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Selected AbstractsHow predictive is a cervical smear suggesting invasive squamous cell carcinoma?CYTOPATHOLOGY, Issue 3 2001S. J. Johnson How predictive is a cervical smear suggesting invasive squamous cell carcinoma? Features have been described in severely dyskaryotic cervical smears that suggest frankly invasive or microinvasive squamous cell carcinoma. These are reported in three separate categories in our department. The aim of the current study was to assess the positive predictive value of these categories for invasive disease on histology. All smears reported in these categories over a five year period were correlated with the histology results. 527 smears were assessed. The positive predictive value of a smear suggesting frank invasion was 55.7% for all invasive squamous carcinomas and 40% for stage IB or above. Smears suspicious of invasion or microinvasion predicted invasive disease in 22.3% and 17.2%, respectively, most carcinomas being stage IA. Invasive squamous cell carcinoma may be predicted to a limited degree by cervical cytology especially when the smear suggests frank invasion. [source] Are there empirically supported and clinically useful subtypes of alcohol dependence?ADDICTION, Issue 2006Victor M. Hesselbrock ABSTRACT Aims This paper provides an overview of several multidimensional empirically derived typologies of alcohol use disorders that have been derived primarily for research purposes in relation to their clinical utility. Methods Studies using multivariate statistical methods for identifying homogeneous groups of subjects were selected for inclusion. Theoretically based typologies were not included in this review. Results While formal diagnostic criteria typically identify separate categories of alcohol abuse and dependence, several studies using different statistical methods consistently suggest as many as four homogeneous types of alcoholism: a chronic/severe type, a depressed/anxious type, a mildly affected type and an antisocial type. Conclusions Even though the longitudinal outcomes of few empirically derived subtypes have been examined, alcoholism typologies remain a viable and potentially valuable tool for investigating etiological pathways, the effectiveness of treatments and the long-term course of alcohol use disorders. [source] A new mixed finite element method for poro-elasticityINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 6 2008Maria Tchonkova Abstract Development of robust numerical solutions for poro-elasticity is an important and timely issue in modern computational geomechanics. Recently, research in this area has seen a surge in activity, not only because of increased interest in coupled problems relevant to the petroleum industry, but also due to emerging applications of poro-elasticity for modelling problems in biomedical engineering and materials science. In this paper, an original mixed least-squares method for solving Biot consolidation problems is developed. The solution is obtained via minimization of a least-squares functional, based upon the equations of equilibrium, the equations of continuity and weak forms of the constitutive relationships for elasticity and Darcy flow. The formulation involves four separate categories of unknowns: displacements, stresses, fluid pressures and velocities. Each of these unknowns is approximated by linear continuous functions. The mathematical formulation is implemented in an original computer program, written from scratch and using object-oriented logic. The performance of the method is tested on one- and two-dimensional classical problems in poro-elasticity. The numerical experiments suggest the same rates of convergence for all four types of variables, when the same interpolation spaces are used. The continuous linear triangles show the same rates of convergence for both compressible and entirely incompressible elastic solids. This mixed formulation results in non-oscillating fluid pressures over entire domain for different moments of time. The method appears to be naturally stable, without any need of additional stabilization terms with mesh-dependent parameters. Copyright © 2007 John Wiley & Sons, Ltd. [source] AN EVALUATION OF THE AVAILABLE TECHNIQUES FOR ESTIMATING MISSING FECAL COLIFORM DATA,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 6 2004Ashu Jain ABSTRACT: This paper presents the findings of a study aimed at evaluating the available techniques for estimating missing fecal coliform (FC) data on a temporal basis. The techniques investigated include: linear and nonlinear regression analysis and interpolation functions, and the use of artificial neural networks (ANNs). In all, seven interpolation, two regression, and one ANN model structures were investigated. This paper also investigates the validity of a hypothesis that estimating missing FC data by developing different models using different data corresponding to different dynamics associated with different trends in the FC data may result in a better model performance. The FC data (counts/100 ml) derived from the North Fork of the Kentucky River in Kentucky were employed to calibrate and validate various models. The performance of various models was evaluated using a wide variety of standard statistical measures. The results obtained in this study are able to demonstrate that the ANNs can be preferred over the conventional techniques in estimating missing FC data in a watershed. The regression technique was not found suitable in estimating missing FC data on a temporal basis. Further, it has been found that it is possible to achieve a better model performance by first decomposing the whole data set into different categories corresponding to different dynamics and then developing separate models for separate categories rather than developing a single model for the composite data set. [source] Procedural considerations for photographic-based joint angle measurementsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2005Colin Dunlevy Abstract Background and Purpose Measuring static joint angles is important to clinicians involved in assessing, diagnosing and treating musculoskeletal disorders. Ne measurement techniques such as the Uillinn Method © (UM) employ the relatively new technology of digital photography and software to form a virtual goniometer. It is of central importance that the errors associated such new measurement techniques are known. Precision in joint angle measurement is a challenge and errors can arise from three separate categories: equipment error, examiner error or biological error. The aim of the present study was to discover the amount of equipment error associated with the UM and to present guidelines for the optimal use of a photographic based measurement technique Method This was a non-clinical agreement study design that attempted to describe the best possible agreement between a mathematical control dataset and the angles calculated from the virtual goniometer, which in this case was the UM. When this was established, the effect of rotation and placing the angle at the periphery of the camera's field of view were tested. Results The repeatability coefficient (RC) between the UM and the control data under optimal conditions was 0.81°; the typical error (TE) was 0.29° (n = 120). When the angle appeared at the edge of the photograph the RC increased to 2° and the TE to 0.73° (n = 48). When 5° rotation was introduced between the camera and the angle no increase in error was detected. However, increasing amounts of rotation above 5° was proportional to increases in the RC (RC at 10° = 2.3°; 20° = 3.86°; 30° = 14.8°; 40° = 27.27°) and the TE (TE at 10° = 0.83°; 20° = 2.7°; 30° = 5.3°; 40° = 9.8°) scores. Conclusion Photographic-based joint angle measurement techniques are subject to error if careful procedures are not observed. Best procedures include photography from a perpendicular viewpoint and centring the lens on the target angle. Copyright © 2005 John Wiley & Sons, Ltd. [source] A review of paroxysmal sympathetic hyperactivity after acquired brain injuryANNALS OF NEUROLOGY, Issue 2 2010Iain Perkes BMedSc Severe excessive autonomic overactivity occurs in a subgroup of people surviving acquired brain injury, the majority of whom show paroxysmal sympathetic and motor overactivity. Delayed recognition of paroxysmal sympathetic hyperactivity (PSH) after brain injury may increase morbidity and long-term disability. Despite its significant clinical impact, the scientific literature on this syndrome is confusing; there is no consensus on nomenclature, etiological information for diagnoses preceding the condition is poorly understood, and the evidence base underpinning our knowledge of the pathophysiology and management strategies is largely anecdotal. This systematic literature review identified 2 separate categories of paroxysmal autonomic overactivity, 1 characterized by relatively pure sympathetic overactivity and another group of disorders with mixed parasympathetic/sympathetic features. The PSH group comprised 349 reported cases, with 79.4% resulting from traumatic brain injury (TBI), 9.7% from hypoxia, and 5.4% from cerebrovascular accident. Although TBI is the dominant causative etiology, there was some suggestion that the true incidence of the condition is highest following cerebral hypoxia. In total, 31 different terms were identified for the condition. Although the most common term in the literature was dysautonomia, the consistency of sympathetic clinical features suggests that a more specific term should be used. The findings of this review suggest that PSH be adopted as a more clinically relevant and appropriate term. The review highlights major problems regarding conceptual definitions, diagnostic criteria, and nomenclature. Consensus on these issues is recommended as an essential basis for further research in the area. ANN NEUROL 2010;68:126,135 [source] The size and mix of government spending on illicit drug policy in AustraliaDRUG AND ALCOHOL REVIEW, Issue 4 2008TIMOTHY J. MOORE Abstract Aim. To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Methods. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002,03, in Australian dollars. Public sector expenditure on reducing drug problems (,proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use (,reactive expenditure') was included as a separate category. Results. Spending by Australian governments in financial year 2002,03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Conclusion. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure. [source] Specificity and characteristics of learning disabilitiesTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 10 2005Natasha Eisenmajer Background:, The specificity of impairments in specific reading disabilities (SRD) and specific language impairments (SLI) has recently been questioned, with many children recruited for studies of SRD and SLI demonstrating impairments in both reading and oral language development. This has implications for the results of SRD and SLI studies where both reading and oral language skills are not assessed. Thus there is a need to compare the profiles of children with both oral language and reading impairments to groups of children with SRD and SLI. Methods:, The reading, oral language, short-term auditory memory, phonological processing, spelling, and maths abilities of 151 children (aged between 7 and 12 years) drawn from a Learning Disabilities Clinic were assessed. Results:, Five groups were identified, including children who demonstrated either a specific reading disability or a specific language impairment and children who showed evidence of both reading and oral language impairments. Differences were found between the groups on maths, phonological processing, short-term auditory memory, and spelling measures, with the children displaying both language and reading deficits generally performing at a lower level than the children with specific reading or language deficits. Conclusions:, It was concluded that more careful screening needs to be conducted in both clinical and research settings to accurately identify the nature of deficits in children with reading and oral language difficulties. Furthermore, a third and separate category of children with a mixed pattern of impairments needs to be considered. [source] Are normal and complicated grief different constructs?CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2008A confirmatory factor analytic test Nowadays, much debate in the bereavement domain is directed towards the inclusion of Complicated Grief (CG) as a separate category in the Diagnostic and Statistical Manual of Mental Disorders. Important within this discussion is the conceptual relationship between CG reactions and normal grief (NG) reactions. This study aims at elucidating this relationship by using data from 456 bereaved young adults, aged 17 to 25 years. We examined the structural distinctiveness of CG and NG reactions, using two criteria sets. The first set ties in with previous research in bereaved adults on the distinctiveness of CG and NG and allows to test the replicability of earlier findings. The second set links up with the recently revised criteria for CG and permits to investigate whether earlier findings hold for the new criteria. For both sets, two models for NG and CG were compared using confirmatory factor analytic procedures. These analyses revealed that CG and NG reactions can be distinguished by their very nature, except for one CG reaction (viz. ,yearning'), that loaded on both factors.,Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||||||||