland management; and (4) increased stocking densities, mainly of cattle in the lowlands and sheep in the uplands. These changes have reduced the amounts of habitat and/or food available to many species. Other changes, such as the removal of hedgerows and ,rough patches', have affected smaller numbers of species, as have changes in the timings of cultivations and harvests. Although at least eight species have shown recent increases in their national population levels, many others seem set to continue declining, or to remain at a much reduced level, unless some relevant aspect of agricultural practice is changed. [source] From subordination to parity: an international comparison of equity securities law claims in insolvency proceedingsINTERNATIONAL INSOLVENCY REVIEW, Issue 3 2007Janis Sarra Securities law claims in insolvency proceedings raise important questions of allocation of risk and remedies. In the ordinary course of business, equity claims come last in the hierarchy of claims during insolvency. What is less clear is whether this should encompass claims arising from the violation of public statutes designed to protect equity investors. Discerning the optimal allocation of risk is a complex challenge if one is trying to maximize the simultaneous advancement of securities law and insolvency law public policy goals. From a securities law perspective, there must be confidence in meaningful remedies for capital markets violations if investors are to continue to invest. From an insolvency perspective, creditors make their pricing and credit availability choices based on certainty regarding their claims and shifting those priorities may affect the availability of credit. The critical question is the nature of the claim advanced by the securities holder and whether subordination of securities law claims gives rise to inappropriate incentives for corporate officers within the insolvency law regime. A comparative analysis reveals that the U.S. has provided a limited statutory exception to complete subordination through the fair funds provision of the Sarbanes-Oxley Act by allowing SEC claims for penalties and disgorgement to rank equally with unsecured claims even though the funds are distributed to shareholders. The U.K. and Australian schemes permit shareholders to claim directly as unsecured creditors for fraudulent acts and misrepresentation by the issuer. In contrast, Canadian law is underdeveloped in its treatment of such claims. The paper canvasses the policy options available to reconcile securities law and insolvency law claims, including a discussion of the appropriate gatekeeping role for regulatory authorities and the courts, and the need for a framework that offers fair and expeditious resolution of such claims. If the public policy goal of both securities law and insolvency law is to foster efficient and cost-effective capital markets, it seems that the systems need to be better reconciled than currently. The paper also examines the codified response to the time and resources consumed in various common law tracing claims by customers in a securities firm insolvency. Copyright © 2007 John Wiley & Sons, Ltd. [source] Improving lipid management , to titrate, combine or switchINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2004H. Schuster Summary Despite the benefits of statin therapy, cholesterol management remains suboptimal and many patients do not achieve their recommended low-density lipoprotein cholesterol (LDL-C) goals. The use of insufficient doses, limited drug effectiveness and poor patient compliance may contribute to the treatment gap. Options for improving lipid management include dose titration, combination therapy or prescribing a more efficacious statin. LDL-C reductions are generally modest when patients' current statin dose is titrated, and there may be an increased potential for adverse effects. Combining statin therapy with another lipid-modifying agent can provide additional LDL-C reductions, but cost, tolerability and compliance should be considered. In general, switching to a more efficacious statin is a cost-effective way of enabling more patients to achieve recommended targets without increasing dosages. When considering the options available, physicians should balance efficacy, cost and safety to enable more patients to attain LDL-C goals and achieve greater therapeutic gain from statin treatment. [source] Technology options for new nutritional conceptsINTERNATIONAL JOURNAL OF DAIRY TECHNOLOGY, Issue 2 2002Hannu Korhonen Recent advances in the food and nutrition sciences support the concept that the diet has a significant role in the modulation of various functions in the body. The diet and/or its components may contribute to an improved state of well-being, a reduction of risks related to certain diseases and even an improvement in the quality of life. These new concepts have led to the introduction of a new category of health-promoting foodstuffs, i.e. functional foods. The concern about health embraces a number of driving issues, needs and opportunities which may be approached by designing specific diets from various food raw materials. These tailor-made products provide physiological benefits that are targeted at particular consumer groups. The functionality of functional foods is based on bioactive components, which may be contained naturally in the product but usually require formulation by appropriate technologies in order to optimise the desired beneficial properties. To this end, it is often necessary to develop and apply novel technologies, e.g. membrane separation, high hydrostatic pressure and supercritical fluid extraction techniques. Also the minimal processing concept could be employed in this context. This review discusses the current technological options available and the future challenges faced in the area. Particular attention is paid to the exploitation of bovine colostrum and milk-derived bioactive compounds for the development of functional foods. [source] Dental hygiene regulation: a global perspectiveINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2008PM Johnson Abstract:, Occupational regulation of health personnel is important to professional associations and their members, the public that relies on their services and the regulatory agencies responsible for their conduct. There is increasing interest in ensuring that dental hygiene regulation fosters the continuing evolution of the profession and its contribution to oral health. The keynote address for the 2007 Regulatory Forum on Dental Hygiene, this paper discusses the rationale for and issues pertaining to occupational regulation, outlines the evolvement of dental hygiene and identifies regulatory options for the profession. Professional regulation exists to ensure public safety, health and welfare. However, negative political-economic side effects coupled with environmental pressures have resulted in increased scrutiny for health professionals. One such profession is dental hygiene. Its evolution has been dramatic, in particular over the past few decades, as illustrated by its rapidly increasing numbers and broader distribution globally, gradual shift to the baccalaureate as the entry-level educational requirement and increase in postgraduate programs and expanding scope of practice and increased professional autonomy. Regulatory changes have been more gradual. Regulation is mandatory for the vast majority of dental hygienists. Of the options available, the practice act , the most rigorous type, is predominant. Globally, regulation tends to be administered directly by the government (n = 9 countries) more so than indirectly through a dental board (n = 4) or self-regulation (n = 3). Whether regulated directly or indirectly, dental hygienists increasingly are seeking a greater role in shaping their professional future. Self-regulation, its responsibilities, misperceptions and challenges, is examined as an option. [source] Quality of life in patients with atopic dermatitis: Impact of tacrolimus ointmentINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006Makoto Kawashima MD Background, Atopic dermatitis (AD), a significant problem in Japan, has a major impact on health-related quality of life (QOL). The development of steroid phobia in patients with AD may restrict the therapeutic options available to these patients. Tacrolimus ointment is a safe and effective nonsteroid treatment for AD. It may be an appropriate alternative for patients with AD and steroid phobia. The aim of this study was to determine the impact of AD on QOL and to investigate the effect of tacrolimus ointment on QOL in patients with steroid phobia. Methods, Firstly, QOL scores were investigated in patients with AD and steroid phobia using the World Health Organization Quality of Life instrument, WHOQOL-26, and were compared with QOL scores from a previous study in volunteers from Tokyo, Japan. Secondly, patients with steroid phobia received tacrolimus ointment treatment for 12 weeks. Quality of life scores were assessed using WHOQOL-26 at baseline and study end. Results, The overall mean QOL score of 106 patients with AD was significantly lower than that of 708 volunteers (3.1 ± 0.5 vs. 3.3 ± 0.5, P < 0.001). The overall QOL score improved from 2.9 ± 0.4 at baseline to 3.3 ± 0.4 following 12 weeks' tacrolimus ointment treatment in 35 patients with AD and steroid phobia (P < 0.001). Conclusions, Atopic dermatitis significantly lowers QOL. Tacrolimus ointment is associated with a significant improvement in QOL in patients with steroid phobia, indicating that it is an effective alternative to topical corticosteroids in these patients. [source] Factors associated with seclusion in a statewide forensic psychiatric service in Australia over a 2-year periodINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2009Stuart D.M. Thomas ABSTRACT Despite seclusion being described as one of the most ethically- and legally-controversial management options available, it remains a widely-used clinical strategy for managing disruptive, aggressive, and violent behaviour. This study sought to determine how frequently seclusion was used, the common characteristics of those secluded and not secluded, and the degree to which the Level of Service Inventory , Revised: Screening Version (LSI-R: SV) could predict seclusion. The study was retrospective, covering the first 2 years of operation of a statewide forensic psychiatry hospital in Victoria, Australia. Data were collected from individual case files, electronic databases, and paper copies of records pertaining to violent incidents and episodes of seclusion. Eighty five (44%) of the 193 patients admitted during this period were secluded. Those secluded were significantly younger and had a more established psychiatric history. LSI-R: SV scores were significantly and positively associated with being secluded. A statistical model containing three LSI-R: SV items, along with age on admission and psychiatric history, achieved an area under the curve of 0.74. Seclusion is used on a regular basis in response to a range of different forms of aggressive behaviour of different severity. The LSI-R: SV demonstrated moderate-to-good accuracy in predicting seclusion and warrants further research using detailed prospective methodologies. [source] Organizational Alternatives for Companies' Management of Occupational Risks: The Examples of Spain and ArgentinaINTERNATIONAL SOCIAL SECURITY REVIEW, Issue 1 2001Eugenia Suárez Serrano This study discusses the various options available to companies for the management of occupational risks. In this context, occupational accident insurance schemes in Spain and Argentina are analysed, with reference to the theory of organizational economics. Spain has 75 years' experience of such schemes, while in Argentina they have only recently been introduced. Although the two models have similar goals, their differences, in terms of competition, regulation and ownership, lead to different incentives for those concerned: workers, companies, insurers and regulatory bodies. [source] U.S. Grand Strategy Following the George W. Bush PresidencyINTERNATIONAL STUDIES PERSPECTIVES, Issue 4 2009David C. Ellis Debates over U.S. grand strategy have devoted a disproportionate level of attention to the War on Terror itself rather than the evolving strategic environment. Challenges including an impending shift in the balance of power, structural deficits, and divided public opinion will significantly impact the policy options available to government leaders, but they have not been adequately addressed. This article analyzes the options available for U.S. grand strategy following the George W. Bush presidency by relating key U.S. national interests with domestic and international policy constraints on the horizon. The analysis concludes that the United States must adopt a defensive grand strategy to rebuild popular consensus, to prevent further strain on the military, and to consolidate its gains in Iraq and Afghanistan. However, this strategy will require flexible coalitions, not formal international organizations, because of a significant divergence of security interests and capabilities with its European allies. [source] Hereditary angioedema: an update on available therapeutic optionsJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 9 2010Marcus Maurer Summary There is no cure for hereditary angioedema (HAE). Therapeutic approaches consist of symptomatic therapy for acute attacks, short-term prophylaxis before surgery, and long-term prophylaxis for those with frequent and severe attacks. In Germany, C1-INH concentrate and icatibant are licensed for acute therapy. C1-INH concentrate, which is obtained from human plasma, is administered intravenously to restore the deficient C1-INH activity. This therapy, which has been available for decades, is effective and well-tolerated. Batch documentation is required by German law. The synthetic decapeptide icatibant is administered subcutaneously. It competes with bradykinin, the responsible inducer of edema formation, for binding to the bradykinin B2 receptor. Icatibant is also effective and well-tolerated, even on repeated administration. An additional human C1-inhibitor, a recombinant human C1-inhibitor and the recombinant inhibitor of kallikrein ecallantide are currently under development. There are no licensed treatment options available in Germany for long- and short-term prophylaxis. Androgen derivatives are established in long-term prophylaxis. However, they are associated with many adverse effects, some of which are severe. Many drug interactions also limit their use. They are contraindicated in pregnancy, lactation, for children and in cases of prostate cancer. Antifibrinolytics have fewer adverse effects but are also less effective than androgens. They are contraindicated in thromboembolic disease and impaired vision. If androgen therapy has too negative an effect on quality of life, it may be worth reducing the dose or discontinuing therapy entirely and treating attacks with acute therapy. [source] Evidence-based (S3) guidelines for the treatment of psoriasis vulgarisJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 2007Alexander Nast Abstract Psoriasis vulgaris is a common and often chronic inflammatory skin disease. The incidence of psoriasis in Western industrialized countries ranges from 1 to 2%. Patients afflicted with severe psoriasis vulgaris may experience a significant reduction in quality of life. Despite the large variety of treatment options available, patient surveys have revealed lack of satisfaction with the efficacy of available treatments and a high rate of non-compliance. To optimize the treatment of psoriasis in Germany, the Deutsche Dermatologische Gesellschaft (DDG) and the Berufsverband Deutscher Dermatologen (BVDD) initiated a project to develop evidence-based guidelines for the management of psoriasis. These resulting Guidelines focus on induction therapy in cases of mild, moderate, and severe plaquetype psoriasis in adults. The Guidelines include evidence-based evaluation of the efficacy of all currently available therapeutic options in Germany. In addition, they offer detailed information on how best to administer the various treatments and give information on contraindications, adverse drug reactions, and drug interactions as well as estimates of practicability and cost. The Guidelines were developed following the recommendations of the Arbeitsgemeinschaft wissenschaftlicher medizinischer Fachgesellschaften (AWMF). The therapeutic recommendations were developed by an expert group and finalized during interdisciplinary consensus conferences. [source] Beyond control: wider implications for the management of biological invasionsJOURNAL OF APPLIED ECOLOGY, Issue 5 2006PHILIP E. HULME Summary 1Government departments, environmental managers and conservationists are all facing escalating pressure to address and resolve a diversity of invasive alien species (IAS) problems. Yet much research to date is primarily concerned with quantifying the scale of the problem rather than delivering robust solutions and has not adequately addressed all stages of the invasion process, and only a few studies embrace the ecosystem approach. 2Three successive steps, prevention, eradication and control, form the cornerstones of recommended best practices aimed at managing IAS. The goal of such actions is the restoration of ecosystems to preserve or re-establish native biodiversity and functions. 3Prevention is widely promoted as being a more environmentally desirable strategy than actions undertaken after IAS establishment, yet is hindered by the difficulty in separating invasive from non-invasive alien species. Furthermore, the high number of candidate IAS, the investment required in taxonomic support and inspection capacity, and the expense of individual risk assessments may act against the net benefits of prevention. More rewarding avenues may be found by pursuing neural networks to predict the potential composition of pest assemblages in different regions and/or model introduction pathways to identify likely invasion hubs. 4Rapid response should be consequent on early detection but, when IAS are rare, detection rates are compromised by low occurrence and limited power to discern significant changes in abundance. Power could be increased by developing composite indicators that track trends in a suite of IAS with similar life histories, shared pathways and/or habitat preferences. 5The assessment of management options will benefit from an ecosystem perspective that considers the manipulation of native competitors, consumers and mutualists, and reviews existing management practices as well as mitigates other environmental pressures. The ease with which an IAS can be targeted should not only address the direct management effects on population dynamics but also indirect effects on community diversity and structure. Where the goal is to safeguard native biodiversity, such activities should take into account the need to re-establish native species and/or restore ecosystem function in the previously affected area. 6Synthesis and applications. A comprehensive approach to IAS management should include consideration of the: (i) expected impacts; (ii) technical options available; (iii) ease with which the species can be targeted; (iv) risks associated with management; (v) likelihood of success; and (vi) extent of public concern and stakeholder interest. For each of these issues, in addition to targeting an individual species, the management of biological invasions must also incorporate an appreciation of other environmental pressures, the importance of landscape structure, and the role of existing management activities and restoration efforts. [source] Urban ecological footprints in AfricaAFRICAN JOURNAL OF ECOLOGY, Issue 4 2008Joy S. Clancy Abstract Africa's rate of urbanization is the highest in the world. This is relevant to ecologists working in Africa because urban growth is strongly associated with habitat destruction, and also creates new fields of study. The ecological footprint concept is used to illustrate how urban settlements in Africa impact on rural ecosystems. At an aggregate level, African countries have the lowest ecological footprints in the world. However, there is little available data for individual cities, so evidence is fragmented making concerted policy initiatives difficult. Wood fuel continues to be a major source of energy for urban households and there is a long running debate as to what extent providing wood fuel for urban use damages forest ecosystems. Growing evidence contests the assertion that urban wood fuel markets are responsible for forest degradation. Although there are other options available, the social consequences of switching energy sources need to be taken into account. Outright bans, for example on charcoal, would lead to a loss of livelihoods in rural and urban households, and may not solve deforestation as well as increasing fossil fuel use would increase the ecological footprint. Résumé Le taux d'urbanisation de l'Afrique est le plus élevé du monde. Cela concerne les écologistes qui travaillent sur ce continent parce que la croissance urbaine est étroitement liée à la destruction des habitats, et cela ouvre aussi de nouveaux champs d'étude. Le concept d'empreinte écologique est utilisé pour illustrer comment les installations urbaines en Afrique ont un impact sur les écosystèmes ruraux. Pris tous ensemble, ce sont les pays africains qui ont la plus légère empreinte écologique du monde. Cependant, nous disposons de peu de données pour des villes individuelles, de sorte que les renseignements sont fragmentés et qu'il est difficile de prendre des initiatives politiques concertées. Le bois de feu continue àêtre une des principales sources d'énergie pour les ménages urbains, et il existe un débat de longue haleine quant à savoir dans quelle mesure l'approvisionnement en bois pour la consommation urbaine endommage les écosystèmes forestiers. Des preuves de plus en plus évidentes remettent en question l'assertion selon laquelle les marchés urbains de bois de feu seraient responsables de la dégradation des forêts. Bien qu'il y ait d'autres options possibles, il faut prendre en compte les conséquences sociales du passage à d'autres sources d'énergie. Les interdictions totales, par exemple du charbon de bois, entraîneraient la perte des moyens de subsistance de ménages ruraux et urbains, et pourraient ne pas résoudre le problème de déforestation, tout comme l'utilisation accrue des combustibles fossiles augmenterait l'empreinte écologique. [source] | |||||||||||||||||||||||||||||||||||||||||||