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Real-life Situations (real-life + situation)
Selected AbstractsAntiviral efficacy and resistance in patients on antiretroviral therapy in Kigali, Rwanda: the real-life situation in 2002HIV MEDICINE, Issue 1 2006A Fischer Our study aimed to complete the published data on ARV therapy in Africa by describing the baseline situation in Rwanda before the launch of a large ARV programme (ESTHER). Prescription habits, frequency and reasons for treatment interruptions but also antiviral efficay, resistance to ARVs and genotypic variability of the viruses present in Rwanda were analysed. Among the 233 patients included in the study, it appeared that a vast majority (91%) were under triple therapy and that half of them had experienced at least one treatment interruption caused mainly by drug shortage or financial difficulties. Among 60 blood samples analysed, 26 were in virological failure with a viral load above 1000 RNA copies/ml and 11 presented major drug resistance mutations. Finally, virological failure could mainly be explained by the high frequency of treatment interruptions but also by the emergence of drug resistance mutations. Consequently the major objective for the ESTHER programme to improve the situation in Rwanda will be to reduce the drug shortage and facilitate the financial accessibility of the treatments. [source] Acoustic features of infant crying related to intended caregiving interventionINFANT AND CHILD DEVELOPMENT, Issue 2 2004Debra M. ZeifmanArticle first published online: 3 JUN 200 Abstract The present study investigated the acoustic features of crying associated with intended caregiving intervention. One hundred eighty-eight parents (138 females, 50 males) viewed a videotape depicting a healthy 4-week-old infant progressing from fussing to crying over the course of 4 minutes, and indicated if and when they would pick up the infant in a real-life situation. There was a distinct peak in responding corresponding to an increase in duration but not fundamental frequency of the infant's cries. This finding is discussed in terms of the existing empirical literature. It is hypothesized that, whereas frequency may convey information about a newborn's neurological integrity and health status at birth, duration and other acoustical variables provide information about slightly older, normal infants' level of distress. Copyright © 2004 John Wiley & Sons, Ltd. [source] Fermented milk containing Bifidobacterium lactis DN-173 010 improved self-reported digestive comfort amongst a general population of adults.JOURNAL OF DIGESTIVE DISEASES, Issue 1 2009A randomized, controlled, open-label, pilot study AIM: Some probiotics improve digestive comfort of people with Irritable Bowel Syndrome, but this needs confirmation in a healthy population. The objective of this pilot study was to investigate the effect of consuming fermented milk containing the probiotics Bifidobacterium lactis DN-173010 and yoghourt strains (test product) on digestive comfort and symptoms amongst adults without diagnosed gastrointestinal disorders. METHODS: The study was designed to approximate a real-life situation, by using a branded product in the intervention groups. In an open-label, randomized, controlled trial, 371 adults reporting digestive discomfort were randomized into three groups who had a daily consumption of either one or two pots of test product over 2 weeks, or to follow their usual diet. Digestive comfort and bother from digestive symptoms were assessed by questionnaire at baseline and follow-up (per protocol population n = 360). Self-reported change in digestive comfort and computed change between baseline and follow-up for each of 20 items were compared between groups (Cochran-Mantel-Haenszel test). RESULTS: A higher percentage of participants consuming the test product reported improved digestive comfort (1-pot group 82.5%; 2-pot group 84.3%), than controls (2.9%). Their self-reported change scores differed significantly (P < 0.001). For both test product groups, almost all symptom scores improved significantly more than controls (P < 0.001). There were no significant differences between 1-pot and 2-pot groups. CONCLUSIONS: This pilot study shows that daily consumption of a probiotic food in real-life conditions may be useful in improving digestive comfort and symptom experience of adults from general population. Further double-blind randomized controlled studies are required to confirm these health benefits. [source] The effects of caffeine on simulated driving, subjective alertness and sustained attentionHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2001Carolyn Brice Abstract There is evidence that caffeine increases alertness and reduces fatigue. This may be especially so in low arousal situations (e.g. working at night or for prolonged hours). Caffeine has also been found to improve performance on vigilance tasks and simple tasks requiring sustained response. Again, these effects are often clearest when alertness is reduced, although there is evidence that benefits may still occur when the individual is unimpaired. Most studies to date have investigated the behavioural effects of caffeine in laboratory experiments using artificial tasks. In the current study 3,mg/kg caffeine was found to improve steering accuracy in a 1,h simulated drive. Measures of mood and performance on a sustained attention task also showed the benefits of caffeine. These findings suggest that laboratory results reflect a general benefit of caffeine that may also be observed in real-life situations. Other evidence examining the effects of caffeine on performance efficiency over the working day has shown the benefits of caffeine consumption on measures of sustained attention and alertness. This study also provided evidence suggesting that caffeine is often consumed when alertness is low to maximise alertness and performance efficiency. The implications of these findings for road safety are also considered. Copyright © 2001 John Wiley & Sons, Ltd. [source] Could interchangeable use of dry powder inhalers affect patients?INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2005D. Price Summary The aim of asthma treatment is optimal disease control. Poor asthma control results in considerable patient morbidity, as well as contributing to the considerable burden placed by the disease on healthcare budgets. There is a need for costs to be carefully scrutinised, with the switching of patients to inhaler devices with lower acquisition costs likely to be increasingly considered. However, before such practice becomes widespread, it is important to establish whether or not this could adversely impact on patients and the level of disease control. For approval to have been given, all marketed inhalers must have satisfied current regulatory requirements for devices. Full preclinical and clinical development programmes are not required when application is made for authorisation to market a new inhaler containing an existing chemical entity, although clinical equivalence testing must be used. Both beneficial and adverse effects should be tested, and the limits of equivalence must be clearly defined, based on therapeutic relevance. It should be noted that equivalence studies are invalid when the end point is not responding (i.e. at the top of the dose,response curve) and when equivalence limits approach or are equal to the magnitude of the drug effect. Approval on the basis of regulations designed to safeguard quality of dry powder inhalers does not mean that devices are interchangeable. When using an inhaler, there are many stages between the patient and the therapeutic effect, involving device design, pharmaceutical performance and patient behaviour. Regulations governing new devices cover only a few of the many factors affecting disease control. Furthermore, clinical trials to assess equivalence may not take into account factors in patient behaviour or variations in patient inhaler technique that may affect use of devices in real-life situations. When assessing the consequences of interchangeable use of dry powder inhalers on healthcare costs, it is important to ensure that the acquisition cost of the devices is not the only cost considered. Other costs that should be considered include the cost of time spent demonstrating to the patient how to use the new device, the cost of additional physician visits to address patient concerns and the management costs if disease control is adversely affected. [source] An approximate analysis of shared-buffer channel-grouped ATM switches under imbalanced trafficINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 5 2006Xuan-Hien Dang Abstract Grouping output channels in a shared-buffer ATM switch has shown to provide great saving in buffer space and better throughput under uniform traffic. However, uniform traffic does not represent a realistic view of traffic patterns in real systems. In this paper, we extend the queuing analysis of shared-buffer channel-grouped (SBCG) ATM switches under imbalanced traffic, as it better represent real-life situations. The study focuses on the impact of the grouping factor and other key switch design parameters on the performance of such switches as compared to the unichannel allocation scheme in terms of cell loss probability, throughput, mean cell delay and buffer occupancy. Numerical results from both the analytical model and simulation are presented, and the accuracy of the analysis is presented. Copyright © 2005 John Wiley & Sons, Ltd. [source] Schematic representation of case study research designsJOURNAL OF ADVANCED NURSING, Issue 4 2007John P. Rosenberg Abstract Title.,Schematic representation of case study research designs Aim., The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Background., Case study research is a methodologically flexible approach to research design that focuses on a particular case , whether an individual, a collective or a phenomenon of interest. It is known as the ,study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. Method., This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. Discussion., The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. Conclusion., The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods. [source] A Generalized Oligopoly ModelMETROECONOMICA, Issue 1 2002Richard Watt This paper generalizes and unifies the traditional quantity competition oligopoly models of Cournot and Stackelberg. Traditional oligopoly models predict that, under constant marginal costs, there will only be one market share (Cournot) or a single firm with a large market share and all others with the same market share (Stackelberg). Without altering the basic assumption set, in particular the assumptions of common marginal cost functions, perfect information and linear demand, the paper presents a general model that may be useful to explain many real-life situations of oligopoly competition, where many different market shares may coexist. Finally, it is shown that certain existing social welfare results are robust to the generalization. [source] Free-riders promote free-riding in a real-world settingOIKOS, Issue 9 2010Nichola J. Raihani A common paradigm in studies of human cooperation is that individuals mediate their investment in a public good according to the investments of others. However, most research on this topic has been conducted in artificial laboratory settings and has assumed that cooperation imposes relatively high monetary costs on players. As such, we do not yet know how humans behave when faced with non-monetary costs of cooperating in more realistic settings. Here, we present results from a real-world public good experiment where the monetary costs of cooperation were relaxed. We manipulated the cleanliness of a sink in a staff tea room (a public good) by adding or removing dirty kitchenware and then recorded the number of items subsequently added to the sink by staff members. We found that when the sink had no dirty items, people were less likely to dump their own used kitchenware and the public good was maintained. In contrast, people were more likely to dump items in the sink when it already contained unwashed kitchenware and increasing the number of dirty items in the sink led to an increase in the number of items that were subsequently dumped. This study shows that defection begets defection in real-life situations, even when cooperation is relatively cheap. [source] Contraception and pregnancy then and now: Examining the experiences of a cohort of mid-age Australian womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Christine READ Background: More than 50% of women who have an unplanned pregnancy report using a contraceptive method. Since the launch of the pill 50 years ago, a number of cross-sectional surveys have examined contraceptive use in the Australian context. There is, however, little data on contraceptive use and efficacy over a woman's reproductive years. Aim: To determine the pattern of contraceptive use of Australian women over their reproductive lifespan, with particular emphasis on the relationship between contraceptive use and pregnancy. Method: One thousand women from the mid-age cohort of the Australian Women's Longitudinal Study were invited to participate in the Family Planning survey by completing a questionnaire about their reproductive histories. Results: Completed questionnaires were received for 812 women. The contraceptive pill was the most commonly ever used contraceptive method at 94% and also the most commonly used method prior to all pregnancies. Contraceptive failure increased with increasing gravidity; 11.4% with the first pregnancy to 23.0% with the fourth pregnancy, while 28.8% of the respondents reported an ,accidental' pregnancy due to stopping contraception for reasons such as concern about long-term effects and media stories. Conclusions: While surveys indicate that 66,70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations. [source] | ||||||||||