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Kinds of Records Terms modified by Records Selected AbstractsRosiglitazone RECORD study: glucose control outcomes at 18 monthsDIABETIC MEDICINE, Issue 6 2007P. D. Home Abstract Aims To compare glucose control over 18 months between rosiglitazone oral combination therapy and combination metformin and sulphonylurea in people with Type 2 diabetes. Methods RECORD, a multicentre, parallel-group study of cardiovascular outcomes, enrolled people with an HbA1c of 7.1,9.0% on maximum doses of metformin or sulphonylurea. If on metformin they were randomized to add-on rosiglitazone or sulphonylurea (open label) and if on sulphonylurea to rosiglitazone or metformin. HbA1c was managed to , 7.0% by dose titration. A prospectively defined analysis of glycaemic control on the first 1122 participants is reported here, with a primary outcome assessed against a non-inferiority margin for HbA1c of 0.4%. Results At 18 months, HbA1c reduction on background metformin was similar with rosiglitazone and sulphonylurea [difference 0.07 (95% CI ,0.09, 0.23)%], as was the change when rosiglitazone or metformin was added to sulphonylurea [0.06 (,0.09, 0.20)%]. At 6 months, the effect on HbA1c was greater with add-on sulphonylurea, but was similar whether sulphonylurea was added to rosiglitazone or metformin. Differences in fasting plasma glucose were not statistically significant at 18 months [rosiglitazone vs. sulphonylurea ,0.36 (,0.74, 0.02) mmol/l, rosiglitazone vs. metformin ,0.34 (,0.73, 0.05) mmol/l]. Increased homeostasis model assessment insulin sensitivity and reduced C-reactive protein were greater with rosiglitazone than metformin or sulphonylurea (all P , 0.001). Body weight was significantly increased with rosiglitazone compared with sulphonylurea [difference 1.2 (0.4, 2.0) kg, P = 0.003] and metformin [difference 4.3 (3.6, 5.1) kg, P < 0.001]. Conclusions In people with diabetes, rosiglitazone in combination with metformin or sulphonylurea was demonstrated to be non-inferior to the standard combination of metformin + sulphonylurea in lowering HbA1c over 18 months, and produces greater improvements in C-reactive protein and basal insulin sensitivity but is also associated with greater weight gain. [source] Rivaroxaban , an oral, direct Factor Xa inhibitor , lessons from a broad clinical study programmeEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2009Sylvia Haas Abstract Anticoagulants are recommended for the prevention and treatment of venous thromboembolism (VTE), prevention of stroke in patients with atrial fibrillation (AF) and secondary prevention in patients with acute coronary syndrome (ACS). There is a clinical need for novel anticoagulants offering improvements over current standard of care, such as fixed oral dosing and no need for routine monitoring. Rivaroxaban, an oral, once-daily, direct Factor Xa inhibitor, has recently completed the RECORD phase III programme for the prevention of VTE in patients undergoing total hip or knee replacement (THR or TKR), an indication for which it is approved in Europe and Canada. It is being investigated in large-scale phase III studies for VTE treatment and prevention of stroke in patients with AF, and phase III studies will soon commence for secondary prevention in patients with ACS. Phase I studies demonstrated that no routine anticoagulation monitoring was required, while phase II studies suggested that fixed daily doses had a wide therapeutic window. The four RECORD studies consistently showed that rivaroxaban was significantly more effective than enoxaparin in the prevention of VTE after THR and TKR, with a similar safety profile. This review describes the development of this novel anticoagulant, from bench to bedside. [source] EXTINCTION DURING EVOLUTIONARY RADIATIONS: RECONCILING THE FOSSIL RECORD WITH MOLECULAR PHYLOGENIESEVOLUTION, Issue 12 2009Tiago B. Quental Recent application of time-varying birth,death models to molecular phylogenies suggests that a decreasing diversification rate can only be observed if there was a decreasing speciation rate coupled with extremely low or no extinction. However, from a paleontological perspective, zero extinction rates during evolutionary radiations seem unlikely. Here, with a more comprehensive set of computer simulations, we show that substantial extinction can occur without erasing the signal of decreasing diversification rate in a molecular phylogeny. We also find, in agreement with the previous work, that a decrease in diversification rate cannot be observed in a molecular phylogeny with an increasing extinction rate alone. Further, we find that the ability to observe decreasing diversification rates in molecular phylogenies is controlled (in part) by the ratio of the initial speciation rate (Lambda) to the extinction rate (Mu) at equilibrium (the LiMe ratio), and not by their absolute values. Here we show in principle, how estimates of initial speciation rates may be calculated using both the fossil record and the shape of lineage through time plots derived from molecular phylogenies. This is important because the fossil record provides more reliable estimates of equilibrium extinction rates than initial speciation rates. [source] NOTES ON A NEW SPECIES AND A NEW RECORD OF THE GENUS CENTISTIDEA HALIDAY (HYMENOPTERA: BRACONIDAE) FROM CHINAINSECT SCIENCE, Issue 2 2000WU Zhi-shan Abstract, A new species and a new record of the genus Centistideu Haliday (Hymenoptera: Braconidae:) are reported from China in this paper. Centistideu immitis Wu et Chen is new to science and Centistideu irruptor (Papp) is recorded for the first time from China. Key to the species of the genus paper is also provided. The type specimens and other material examined are deposited in the Beneficial Insects Lab, Fujian Agricultural University, Fuzhou. [source] 10th INTERNATIONAL VETERINARY EMERGENCY & CRITICAL CARE SYMPOSIUM DRAWS RECORD 2800!!JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 4 2004Article first published online: 24 NOV 200 [source] HOLOCENE RECORD OF THE DUGONG (DUGONG DUGON) FROM VICTORIA, SOUTHEAST AUSTRALIAMARINE MAMMAL SCIENCE, Issue 2 2005Erich M. G. Fitzgerald [source] WEALTH AND POWER IN THE BRONZE AGE OF THE SOUTH-EAST OF THE IBERIAN PENINSULA: THE FUNERARY RECORD OF CERRO DE LA ENCINAOXFORD JOURNAL OF ARCHAEOLOGY, Issue 1 2006GONZALO ARANDA Summary. As a result of recent fieldwork undertaken at the archaeological site of Cerro de la Encina, our knowledge of the funerary ritual has increased considerably. The funerary record shows a significant concentration of wealth in burials corresponding to the family groups of the highest social status. Dramatic social differences can also be found in the internal organization of the settlement. The locations of burials within the settlement area, under the floors of dwellings, allow us to establish that the settlement space was closely related to the social identity of the families. The high number of burials with double and triple inhumations, in contrast to other Argaric necropolis, also stands out as an important feature of Cerro de la Encina, suggesting that familial relationships seem to be more marked here than at other Argaric sites. All these data are discussed in relation to the funerary ritual of the Argaric Culture. [source] FIRST RECORD OF AN AQUATIC BEETLE LARVA (INSECTA: COLEOPTERA) FROM THE PARSORA FORMATION (PERMO-TRIASSIC), INDIAPALAEONTOLOGY, Issue 6 2007S. C. GHOSH Abstract:, The fossilized larva of an aquatic beetle, Protodytiscus johillaensis gen. et sp. nov., is described from a ferruginous micaceous siltstone bed of the Permo-Triassic Parsora Formation of the South Rewa Gondwana Basin, Madhya Pradesh, India, and its systematic position and ordinal relationships within the coleopterous suborder Adephaga are discussed. Hitherto, the oldest known fossils of the hydradephagan superfamily Dytiscoidea have been Jurassic. The discovery of P. johillaensis extends the range of the Dytiscoidea back to the Permo-Triassic period. [source] THE SHAPE OF THE PHANEROZOIC MARINE PALAEODIVERSITY CURVE: HOW MUCH CAN BE PREDICTED FROM THE SEDIMENTARY ROCK RECORD OF WESTERN EUROPE?PALAEONTOLOGY, Issue 4 2007ANDREW B. SMITH Abstract:, Palaeodiversity curves are constructed from counts of fossils collected at outcrop and thus potentially biased by variation in the rock record, specifically by the amount of sedimentary rock representative of different time intervals that has been preserved at outcrop. To investigate how much of a problem this poses we have compiled a high-resolution record of marine rock outcrop area in Western Europe for the Phanerozoic and use this to generate a model that predicts the sampled diversity curve. We find that we can predict with high accuracy the variance of the marine genus diversity curve (itself dominated by European taxa) from rock outcrop data and a three-step model of diversity that tracks supercontinent fragmentation, coalescence and fragmentation. The size and position of two of the five major mass extinction spikes are largely predicted by rock outcrop data. We conclude that the long-term trends in taxonomic diversity and the end-Cretaceous extinction are not the result of rock area bias, but cannot rule out that rock outcrop area bias explains many of the short-term rises and falls in sampled diversity that palaeontologists have previously sought to explain biologically. [source] A retrospective evaluation of congestive heart failure and myocardial ischemia events in 14,237 patients with type 2 diabetes mellitus enrolled in 42 short-term, double-blind, randomized clinical studies with rosiglitazonePHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2008Alexander Cobitz MD Abstract Purpose Retrospectively investigate potential associations between rosiglitazone and congestive heart failure (CHF) and, separately, events of myocardial ischemia. Methods Data from 14,237 individuals in 42 short-term, double-blind, randomized studies of rosiglitazone versus placebo or active diabetes medications were analyzed across seven treatment comparisons using an exact logistic regression model, adjusted for number of major cardiovascular risk factors and duration of exposure. Results CHF incidence ranged 0,1.27% (SAEs) and 0.12,2.42% (all AEs) with rosiglitazone versus 0.07,0.75% (SAEs) and 0.25,1.36% (all AEs) with control. Higher odds ratios (95%CI) were observed for CHF SAEs with sulfonylurea- and insulin-containing combinations: rosiglitazone monotherapy versus placebo, 0.25 (<0.01,4.75); rosiglitazone monotherapy versus sulfonylurea/metformin monotherapy, 0.23 (<0.01,2.14); sulfonylurea,+,rosiglitazone versus sulfonylurea monotherapy, 0.95 (0.01,75.20); metformin,+,rosiglitazone versus metformin monotherapy, 0.60 (0.00,8.28); metformin,+,rosiglitazone versus metformin,+,sulfonylurea, 1.04 (0.39,2.86); sulfonylurea,+,metformin,+,rosiglitazone versus sulfonylurea,+,metformin, 3.15 (0.35,150.52); insulin,+,rosiglitazone versus insulin monotherapy, 1.63 (0.52,6.01). Myocardial ischemia incidence ranged 0.75,1.40% (SAEs) and 1.49,2.77% (all AEs) with rosiglitazone versus 0.21,2.04% (SAEs) and 0.56,2.38% (all AEs) with control. Each comparison had an OR >1, with wide confidence intervals generally including unity. With data pooling, more events of myocardial ischemia were observed with rosiglitazone (2.00%) versus control (1.53%) (HR 1.30, 95%CI 1.004,1.69). Conclusions CHF incidence may be greater when rosiglitazone is combined with sulfonylureas or insulin. When data were pooled, more events of myocardial ischemia were observed with rosiglitazone versus control. Final results from RECORD will allow a more rigorous evaluation of the cardiovascular safety profile. Copyright © 2008 John Wiley & Sons, Ltd. [source] Latest news and product developmentsPRESCRIBER, Issue 12 2007Article first published online: 4 OCT 200 NAO: GPs still not prescribing efficiently The National Audit Office (NAO) says NHS funds are being wasted through inefficient GP prescribing and patients not taking their medicines. The NAO's long-awaited report, Prescribing Costs in Primary Care (www.nao.org.uk), found large variations between PCTs in generic prescribing of statins, ACE inhibitors and angiotensin-II antagonists, and protonpump inhibitors; PCTs were also paying widely differing prices for these products. There was a five-fold variation in prescribing volume for clopidogrel between PCTs. These four drugs accounted for only 19 per cent of total spending but, if all practices matched the performance of the best 25 per cent, the NHS would save £200 million annually. PCTs should do more to rationalise prescribing and support their GPs, the NAO concludes. The NAO says that the cost of medicines dispensed for but not taken by patients lies somewhere in the range £100-£800 million annually. Strategies to reduce waste include public awareness campaigns and restricting supplies to four weeks (or two weeks for new medicines). Rosiglitazone may increase CV death risk A meta-analysis of 42 clinical trials has suggested that rosiglitazone is associated with increased risks of myocardial infarction (MI) and cardiovascular death (N Engl J Med 2007; published online 21 May: doi 10.1056/ NEJMoa072761). Like the COX-2 inhibitors, rosiglitazone was licensed without determining its possible effects on long-term cardiovascular outcomes, and interpretation of the latest findings is complicated by the multiple comparisons involved. For risk of MI, there was no significant difference between rosiglitazone and placebo (though this was of borderline statistical signifi-cance , p=0.07), metformin, sulphonylureas or insulin. Rosiglitazone was associated with a statistically significant 43 per cent increased risk compared with all comparators combined but the absolute increase in risk was very small (0.02 per cent). The trends were similar for risk of cardiovascular death, though rosiglitazone was associated with a 64 per cent increased risk compared with all comparators combined that was of borderline statistical significance (p=0.06). The authors acknowledge that their analysis pooled short-term studies that excluded patients at risk of heart disease and was not designed to determine cardiovascular outcomes, and they had no access to patientlevel data; as a result, there is uncertainty about their findings. Nevertheless, they say there is now an urgent need to clarify the risk associated with rosiglitazone. GlaxoSmithKline has rebutted the findings, stating that the cardiovascular risk profile of rosiglitazone is comparable with that of other oral antidiabetic drugs. The MHRA says warnings in the current SPCs for Avandia and Avandamet already reflect most of the data in the latest US review. The possible effects of rosiglitazone on cardiovascular events is currently being evaluated in the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of glycaemia in Diabetes (RECORD) study. Good management tool The Department of Health has published a disease management tool to enable PCTs to model local interventions that could reduce emergency admissions. The web-based ,voluntary good practice tool' will demonstrate how interventions in primary care and social care settings can improve the management of long-term conditions including cardiovascular disease, asthma and COPD, and dementia and depression. Counterfeit medicines The MHRA has issued an unprecedented three alerts about fake medicines in the legitimate supply chain, recalling all affected lot numbers. Three batches of Zyprexa 10mg tablets (olanzapine) were withdrawn after a company printing labels became suspicious and alerted Eli Lilly. Two of the batches, which contained 60 per cent of the stated active ingredient, had reached patients but no adverse events were reported. Two lots of parallel-imported Plavix 75mg tablets (clopidogrel) have been withdrawn after counterfeit packs were identified. The lots were in French original packaging but will have been overlabelled for the UK market. The counterfeits were mixed with genuine packs from Sanofi-Aventis. Fake Casodex 50mg tablets (bicalutamide) have been identified in a parallel import from France. The Royal Pharmaceutical Society reports that the fake contains 75 per cent of the stated dose of bicalutamide. Alcohol-free mometasone Schering-plough has introduced an alcohol-free formulation of mometasone furoate nasal spray (Nasonex) for hay fever. The company says that an alcohol vehicle causes nasal irritation and leaves an unpleasant aftertaste, adding that over 40 per cent of patients cite this as the main reason for stopping treatment, and over 50 per cent state a preference for an alcohol-free product. Aid to improve statin adherence Adherence to statin therapy can be improved if patients use a decision aid when they are offered treatment,US investigators say (Arch Intern Med 2007;167:1076-82). The decision aid estimated the individual's 10-year cardiovascular risk and the risk reduction from treatment, and summarised the disadvantages of statins.Patients with diabetes who used the aid knew more about their risk and were less indecisive about treatment than those who did not. The odds of having missed a dose over three months were three times higher for patients who had not used the aid. Online tool calculates switch savings A new online tool can help GPs estimate the savings achievable from switching patients to cheaper medicines. The Switch Saving Calculator, developed by the Prescribing Analysis & Support Team at the NHS Regional Drug and Therapeutics Centre in Newcastle, calculates potential savings based on past, current or projected use of the target drug. It can be applied to individual prescribers or scaled up to practice, commissioning group, PCT, health authority or even national level. Separate calculators are available for primary and secondary care. The current version calculates potential savings by switching from atorvastatin to simvastatin. The Newcastle team says other drugs will be added and they will update prices regularly. The calculator is at www.nyrdtc.nhs.uk:80/Services/presc_supp/ switch_saving_calculator/switch_saving_calculator.html. No improvement in drug information for patients leaving hospital The information given to patients discharged from hospital is not improving, according to the Healthcare Commission's annual patient survey (www.healthcare commission.org.uk). The 2006 survey found that the commonest reason patients were kept waiting for at least four hours to leave hospital was the delay in providing discharge medicines. Provision of written information increased from 62 per cent of patients in 2005 to 65 per cent in 2006. However, only 76 per cent said they had been told about their medicines in a way they could ,completely' understand (79 per cent in 2002). The proportion of patients reporting complete information about sideeffects also fell (from 40 per cent in 2005 to 37 per cent). Aspirin in preeclampsia A new meta-analysis has found that primary prevention with low-dose aspirin modestly but consistently reduces the risk of preeclampsia (Lancet 2007; published online 18 May). The study of 31 trials involving 32 217 women at low to moderate risk found that antiplatelet agents (mostly aspirin) reduced the risk of pre-eclampsia and preterm birth by 10 per cent without an increased risk of bleeding. The benefit was similar across subgroups. There were also nonsignificant reductions in the risk of small for age, stillborn and death before discharge. New from NICE NICE approves varenicline for NHS NICE has endorsed the use of varenicline (Champix) as an aid to smoking cessation within the NHS for England and Wales; it has already been approved for use in Scotland by the Scottish Medicines Consortium. Varenicline is a partial agonist at the ,4,2 nicotinic receptor. It alleviates craving and withdrawal symptoms, and reduces the rewarding and reinforcing effects of smoking. The commonest adverse effect is mild to moderate nausea, which improves with time.1 Varenicline is licensed for smoking cessation in adults; NICE says it should be offered as an option for smokers who say they want to quit as part of a programme of behavioural support. However, treatment should not be withheld if counselling and support are not available. NICE was critical of manufacturer Pfizer's economic arguments in favour of varenicline, which inappropriately included US data, assumed a single quit attempt and may have overestimated its efficacy. It nonetheless concluded that varenicline is more effective than nicotine replacement therapy (NRT) or bupropion (Zyban) in achieving continuous abstinence. NICE estimated that, compared with NRT, the odds of abstinence at one year with varenicline were 54 per cent greater. A Cochrane review1 concluded that abstinence was 66 per cent more likely with varenicline than with bupropion, and three times more likely than with placebo. There was also a benefit from offering smokers a wider choice of treatments. A 12-week course of varenicline costs £163.80; it is also licensed for an additional 12-week course and dose tapering may be considered for those at high risk of relapse. The final appraisal determination does not state which is the treatment of first choice for smoking cessation. NICE is currently preparing guidance on smoking cessation in pri-mary care, pharmacies and workplaces. Copyright © 2007 Wiley Interface Ltd [source] ASSESSING WHAT LIES BENEATH THE SPATIAL DISTRIBUTION OF A ZOOARCHAEOLOGICAL RECORD: THE USE OF GIS AND SPATIAL CORRELATIONS AT EL MIRÓN CAVE (SPAIN)*ARCHAEOMETRY, Issue 3 2009A. B. MARÍN ARROYO Geographical Information Systems (GIS) are being incorporated into archaeology as a technique to improve the understanding of spatial organization and the relationships among finds within specific areas. Although their use as a basic tool in predicting the location of archaeological sites or in assessing the extent of their catchment areas is relatively common, in general, they have less often been applied to the study of the spatial distribution of archaeological remains within individual deposits, and in particular to faunal assemblages. Despite this, they can prove essential to understanding dispersion and grouping patterns within deposits fully, and, together with various correlation analytical techniques, they provide valuable information about the economic organization of settlements and inhabitant lifeways. To demonstrate the potential of this methodology, a zooarchaeological GIS has been prepared for the Middle and Late Magdalenian and Azilian layers in El Mirón Cave (eastern Cantabria, Spain), and the spatial distribution patterns of various attributes of the archaeological record have been analysed. Significant conclusions in terms of type and duration of human occupation have been drawn. [source] CONTINUUM OF CARE AND THE ANTENATAL RECORD IN RURAL NEW SOUTH WALESAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2003Karen Patterson ABSTRACT Objective: The aim of the study was to determine the effect of the woman held antenatal record card (PNC2) on the continuity of maternity care received when presenting to the acute rural setting for clinical assessment. Design: Qualitative, open-ended questionnaires. Setting: Rural New South Wales public hospital. Subjects: Maternity consumers, 50 women who were inpatients receiving antenatal or postnatal care between August and October 1998. A stratified sample of healthcare professionals employed by the service, 12 midwives and 13 general practitioners. Main outcome measure: The self reported use of the antenatal card and the viewed effects of the card on the continuity of healthcare received. Results: The study identified a significant difference between the responding professionals (93%) positive perception of the effect of the PNC2 on the women's pregnancy continuum of care and the maternity consumer (36%), who felt it bore little impact on their care. The study findings suggested a lack of compliance and standardisation in usage of the antenatal card negated any flow on effects for the women. Conclusions: The intended purposes of the PNC2 were compromised in this rural setting. The study recommends that stakeholders in rural maternity care be accountable for examining the benefits and barriers of their antenatal practices, that the rural community's expectations of ,continuity of maternity care' are sought and that there should be a review of the available models of rural antenatal care. [source] TEMPERATURE PROXY RECORDS COVERING THE LAST TWO MILLENNIA: A TABULAR AND VISUAL OVERVIEWGEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 1 2009FREDRIK CHARPENTIER LJUNGQVIST ABSTRACT. Proxy data are our only source of knowledge of temperature variability in the period prior to instrumental temperature measurements. Until recently, very few quantitative palaeotemperature records extended back a millennium or more, but the number is now increasing. Here, the first systematic survey is presented, with graphic representations, of most quantitative temperature proxy data records covering the last two millennia that have been published in the peer-reviewed literature. In total, 71 series are presented together with basic essential information on each record. This overview will hopefully assist future palaeoclimatic research by facilitating an orientation among available palaeotemperature records and thus reduce the risk of missing less well-known proxy series. The records show an amplitude between maximum and minimum temperatures during the past two millennia on centennial timescales ranging from c. 0.5 to 4°C and averaging c. 1.5,2°C for both high and low latitudes, although these variations are not always occurring synchronous. Both the Medieval Warm Period, the Little Ice Age and the 20th century warming are clearly visible in most records, whereas the Roman Warm Period and the Dark Age Cold Period are less clearly discernible. [source] A POTENTIAL CENTURY,SCALE RHYTHM IN SIX MAJOR PALAEOCLIMATIC RECORDS IN THE NORTHERN HEMISPHEREGEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 2 2007MAXIM OGURTSOV ABSTRACT. Six millennial proxy records of temperature in the northern hemisphere were analysed using both the Fourier and wavelet approaches. We found that the analysed temperature proxies have appreciable synchrony at multidecadal and centennial time scales. These data also show evidence for the presence of a roughly regular large-scale rhythm with a periodicity of 50,130 years in the climate of the northern hemisphere over the last millennium. It is shown that the amplitude of this variation might reach 0.20,0.28°C and contribute appreciably to the rise of global temperature over the first part of the 20th century. Possible origins of the global centennial climatic cycles are discussed. [source] CLIMATE OSCILLATIONS AS RECORDED IN SVALBARD ICE CORE ,18O RECORDS BETWEEN AD 1200 AND 1997GEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 1 2005ELISABETH ISAKSSON ABSTRACT. We apply two different time series analytical tools to ,18O records from two Svalbard ice cores. One ice core is from Lomonosovfonna at 1250 ma.s.l. and the other from Austfonna at 750 m a.s.l. These cores are estimated to cover at least the past 800 years and have been dated using a combination of known reference horizons and glacial modelling. Wavelet analysis reveals low frequency oscillations on the 60,120,year scale on the lower elevation site Austfonna while the higher altitude site on Lomonosovfonna does not reveal such variability throughout the record. The second method, Significant Zero Crossing of Derivates (SiZer) does not resolve the low-frequency periodicity seen in the wavelet analysis. The low-frequency variability resolved by the wavelet analysis is similar to what has been found in various climate records including instrumental temperatures and tree-rings, and has been proposed as the most important oscillation for the observed trends in Arctic air temperatures. [source] Beijing Plus Ten: An Ambivalent Record on Gender JusticeDEVELOPMENT AND CHANGE, Issue 6 2005Maxine Molyneux The 1995 Fourth World Conference on Women (the ,Beijing Conference') was a landmark in policy terms, setting a global policy framework to advance gender equality. Ten years after Beijing, in March 2005, the UN's Commission on the Status of Women presided over an intergovernmental meeting in New York to review the progress achieved on the commitments made in the Beijing Declaration and Platform for Action. This ,Plus 10' event was decidedly low key. Its aim was not agenda setting but agenda confirming; not policy formulation but policy affirmation. Whether it proves to be part of an ongoing worldwide movement in support of gender equality, or whether it marks the decline of that process, is a question that many in international women's movements are asking. This article, drawing on research undertaken for the UNRISD report, Gender Equality: Striving for Justice in an Unequal World, reflects on the ambivalent record of progress achieved by women over the last decades and considers how the policy environment has changed over the period since the high point of global women's movements. It examines how the changing international policy and political climate over this period has given rise to new issues and challenges for those active in global women's movements. [source] A New Record of Larerannis miracula (Prout) from Korea (Lepidoptera, Geometridae)ENTOMOLOGICAL RESEARCH, Issue 1 2005Sei-Woong CHOI ABSTRACT An ennomine species, Larerannis miracula (Prout, 1929), is newly recorded from Korea. Description of the adult and life history and illustration of male genitalia are provided. [source] A New Record of Pterotocera ussurica Djakonov (Lepidoptera, Geometridae) from KoreaENTOMOLOGICAL RESEARCH, Issue 2 2003Yoo-Hang SHIN ABSTRACT One species of the genus Pterotocera Staudinger, P. ussurica Djakonov, is first recorded from Korea. Description of adult and illustration of male genitalia are provided. Based on the previous and the present works, there are 22 winter geometrid moths in Korea. [source] Menstrual cycle symptoms are associated with changes in low-grade inflammationEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2006J. J. Puder Abstract Background, A close link between mood, low-grade inflammation and obesity has been demonstrated even in healthy subjects. We investigated the relationship between changes in physical and psychological symptoms and inflammatory markers during the menstrual cycle both in normal weight and in overweight women. Materials and methods, Eight healthy normal weight (body mass index 21·6 ± 1·9 kg m,2) and seven overweight (body mass index 30 ± 2·4 kg m,2) young women with normal ovarian function and with no premenstrual syndrome were assessed 15 times throughout their menstrual cycle. At each time point fasting blood was drawn and symptoms were recorded using the Freeman Daily Symptom Record. Results, Independent of weight status, the serum concentrations of highly sensitive C-reactive protein (hs-CRP) and the total scores, in addition to the individual four factors (mood, behaviour, pain and physical symptoms), of the Daily Symptom Record varied significantly during the menstrual cycle (all P , 0·04) and paralleled each other. During the menstrual cycle, repeated hs-CRP serum concentrations correlated to the corresponding total symptom score and the factors mood, behaviour and physical symptoms, independent of both weight status and changes in circulating gonadal steroids (all P , 0·04). These associations were not observed for tumour necrosis factor-, serum levels. The mean hs-CRP concentrations were associated with the mean total symptom score, independent of weight status (r = 0·56, P = 0·04). Conclusion, Healthy young women showed psychological and physical symptoms during the menstrual cycle which changed in association with alterations in low-grade inflammation and which were independent of body weight or plasma levels of gonadal steroids. [source] A Model Emergency Department Systemic Sedation RecordACADEMIC EMERGENCY MEDICINE, Issue 5 2000Kristi L. Koenig MD No abstract is available for this article. [source] Annual Meeting Breaks all Record with More Than 6,500 in AttandanceFOREIGN LANGUAGE ANNALS, Issue 1 2001Article first published online: 31 DEC 200 No abstract is available for this article. [source] Comparison of the maritime Sites and Monuments Record with side-scan sonar and diver surveys: A case study from Rathlin Island, IrelandGEOARCHAEOLOGY: AN INTERNATIONAL JOURNAL, Issue 5 2002Rory Quinn Rathlin Island, off the north coast of Ireland, has a history of settlement and seafaring from the Late Mesolithic period to the present day. The maritime Sites and Monuments Record (SMR) for Rathlin indicates many wrecking incidents. In 1999, a reconnaissance side-scan sonar survey confirmed the presence of 46 targets of possible archaeological potential around Rathlin Island. Thirteen of these anomalies were positively identified as shipwrecks. Of the remaining 33 targets, nine were dived on in order to ground-truth the geophysical data. A successful and rapid methodology of ground-truthing side-scan sonar data for archaeological purposes was developed. The results confirmed the presence of a Danforth Anchor at one site, while the remaining anomalies were identified as geological features. The results from the side-scan survey and diver-truthing exercise enhanced the existing maritime SMR. © 2002 Wiley Periodicals, Inc. [source] Application of the ICHD-II Criteria to the Diagnosis of Primary Chronic Headaches Via a Computerized Structured RecordHEADACHE, Issue 1 2007Paola Sarchielli MD Background.,The authors recently developed a software program designed to analyze clinical data from patients affected by primary headache. The program is based exclusively on the International Classification of Headache Disorders 2nd edition (ICHD-II) criteria. This software examines all the diagnoses of primary headaches on the basis of the variables needed to fulfill these mandatory criteria. Methods.,We tested the software, Primary Headaches Analyser 1.0 INT (PHA), by entering and analyzing clinical data from 200 consecutive patients affected by primary chronic headaches and evaluating the corresponding output diagnoses. Results.,The diagnosis of chronic migraine (1.5.1) was obtained in 68 cases (34 %) and that of probable chronic migraine (1.6.5) plus probable medication-overuse headache (8.2.8) in 46 (23%). Chronic tension-type headache (2.3) and probable chronic tension-type headache (2.4.3) plus probable medication-overuse headache (8.2.8) were diagnosed in 24 (12%) and 2 (1%) patients, respectively. Moreover, 4 and 12 patients, respectively, received both the diagnosis of chronic migraine (1.5.1) plus chronic tension-type headache (2.3) and of probable migraine (1.6.1) without aura plus chronic tension-type headache (2.3). In the remaining 44 cases (22%), none of the chronic primary headaches disorders defined by ICHD-II received an output diagnosis from the program. This was due mainly to the fact that the criteria fulfilled were insufficient for the diagnoses of migraine without (1.1) aura plus chronic migraine or, more infrequently, chronic tension-type headache. Conclusions.,Our software program permitted diagnoses of chronic migraine, chronic tension-type or their probable forms (with or without MOH) in 78% of 200 patients with headache 15 or more days per month. In the remaining cases the inability to provide a specific diagnosis may be explained in part by the fact that the criteria for both diagnoses are too stringent and do not accurately reflect variations of the headache pattern in these chronic forms. [source] Application of the 1988 International Headache Society Diagnostic Criteria in Nine Italian Headache Centers using a Computerized Structured RecordHEADACHE, Issue 10 2002Virgilio Gallai MD Background.,The actual application of the current International Headache Society (IHS) diagnostic criteria in clinical practice has not been investigated thoroughly. Objectives.,To develop a computerized, structured, medical record based exclusively on the IHS classification system. Design and Method.,We tested the computerized structured record by entering and analyzing data reported on the case sheets of 500 consecutive patients attending nine headache centers in Italy. All clinical diagnoses in the study were made according to current IHS criteria. The rate of concordance between the diagnosis provided by the computerized structured record and that reported by clinicians on the case sheets was calculated, and reasons for any discrepancies between the two diagnoses were analyzed. Results.,Concordance between the two diagnoses was found in 345 of 500 cases examined (69%). In the remaining 155 cases, diagnoses reached with the computerized structured record and case sheets were impossible or discordant with respect to the diagnoses made by the clinician. In 144 of these cases (28.8%), this was due to missing information or errors in the diagnosis recorded by the clinicians on the patient case sheet. In particular, the diagnosis could not be reached using the computerized structured record in 105 cases (20.6%) because of a lack of one or more data needed in formulating a correct diagnosis according to the IHS operational criteria for one of the primary headache disorders. In the remaining 41 cases some data were missing, but the data available were sufficient to reach a diagnosis according to the IHS criteria. Moreover, the diagnoses reached using the computerized structured record were not in agreement with those made by the clinicians in another 39 cases (7.9%) due to an incorrect interpretation by the clinicians of the data reported on the patients' case sheets. In only 2.2% of the cases (n = 11) misdiagnoses were due to errors of the program that were promptly corrected. Conclusions.,The present study suggests that incorrect application of IHS criteria for the diagnosis of primary headache may occur in as many as one third of patients attending headache centers and that use of a computerized structured record based exclusively on current IHS criteria may overcome this deficiency. [source] Response to "Abortions and breast cancer: Record-based case-control study" by Brind and ChinchilliINTERNATIONAL JOURNAL OF CANCER, Issue 6 2004Gunnar Erlandsson No abstract is available for this article. [source] Abortions and breast cancer: Record-based case-control studyINTERNATIONAL JOURNAL OF CANCER, Issue 5 2003Gunnar Erlandsson Abstract It has been suggested that abortions leave the breast epithelium in a proliferative state with an increased susceptibility to carcinogenesis. Results from previous studies of induced or spontaneous abortions and risk of subsequent breast cancer are contradictory, probably due to methodological considerations. We investigated the relationship between abortions and subsequent breast cancer risk in a case-control study using prospectively recorded exposure information. The study population comprised women recorded in the population-based Swedish Medical Birth Register between 1973,91. Cases were defined by linkage of the birth register to the Swedish Cancer Register and controls were randomly selected from the birth register. From the subjects' antenatal care records we abstracted prospectively collected information on induced and spontaneous abortions, as well as a number of potential confounding factors. Relative risk of breast cancer was estimated by odds ratios (OR) with 95% confidence intervals (95% CI). A reduced risk of breast cancer was observed for women with a history of at least 1 compared to no abortions (adjusted OR = 0.84, 95% CI = 0.72,0.99). The adjusted OR decreases step-wise with number of abortions to 0.59 (95% CI = 0.34,1.03) for 3 or more compared to no abortions. The patterns are similar for induced and spontaneous abortions. In conclusion, neither a history of induced nor spontaneous abortions is associated with an increased risk of breast cancer. Our data suggest a protective effect of pregnancies regardless of outcome. © 2002 Wiley-Liss, Inc. [source] Implementation of Standardized Nomenclature in the Electronic Medical RecordINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 4 2009Joan Klehr RNC MPH PURPOSE., To describe a customized electronic medical record documentation system which provides an electronic health record, Epic, which was implemented in December 2006 using standardized taxonomies for nursing documentation. DATA SOURCES., Descriptive data is provided regarding the development, implementation, and evaluation processes for the electronic medical record system. Nurses used standardized nursing nomenclature including NANDA-I diagnoses, Nursing Interventions Classification, and Nursing Outcomes Classification in a measurable and user-friendly format using the care plan activity. CONCLUSIONS AND IMPLICATIONS., Key factors in the success of the project included close collaboration among staff nurses and information technology staff, ongoing support and encouragement from the vice president/chief nursing officer, the ready availability of expert resources, and nursing ownership of the project. Use of this evidence-based documentation enhanced institutional leadership in clinical documentation. [source] Commerce and Imagination: The Sources of Concern about International Human Rights in the US CongressINTERNATIONAL STUDIES QUARTERLY, Issue 3 2010Ellen A. Cutrone Do members of Congress put human rights concerns on the agenda in response to their constituents' demands for trade protection? Humanitarian concern may be an important motive, but the normative weight of these issues also makes them a potentially powerful tool for politicians with less elevated agendas. They may criticize the behavior of countries with whom their constituents must compete economically, while overlooking the actions of countries with which their constituents have more harmonious economic relations. This paper tests several hypotheses about the salience of human rights concerns in the politics of US foreign policy using data on congressional speeches during the late 1990s gathered from the Congressional Record. We find evidence that, while humanitarian interests remain an important motive for raising human rights issues, the economic interests of their constituents influence which members of Congress speak out on these questions, and the countries on which they focus their concern. [source] Effectiveness of the Electronic Medical Record in Improving the Management of HypertensionJOURNAL OF CLINICAL HYPERTENSION, Issue 6 2002James W. Kinn MD Clinical studies suggest that hypertension is often undiagnosed, undertreated, and poorly controlled. In 1997, the authors developed a comprehensive electronic medical record that interfaces with physicians during each outpatient visit and provides real-time feedback about patient care management, including the management of hypertension. The purpose of this study was to determine whether this interactive electronic medical record results in better detection and control of hypertension. During a 12-month study period, consecutive outpatients (n=1076) were seen for routine follow-up; patient care documentation relied solely on the electronic medical record. Quality indicators for hypertension included: 1) documentation of the diagnosis of hypertension; 2) use of blood pressure-lowering drugs; and 3) successful blood pressure lowering to ,140/90 mm Hg. The authors compared the hypertension management of these patients to a control group of similar patients (n=723) with medical records consisting solely of traditional "pen and paper" charts. Baseline characteristics were similar between the two groups, including the prevalence of hypertension (73 % vs. 70%; p=NS). However, the electronic medical record resulted in higher documentation rates of hypertension (90% vs. 77%; p<0.001), greater use of antihypertensive therapy (94% vs. 90%; p<0.01), and more successful blood pressure lowering to ,140/90 mm Hg (54% vs. 28%; p<0.001). In conclusion, the electronic medical record with real-time feedback improves the physician's ability to detect, treat, and control hypertension. [source] | |||||||||||||||||||||||||||||||||||||||||||