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Problematic
Terms modified by Problematic Selected AbstractsMODEL MISSPECIFICATION: WHY AGGREGATION OF OFFENSES IN FEDERAL SENTENCING EQUATIONS IS PROBLEMATICCRIMINOLOGY, Issue 4 2003CELESTA A. ALBONETTI This paper addresses two concerns that arise from Steffensmeier and Demuth (2001) analysis of federal sentencing and their misrepresentation of my analyses of sentence severity (Albonetti, 1997). My primary concern is to alert researchers to the importance of controlling for the guidelines offense that drives the sentencing process under the Federal Sentencing Guidelines. My second concern is to correct Steffensmeier and Demuth's (2001) errors in interpretation of my earlier findings of the effect of guidelines offense severity on length of imprisonment. [source] Why All Counter-Evidence to the Critical Period Hypothesis in Second Language Acquisition Is not Equal or ProblematicLINGUISTICS & LANGUAGE COMPASS (ELECTRONIC), Issue 6 2008Jason Rothman That adult and child language acquisitions differ in route and outcome is observable. Notwithstanding, there is controversy as to what this observation means for the Critical Period Hypothesis' (CPH) application to adult second language acquisition (SLA). As most versions of the CPH applied to SLA claim that differences result from maturational effects on in-born linguistic mechanisms, the CPH has many implications that are amendable to empirical investigation. To date, there is no shortage of literature claiming that the CPH applies or does not apply to normal adult SLA. Herein, I provide an epistemological discussion on the conceptual usefulness of the CPH in SLA (cf. Singleton 2005) coupled with a review of Long's (2005) evaluation of much available relevant research. Crucially, I review studies that Long did not consider and conclude differently that there is no critical/sensitive period for L2 syntactic and semantic acquisition. [source] Quality of evidence for the present Swedish child health surveillance programmeACTA PAEDIATRICA, Issue 2000S Bremberg The present Swedish health surveillance programme includes 15 examinations by a nurse, 5 examinations by a physician, 7 assessments of development, 2 assessments of hearing and 1 assessment of visual acuity. The WHO criteria for evaluation of screening programmes can be applied to the Swedish health surveillance programme. These criteria state that the health problem must be important, that there should be an early phase during which the condition is only detectable by medical professionals and that treatment at an early phase should favourably affect the prognosis. The quality of evidence for fulfilment of these criteria has been graded I-III. Grade II-2 refers to evidence obtained from well-designed cohort or case-control analytical studies. The following disorders might be affected by health surveillance at child health centres: amblyopia, ADHD/DAMP, failure to thrive, cerebral palsy, congenital heart failure, congenital luxation of hip, hearing impairment (severe or moderate), mental retardation, retentio testis and hydrocephalus. None of these conditions fulfils the WHO criteria with quality of evidence grade II-2 or better. Thus, the evidence for the present Swedish health surveillance programme is problematic. [source] Studying protein folding on the Grid: experiences using CHARMM on NPACI resources under LegionCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 4 2004Anand Natrajan Abstract One benefit of a computational Grid is the ability to run high-performance applications over distributed resources simply and securely. We demonstrated this benefit with an experiment in which we studied the protein-folding process with the CHARMM molecular simulation package over a Grid managed by Legion, a Grid operating system. High-performance applications can take advantage of Grid resources if the Grid operating system provides both low-level functionality as well as high-level services. We describe the nature of services provided by Legion for high-performance applications. Our experiences indicate that human factors continue to play a crucial role in the configuration of Grid resources, underlying resources can be problematic, Grid services must tolerate underlying problems or inform the user, and high-level services must continue to evolve to meet user requirements. Our experiment not only helped a scientist perform an important study, but also showed the viability of an integrated approach such as Legion's for managing a Grid. Copyright © 2004 John Wiley & Sons, Ltd. [source] Wildfire Policy and Public Lands: Integrating Scientific Understanding with Social Concerns across LandscapesCONSERVATION BIOLOGY, Issue 4 2004MICHAEL P. DOMBECK administración de bosques; fuego no controlado; política; Servicio Forestal Estados Unidos; tierras públicas Abstract:,Efforts to suppress wildfires have become increasingly problematic in recent years as costs have risen, threats to firefighter safety have escalated, and detrimental impacts to ecosystems have multiplied. Wildfires that escape initial suppression often expand into large, high-intensity summer blazes. Lost is the legacy of smaller fires that likely burned outside extreme weather and fuel conditions and resulted in less severe impacts. Despite the recognized need for modifications to existing policies and practices, resource agencies have been slow to respond. The spread of exotic species, climate change, and increasing human development in wildlands further complicates the issue. New policies are needed that integrate social and ecological needs across administrative boundaries and broad landscapes. These policies should promote a continuum of treatments with active management and reduction of fuel hazard in wildland-urban interface zones and reintroduction of fire in wildlands. Management goals should focus on restoration of the long-term ecological health of the land. Projects that reduce fuel loads but compromise the integrity of soil, water supplies, or watersheds will do more harm than good in the long run. Despite significant ecological concerns, learning to live with fire remains primarily a social issue that will require greater political leadership, agency innovation, public involvement, and community responsibility. Resumen:,En años recientes, los esfuerzos para suprimir los fuegos no controlados se han vuelto cada vez más problemáticos por el incremento de costos, el aumento de las amenazas a la seguridad de bomberos y se la multiplicio, de los impactos perjudiciales a los ecosistemas. Los incendios que escapan la supresión inicial a menudo se expanden a grandes conflagraciones estivales de alta intensidad. Se ha perdido el legado de fuegos menores que probablemente se llevaban a cabo en condiciones climáticas y de combustible extremas que tenían impactos menos severos. A pesar del reconocimiento de la necesidad de modificaciones a las políticas y prácticas actuales, las agencias han respondido lentamente. La expansión de especies exóticas, el cambio climático y el incremento del desarrollo humano en áreas silvestres complican el problema aún más. Se requieren políticas nuevas que integren necesidades sociales y ecológicas más allá de límites administrativos y en paisajes amplios. Estas políticas deben promover un continuo de tratamientos con gestión activa y reducción de riesgo de combustión en la interfase área silvestre-urbana y la reintroducción de fuego en áreas silvestres. Las metas de la gestión deben enfocar en la restauración de la salud ecológica a largo plazo. Los proyectos que reducen la carga de combustible pero que comprometen la integridad del suelo, las reservas de agua o cuencas hidrológicas no serán de mucha utilidad en el largo plazo. A pesar de preocupaciones ecológicas significativas, aprender a vivir con fuego seguirá siendo un aspecto social que requerirá de mayor liderazgo político, innovación de agencias, participación del público y responsabilidad comunitaria. [source] Individual, Population, Community, and Ecosystem Consequences of a Fish Invader in New Zealand StreamsCONSERVATION BIOLOGY, Issue 1 2003Colin R. Townsend But because invaders can have unexpected indirect effects in food webs, invasion ecologists need to integrate processes at the population level and other ecological levels. I describe a series of coordinated studies in New Zealand streams that address the effect of an exotic fish on individual behavior, population, community, and ecosystem patterns. Such case studies are important as an aid to the formulation of policy about invasions that are especially likely to become problematic. At the individual level, grazing invertebrates showed changes in behavior as a result of the introduction of brown trout ( Salmo trutta), a predator that exerts a very different selection pressure than do native fish. At the population level, trout have replaced nonmigratory galaxiid fish in some streams but not others, and have affected the distributions of crayfish and other large invertebrates. At the community level, trout have suppressed grazing pressure from invertebrates and are thus responsible for enhancing algal biomass and changing algal species composition. Finally, at the ecosystem level, essentially all annual production of invertebrates is consumed by trout ( but not by galaxiids), and algal primary productivity is six times higher in a trout stream. This leads, in turn, to an increased flux of nutrients from the water to the benthic community. The trout invasion has led to strong top-down control of community structure and ecosystem functioning via its effects on individual behavior and population distribution and abundance. Particular physiological, behavioral, and demographic traits of invaders can lead to profound ecosystem consequences that managers need to take into account. Resumen: Para desarrollar procedimientos y políticas de manejo efectivos a menudo será necesario conocer la biología de la población de especies invasoras. Sin embargo, debido a que los invasores pueden tener efectos indirectos inesperados en las redes alimenticias, ecólogos de invasión necesitan integrar procesos en la población y otros niveles ecológicos. Describo una serie de estudios coordinados en arroyos de Nueva Zelanda que enfocan el impacto de un pez exótico sobre los patrones de comportamiento individual, de la población, la comunidad y el ecosistema. Tales estudios de caso son importantes como un auxiliar para la formulación de políticas sobre invasiones que pueden ser especialmente problemáticas. Al nivel individual, los invertebrados que pastorean mostraron cambios de conducta como resultado de la introducción de la trucha café ( Salmo trutta), un depredador que ejerce una presión de selección muy diferente a la de los peces nativos. En el nivel de población, las truchas han reemplazado a peces galaxídos no migratorios en algunos arroyos pero no en otros y han afectado las distribuciones de cangrejos de río y otros invertebrados mayores. Al nivel de comunidad, las truchas han suprimido la presión de pastoreo por invertebrados y por lo tanto son responsables del incremento de la biomasa de algas y del cambio en la composición de especies de algas. Finalmente, a nivel de ecosistema, la producción anual de invertebrados esencialmente es consumida por las truchas ( pero no por galaxídos), y la productividad primaria de algas es seis veces mayor en arroyos con truchas. A su vez, esto conduce a incrementos en el flujo de nutrientes del agua hacia la comunidad béntica. La invasión de truchas ha conducido a un fuerte control de arriba hacia abajo de la estructura de la comunidad y del funcionamiento del ecosistema por medio de sus efectos sobre la conducta individual y la distribución y abundancia de la población. Las características fisiológicas, de conducta y demográficas particulares de los invasores pueden llevar a consecuencias profundas en los ecosistemas que los administradores necesitan tomar en consideración. [source] Formaldehyde-releasers: relationship to formaldehyde contact allergy.CONTACT DERMATITIS, Issue 2 2009Contact allergy to formaldehyde, inventory of formaldehyde-releasers This is one of series of review articles on formaldehyde and formaldehyde-releasers (others: formaldehyde in cosmetics, in clothes and in metalworking fluids and miscellaneous). Thirty-five chemicals were identified as being formaldehyde-releasers. Although a further seven are listed in the literature as formaldehyde-releasers, data are inadequate to consider them as such beyond doubt. Several (nomenclature) mistakes and outdated information are discussed. Formaldehyde and formaldehyde allergy are reviewed: applications, exposure scenarios, legislation, patch testing problems, frequency of sensitization, relevance of positive patch test reactions, clinical pattern of allergic contact dermatitis from formaldehyde, prognosis, threshold for elicitation of allergic contact dermatitis, analytical tests to determine formaldehyde in products and frequency of exposure to formaldehyde and releasers. The frequency of contact allergy to formaldehyde is consistently higher in the USA (8,9%) than in Europe (2,3%). Patch testing with formaldehyde is problematic; the currently used 1% solution may result in both false-positive and false-negative (up to 40%) reactions. Determining the relevance of patch test reactions is often challenging. What concentration of formaldehyde is safe for sensitive patients remains unknown. Levels of 200,300 p.p.m. free formaldehyde in cosmetic products have been shown to induce dermatitis from short-term use on normal skin. [source] Corporate Governance and Business Ethics: insights from the strategic planning experience*CORPORATE GOVERNANCE, Issue 6 2005Ingrid Bonn In this paper we develop an integrated approach towards corporate governance and business ethics. Our central argument is that organisations can learn from the development of strategic planning in the 1970s and 1980s. We identify three weaknesses , a bureaucratic and formalised approach, lack of implementation and lack of integration throughout the organisation , which were prevalent in strategic planning in the past and which are potentially just as problematic for an integrated corporate governance approach to business ethics. We suggest ways these weaknesses might be avoided and provide questions for boards of directors to consider when integrating ethical concerns into their organisations' corporate governance structures. [source] IMAGES OF GOD AND PUBLIC SUPPORT FOR CAPITAL PUNISHMENT: DOES A CLOSE RELATIONSHIP WITH A LOVING GOD MATTER?,CRIMINOLOGY, Issue 4 2006JAMES D. UNNEVER This study argues that the nature and intensity of a person's relationship with God creates a transposable cognitive schema that shapes people's views toward public policies such as executing convicted murderers. In this context, we investigate whether Americans who report having a close personal relationship with a loving God are less likely to support the death penalty. We hypothesize that such a relationship tempers the tendency to see punitiveness as an appropriate response to human failings. Individuals who hold a loving God image are more likely to believe that God responds to those who have "failed" or "sinned" by demonstrating unconditional love, forgiveness, and mercy. Accordingly, support for capital punishment is problematic because it contradicts the image of a merciful, forgiving deity; God's purpose,and admonition to believers,is to demonstrate compassion toward those who have trespassed against others. We test these possibilities using the 2004 General Social Survey (GSS). Controlling for a range of religious factors and other known predictors of death penalty attitudes, the results show that Americans with a personal relationship with a loving God are less likely to support capital punishment for convicted murderers. [source] STORIES AND COSMOGONIES: Imagining Creativity Beyond "Nature" and "Culture"CULTURAL ANTHROPOLOGY, Issue 2 2009STUART McLEAN ABSTRACT What does it mean to create? Who or what could be said to create? God? Artists? Evolution? Markets? The Dialectic? Do things "just happen" and if so is that a kind of creativity? Taking storytelling as its point of reference, this essay considers the notion of creativity as it applies both to the productions of the human imagination, especially stories, and to the self-making of the material universe. I define creativity broadly as the bringing forth of new material, linguistic, or conceptual formations or the transformation of existing ones and as calling, not for a "cultural poetics," but for a more broadly conceived poetics of making (poesis, in its most inclusive sense), encompassing both the natural and cultural realms as conventionally designated, a poetics capable of articulating the stories human beings tell with cosmogonies detailing the coming-to-being of the physical universe. Extending the purview of creativity beyond the human realm to include the processes shaping the material universe allows us to envision creativity itself in terms of a generative multiplicity that resists articulation in binary oppositional terms and that demands therefore to be thought as ontologically prior to any possible differentiation between the domains of nature and culture, or between reality and its cultural,linguistic representations, challenging us to reimagine not only the relationship between nature and culture but also the problematic of representation that continues to inform much work in the humanities and social sciences. Such a reimagining might proceed precisely from an enlarged understanding of creativity,and in particular of storytelling,and I consider some of the epistemic and writerly implications of this claim for anthropology as a discipline concerned preeminently with exploring and documenting the varieties of human being-in-the-world. [source] Peripheral endothelial cells are not reliable in differentiating primary benign and malignant hepatocellular lesions in fine needle aspirates of the liverCYTOPATHOLOGY, Issue 3 2002GORDON H. YU The distinction of hepatocellular carcinoma (HCC) from benign lesions of the liver in fine needle aspiration (FNA) specimens can be problematic. In an attempt to separate well-differentiated HCC from benign hepatocellular lesions, the presence of tissue fragments displaying peripheral endothelial cells (PE) has been proposed in a previous study as a useful feature in favour of malignancy. In this study, we evaluated slides from 59 cases of liver masses undergoing FNA (19 HCC, 40 benign) and evaluated them for the presence of tissue fragments containing PE. We found that 90% of cases of HCC contained tissue fragments in which PE were either focally present or abundant. However, 68% of cases containing only benign hepatocytes also contained tissue fragments in which PE were at least focally present. In addition, it appears that within the group of benign lesions, the presence of PE was related to the overall cellularity of the specimen rather than the specific nature of the lesion. Thus, the presence of PE in tissue fragments does not, in isolation, appear to be a useful morphological feature for the separation of benign and malignant hepatocellular lesions in FNA material. [source] An audit of ,equivocal' (C3) and ,suspicious' (C4) categories in fine needle aspiration cytology of the breastCYTOPATHOLOGY, Issue 4 2001R. A. Deb An audit of ,equivocal' (C3) and ,suspicious' (C4) categories in fine needle aspiration cytology of the breast We have audited the frequency of use and outcome of the ,equivocal/atypia probably benign' (C3) and ,suspicious of malignancy' (C4) category for breast cytology in our Unit. A total of 14 935 cytological specimens were reported by at least one of the three pathologists with a special interest in breast pathology, according to five categories of the NHSBSP guidelines for cytology reporting, 1992; 3.7% (555 cases) and 3.9% (587 cases) of cases were classified as equivocal (C3) and suspicious (C4), respectively, giving a total rate (C3 + C4) of 7.6%. Of the C3 cases, 68% were subsequently benign and 32% were malignant. Of the C4 cases, 19% were subsequently benign and 81% malignant. The commonest benign lesions in both categories were fibroadenomas (7.6% of C3 and 19.8% of C4), fibrocystic change (14.3% of C3 and 12.5% of C4), radial scars (6.2% of C3 and 10.4% of C4) and papillomas (6.2% of C3 and 6.3% of C4). Of the malignant lesions (particularly those classified as C3), a high proportion were low grade or special type cancers. The categories of atypia probably benign (C3) and suspicious of malignancy (C4) in breast cytology provide a strategy for classification of problematic or uncertain cases; this maintains the predictive value of the benign (C2) and malignant (C5) categories, and allows separation of these difficult cases into clinically useful groups with differing probabilities of malignancy. [source] Bacteria of asymptomatic periradicular endodontic lesions identified by DNA-DNA hybridizationDENTAL TRAUMATOLOGY, Issue 5 2000J. J. Gatti Abstract , Possible inclusion of contaminant bacteria during surgery has been problematic in studies of periradicular lesions of endodontic origin. Therefore, in this study, two different surgical techniques were compared. A second problem is that some difficult to cultivate species may not be detected using bacteriological methods. Molecular techniques may resolve this problem. DNA-DNA hybridization technology has the additional advantage that DNA is not amplified. The purpose of this investigation was to determine if bacteria from periradicular endodontic lesions could be identified using DNA-DNA hybridization. A full thickness intrasulcular mucoperiosteal (IS) flap (n=20) or a submarginal (SM) flap (n=16) was reflected in patients with asymptomatic apical periodontitis. DNA was extracted and incubated with 40 digoxigenin-labeled whole genomic probes. Bacterial DNA was detected in all 36 lesions. Seven probes were negative for all lesions. In patients with sinus tract communication, in teeth lacking intact full coverage crowns, and in patients with a history of trauma, 4,13 probes provided positive signals. Seven probes were positive in lesions obtained by the IS, but not the SM technique. Two probes were in samples obtained with the SM technique, but not the IS. Only Bacteroides forsythus and Actinomyces naeslundii genospecies 2 were present in large numbers using either the IS or the SM technique. The SM flap technique, in combination with DNA-DNA hybridization, appeared to provide excellent data pertaining to periradicular bacteria. These results supported other studies that provide evidence of a bacterial presence and persistence in periradicular lesions. [source] A review of empirically supported psychological therapies for mood disorders in adultsDEPRESSION AND ANXIETY, Issue 10 2010Steven D. Hollon Ph.D. Abstract Background: The mood disorders are prevalent and problematic. We review randomized controlled psychotherapy trials to find those that are empirically supported with respect to acute symptom reduction and the prevention of subsequent relapse and recurrence. Methods: We searched the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to identify appropriate articles. Results: One hundred twenty-five studies were found evaluating treatment efficacy for the various mood disorders. With respect to the treatment of major depressive disorder (MDD), interpersonal psychotherapy (IPT), cognitive behavior therapy (CBT), and behavior therapy (BT) are efficacious and specific and brief dynamic therapy (BDT) and emotion-focused therapy (EFT) are possibly efficacious. CBT is efficacious and specific, mindfulness-based cognitive therapy (MBCT) efficacious, and BDT and EFT possibly efficacious in the prevention of relapse/recurrence following treatment termination and IPT and CBT are each possibly efficacious in the prevention of relapse/recurrence if continued or maintained. IPT is possibly efficacious in the treatment of dysthymic disorder. With respect to bipolar disorder (BD), CBT and family-focused therapy (FFT) are efficacious and interpersonal social rhythm therapy (IPSRT) possibly efficacious as adjuncts to medication in the treatment of depression. Psychoeducation (PE) is efficacious in the prevention of mania/hypomania (and possibly depression) and FFT is efficacious and IPSRT and CBT possibly efficacious in preventing bipolar episodes. Conclusions: The newer psychological interventions are as efficacious as and more enduring than medications in the treatment of MDD and may enhance the efficacy of medications in the treatment of BD. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Problematic internet use: Proposed classification and diagnostic criteriaDEPRESSION AND ANXIETY, Issue 4 2003Nathan A. Shapira M.D., Ph.D. Abstract Since the mid-1990s, there have been frequent reports of individuals whose use of the computer and internet is problematic. Given the recent expansion and the expected increase in internet availability and usage in the coming years, it is important that healthcare professionals be informed about this behavior and its associated problems. Recently, psychological and psychiatric literature has described individuals that exhibit problematic internet use who often suffer from other psychiatric disorders. In the face of this comorbidity, it is essential to evaluate whether these individuals represent a distinct class of disorder, or a manifestation/coping mechanism related to other underlying diagnosis. In either event, problematic internet use negatively impacts social and emotional functioning. Based on the current limited empirical evidence, problematic internet use may best be classified as an impulse control disorder. It is therefore imperative that problematic internet use be appropriately identified among symptomatic individuals. For these reasons, we propose specific diagnostic criteria that will allow for consistent identification and assist in further study of this behavior. Depression and Anxiety 17:207,216, 2003. © 2003 Wiley-Liss, Inc. [source] Metallic Taste: An Unusual Reaction to Botulinum Toxin ADERMATOLOGIC SURGERY, Issue 5 2003Christian Murray MD BACKGROUND Botulinum neurotoxin formulations are safe and effective agents for the treatment of facial rhytides. OBJECTIVES A patient is described who complained of metallic taste after each treatment with botulinum toxin A (BTX-A). RESULTS The sensation of metallic taste diminished after successive treatments with BTX-A, despite adequate dosing for cosmetic purposes. CONCLUSION Metallic taste is associated with the use of numerous medications; however, the pathogenesis remains unclear. Alteration in zinc metabolism, which may occur with BTX-A administration, has been suggested as a possible mechanism. Although this is the first known report of dysgeusia after BTX-A, physicians and patients may be reassured that the taste alteration was self-limited and was not significantly problematic for the patient in our case. [source] From age correction to genome-wide associationACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009S. Cohen-Woods Objective:, Eric Strömgren was one of the pioneers of psychiatric genetics and family studies. There has now been an explosion of interest in this field and research progress, including linkage and association studies, whole genome genotyping, copy number variants and epigenetics is reviewed here. Method:, An overview of this area of psychiatric research is presented and discussed based on the relevant literature aiming at giving a recent status of the progress. Results:, Broadly speaking linkage and association are complementary approaches used to locate genes contributing to the genetic aetiology of psychopathology. Linkage can be detected over comparatively large distances, however power is problematic when searching for quantitative trait loci with small effect sizes. In contrast, association studies can detect small effects but only over very small distances. Therefore, while several genome-wide linkage studies in psychiatric disorders have been performed, the majority of association studies have investigated specific functional candidate genes. Conclusion:, Due to very recent technological advancements, genome-wide association studies have now become possible and have identified some completely novel susceptibility loci. Other recent advances include the discovery of epigenetic phenomena and copy number variants. [source] A Bigger Piece of a Very Small Pie: Intrahousehold Resource Allocation and Poverty Reduction in AfricaDEVELOPMENT AND CHANGE, Issue 1 2007Bridget O'Laughlin ABSTRACT Feminist research has convincingly shown that an increase in household income does not necessarily lead to improvement in the well-being of all members of the household. More questionable is the policy conclusion often drawn from this research for rural Africa: redressing gender imbalance in control of productive resources will significantly reduce poverty. This contribution argues that the evidence and analysis presented by two studies repeatedly cited to show that gender inequality is inefficient are problematic. It is mythical to suggest that tinkering with women's market position by exchanging unequal collective rights to productive resources for individual ones will decisively reduce rural poverty in Africa. That will depend on the restructuring of long-term and deeply unequal processes of integration in the market, not on a firmer insertion of women within existing patterns of individualization and commodification of productive resources. [source] Generalised and Particularistic Thinking in Policy Analysis and Practice: The Case of Governance Reform in South AfricaDEVELOPMENT POLICY REVIEW, Issue 3 2009Olle Frödin This article is concerned with the relationship between generalised and particularistic knowledge in the context of policy-making and policy analysis. It argues that it is problematic to assume that a reform model will generate similar outcomes across a wide variety of contexts. It presents a conceptual framework, including the concepts of transaction domain and domain consensus, that enables context-sensitive analyses. The argument is exemplified by South Africa's introduction in the 1990s of an Integrated Development Planning model, based on British reform experience and various international public-management models. With a case study of such planning in Lukhanji Municipality in the Eastern Cape Province, it illustrates how the conceptual framework may be used in policy research and analysis. [source] Diagnostic value of GLUT-1 immunoreactivity to distinguish benign from malignant cystic squamous lesions of the head and neck in fine-needle aspiration biopsy materialDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2004Michael F. Weiner M.D. Abstract The distinction of cystic squamous-cell carcinoma (SCC) from benign cystic squamous lesions (BCSLs) of the head and neck can be problematic on fine-needle aspiration biopsy (FNAB) material, particularly when BCSLs display epithelial reactive atypia or when SCC is well differentiated. Glucose transporter 1 (GLUT-1), a facilitative cell surface glucose transport protein, is aberrantly expressed in many cancers including oral and hypopharyngeal SCC. We evaluated the expression of GLUT-1 by immunochemistry on FNAB material to determine its value in distinguishing cystic SCC from BCSL of the head and neck. A 5-yr retrospective review of all head and neck cystic squamous lesions having FNAB specimens with cell block material, radiological studies, and histological confirmation was performed at our institution. Cell block material from 24 cystic squamous lesions, including 8 (33%) BCSL (7 branchial cleft cysts and 1 thyroglossal duct cyst[TDC]) and 16 (67%) metastatic SCCs with cystic/liquefactive degeneration, was retrieved and immunostained with anti-GLUT-1. GLUT-1 expression was considered positive when at least 10% of squamous cells exhibited distinct cell membrane reactivity. Positive GLUT-1 immunostaining was detected in all 16 SCCs and in none of the 8 BCSLs. In the carcinoma cases, the majority of malignant cells exhibited GLUT-1 reactivity; only a minor population of well-differentiated SCC cells displaying keratinization and arranged as squamous pearls did not express GLUT-1. GLUT-1 expression in cell block material can help to distinguish cystic SCCs from BCSLs of the head and neck. In conjunction with clinical and radiological correlation, GLUT-1 immunoreactivity can be an important diagnostic aid when the cytological findings are ambiguous. Diagn. Cytopathol. 2004;31:294,299. © 2004 Wiley-Liss, Inc. [source] Early detection and intervention in first-episode schizophrenia: a critical reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2001T. K. Larsen Objective: To review the literature on early intervention in psychosis and to evaluate relevant studies. Method: Early intervention was defined as intervention in the prodromal phase (primary prevention) and intervention after the onset of psychosis, i.e. shortening of duration of untreated psychosis (DUP) (secondary prevention). Results: We found few studies aimed at early intervention, but many papers discussing the idea at a more general level. We identified no studies that prove that intervention in the prodromal phase is possible without a high risk for treating false positives. We identified some studies aimed at reducing DUP, but the results are ambiguous and, until now, no follow-up data showing a positive effect on prognosis have been presented. Conclusion: Early intervention in psychosis is a difficult and important challenge for the psychiatric health services. At the time being reduction of DUP seems to be the most promising strategy. Intervention in the prodromal phase is more ethically and conceptually problematic. [source] Clinical and diagnostic significance of blood in cervical smearsDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2003Mathilde E. Boon M.D., Ph.D. Abstract A heavy admixture of blood in cervical smears can be problematic for the screener, as the presence of blood can influence the staining quality of the cancer cell nuclei. However, it might also be a blessing in disguise. A retrospective study of 40 clinically important smears, 34 originally signed out as negative for squamous cell carcinoma of the cervix and 6 smears as unsatisfactory, was carried out in comparison with 100 smears from healthy women. Sample parameters were analyzed by macroscopy and neural network scanning. Differences between the two study groups were measured by Pearson's ,2 test. Of the 40 study cases, one case featured insufficient material, while 16 cases (40%) could confidently be classified as malignant or negative for malignancy. The most important macroscopic parameter of the smears was an admixture of blood. This background feature was also highlighted by the NNS system. Angiogenesis was visualized by the expression of CD34 in many sampled capillary fragments included in the smears. In conclusion, blood in cervical smears may have clinical and diagnostic significance. The rate of "failed smears" in routine cervical screening might thus by CD34 be considerably decreased. Diagn. Cytopathol. 2003;28:181,185. © 2003 Wiley-Liss, Inc. [source] Surviving psychiatry in an era of,popular punitiveness'ACTA PSYCHIATRICA SCANDINAVICA, Issue 399 2000J. Peay In an era when sentencing of mentally disordered offenders has been progressively influenced by protective considerations, the role psychiatrists play in the sentencing process is problematic. Where an offender's legitimate expectation of proportionality in sentencing can be trumped by psychiatric assessments, not of therapeutic need, but of either predictions of risk or untreatability or both, leading to disproportionate and potentially damaging custodial sentences, then psychiatrists should recognize that they are ethically compromised. [source] Elusive '68: The Challenge to PedagogyDIE UNTERRICHTSPRAXIS/TEACHING GERMAN, Issue 2 2008William Collins Donahue Teaching ,68 presents pedagogical challenges far greater than assembling a set of workable classroom materials. Divisive controversies that were the hallmark of the time,e.g., the debate over the nature and appropriate use of violence,are with us still, though in a somewhat different form. Further, the instructor,s own politics and positionality can hardly be ignored,as they will certainly not be overlooked by our students. Additionally, this essay argues that fundamental terms (such as who qualifies as a ,68er) remain problematic; that the instrumentalization of the Holocaust by the German New Left continues to affect political decisions down to the present; that our investment as teachers in poststructuralist literary theory may,perhaps inadvertently,affect the way we view and therefore teach ,68; and, finally, that there is a pressing need, despite a recent explosion in Germany of publications celebrating the fortieth anniversary of ,68, for a didacticized reader designed for the North American German Studies classroom. [source] ,We All Knew that a Cyclone Was Coming': Disaster Preparedness and the Cyclone of 1999 in Orissa, IndiaDISASTERS, Issue 4 2004Frank Thomalla Imagine that a cyclone is coming, but that those living in the affected areas do nothing or too little to protect themselves. This is precisely what happened in the coastal state of Orissa, India. Individuals and communities living in regions where natural hazards are a part of daily life develop strategies to cope with and adapt to the impacts of extreme events. In October 1999, a cyclone killed 10,000 people according to government statistics, however, the unofficial death toll is much higher. This article examines why such a large loss of life occurred and looks at measures taken since then to initiate comprehensive disaster-preparedness programmes and to construct more cyclone shelters. The role of both governmental organisations and NGOs in this is critically analysed. The good news is that, based on an assessment of disaster preparedness during a small cyclone in November 2002, it can be seen that at community-level awareness was high and that many of the lessons learnt in 1999 were put into practice. Less positive, however, is the finding that at the state level collaboration continues to be problematic. [source] Internal Displacement in BurmaDISASTERS, Issue 3 2000Steven Lanjouw The internal displacement of populations in Burma is not a new phenomenon. Displacement is caused by numerous factors. Not all of it is due to outright violence, but much is a consequence of misguided social and economic development initiatives. Efforts to consolidate the state by assimilating populations in government-controlled areas by military authorities on the one hand, while brokering cease-fires with non-state actors on the other, has uprooted civilian populations throughout the country. Very few areas in which internally displaced persons (IDPs) are found are not facing social turmoil within a climate of impunity. Humanitarian access to IDP populations remains extremely problematic. While relatively little information has been collected, assistance has been focused on targeting accessible groups. International concern within Burma has couched the problems of displacement within general development modalities, while international attention along its borders has sought to contain displacement. With the exception of several recent initiatives, few approaches have gone beyond assistance and engaged in the prevention or protection of the displaced. [source] Partnerships: imperative or illusion in work-force developmentDRUG AND ALCOHOL REVIEW, Issue 3 2002CELIA WILKINSON Abstract The central theme of the National Drug Strategy is "building partnerships". In the education and training arena, intersectoral partnerships are important to increase the skill and knowledge base of generic professionals. However, partnerships are neither simple nor straightforward endeavours. While this paper argues that they are imperative, they can be time-consuming and problematic. Discussion of the stages of change and how this model applies to partnerships and elements of successful partnerships form the basis of the paper. [source] Identifying young people who drink too much: the clinical utility of the five-item Alcohol Use Disorders Identification Test (AUDIT)DRUG AND ALCOHOL REVIEW, Issue 1 2001HELEN MILES Researcher Abstract The current study investigated the patterns and consequences of alcohol use among young people and their perceptions of associate health risk, and explored the clinical utility of the five-item version of the Alcohol Use Disorders Identification Test (AUDIT) in screening young people for hazardous drinking. A cross-sectional sample of 393 young people aged 16,19 years were accessed through two tertiary colleges in South London and self-completed an anonymous, confidential questionnaire recording the five-item AUDIT, patterns of alcohol consumption, hazardous consequences and perception of associate health risk. Over 90% of the sample reported drinking alcohol regularly, commonly excessive weekend use and related physical, psychological and social consequences. A significant minority (20.4% of males, 18.0% of females) reported consumption of alcohol in excess of UK recommended limits, while almost a third (34.2% of males, 30.2% of females) reported scores in the ,hazardous' range of the five-item AUDIT. However, the majority had little perception of associate health risk, perceiving their use to be ,light' and unproblematic. Only one in 10 of those drinking at ,hazardous' levels recognized their alcohol use as problematic, most believing the hazardous consequences of this use were acceptable. Self-reported patterns of alcohol consumption (except age first used) and total number of psychological and social hazardous consequences were found to significantly predict AUDIT scores using linear regression analysis. Therefore the five-item AUDIT appears to have predictive validity, reflecting self-reported alcohol consumption, perception of associate health risk and hazardous consequences among young people. It is concluded that it may consequently have clinical utility as a simple screening tool (suitable for use by a variety of professionals in contact with young people) for the identification of hazardous alcohol consumption among this population. [source] Tools for planning and coordinating development of medical countermeasures in the public sectorDRUG DEVELOPMENT RESEARCH, Issue 4 2009Ian Manger Abstract In spite of significant increases in biodefense spending in the 7 years since the 2001 anthrax attacks, the United States may not yet be fully prepared to respond effectively to many potential biothreats. The principal reasons appear to be that: (1) the problem is extremely complex, and the metrics for success are often unclear; (2) although the US Congress has allocated substantial resources for this effort, these funds are insufficient for the task as initially conceived, i.e., "one drug for each bug;" and (3) there is insufficient coordination among the many agencies working to achieve the goal of protecting the nation from biothreats. In the last few years, much of the biodefense community has come to recognize that an approach that focuses on developing and stockpiling a medical countermeasure (MCM) for each possible biothreat agent is unachievable for reasons of cost, time, and the sheer diversity of emerging threats. Promising alternative models are emerging, including broad spectrum and technology platform approaches, but the requisite cross-agency planning and coordination, although improving, is still problematic. We have developed a set of software tools and methods for using them that could support the desired coordination and that could also provide for more rapid, comprehensive, and shared identification of key enabling technologies for accomplishing the development of effective medical countermeasures in time to counter or prevent a biothreat. The tools and methods could also make possible a collaborative public-private partnership for the development of MCM, which many believe is critical to success. Drug Dev Res 70:327,334, 2009 © 2009 Wiley-Liss, Inc. [source] St Columba and the convention at Druimm Cete: peace and politics at seventh-century IonaEARLY MEDIEVAL EUROPE, Issue 3 2007James E. Fraser Attendance at the ,convention of kings' at Druimm Cete in north-east Ireland is one of the most famous episodes in the career of St Columba or Colum Cille, who died in 597. Discussion of the significance of this shadowy summit, largely informed by unreliable late evidence, has hitherto focused upon what (may have) transpired there between kings based in Ireland and Scotland. The result has been the neglect of the hagiographical dimension of the presentation of Druimm Cete in our principal source, Adomnán's Vita Sancti Columbae, composed c.700. Analysis of this material shows that Adomnán's information about the convention came from his principal source, composed some sixty years earlier. It reveals moreover that Druimm Cete assumed prominence within the Columban dossier in the 640s for what it represented, rather than because of what actually happened there. Once the hagiographical agenda of Vita Sancti Columbae and its principal source is restored to its rightful place in evaluating the text, it emerges that several of its best-known stories , including the story of Columba's ordination of a Scottish king , are much more problematic as witnesses to sixth-century history than is conventionally supposed. As scholars begin to lose their grip upon the historical Columba, however, they grow better able to grasp seventh-century political history in north-east Ireland and Gaelic Scotland. [source] | |||||||||||||||||||||||||||||||||||||