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Third Phase (third + phase)
Selected AbstractsIntra- and interlaboratory calibration of the DR CALUX® bioassay for the analysis of dioxins and dioxin-like chemicals in sedimentsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 12 2004Harrie T. Besselink Abstract In the Fourth National Policy Document on Water Management in the Netherlands [1], it is defined that in 2003, in addition to the assessment of chemical substances, special guidelines for the assessment of dredged material should be recorded. The assessment of dredged material is based on integrated chemical and biological effect measurements. Among others, the DR CALUX® (dioxin responsive,chemically activated luciferase expression) bioassay has tentatively been recommended for inclusion in the dredged material assessment. To ensure the reliability of this bioassay, an intra- and interlaboratory validation study, or ring test, was performed, organized by the Dutch National Institute for Coastal and Marine Management (RIKZ) in cooperation with BioDetection Systems BV (BDS). The intralaboratory repeatability and reproducibility and the limit of detection (LOD) and quantification (LOQ) of the DR CALUX bioassay were determined by analyzing sediment extracts and dimethyl sulfoxide (DMSO) blanks. The highest observed repeatability was found to be 24.1%, whereas the highest observed reproducibility was calculated to be 19.9%. Based on the obtained results, the LOD and LOQ to be applied for the bioassay are 0.3 and 1.0 pM, respectively. The interlaboratory calibration study was divided into three phases, starting with analyzing pure chemicals. During the second phase, sediment extracts were analyzed, whereas in the third phase, whole sediments had to be extracted, cleaned, and analyzed. The average interlaboratory repeatability increased from 14.6% for the analysis of pure compound to 26.1% for the analysis of whole matrix. A similar increase in reproducibility with increasing complexity of handlings was observed with the interlaboratory reproducibility of 6.5% for pure compound and 27.9% for whole matrix. The results of this study are intended as a starting point for implementing the integrated chemical,biological assessment strategy and for systematic monitoring of dredged materials and related materials in the coming years. [source] An audit of intra-oral digital radiographs for endodonticsINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2010R. Austin Aim, The aim of this study was to improve the quality of digital radiographs taken during endodontic treatment at King's College Hospital Dental Institute, UK. There were three phases. The first phase compared the Schick CDR system with Digora Optime. The second and third phases involved ways of improving the quality of the digital radiographs produced by the Schick CDR system. Methodology, The Faculty of General Dental Practitioners Royal College of Surgeons of England (FGDP) guidelines on Selection Criteria for Dental Radiography and Guidance Notes for Dental Practitioners on the Safe Use of X-Ray Equipment-National Radiological Protection Board enabled the use of a three point quality scale (one excellent, two diagnostically acceptable, three unacceptable), which took into consideration sensor angulation, positioning, contrast and focusing. The recommended FGDP guidelines are not less than 70% images scoring excellent. For the first phase 50 exposures recorded with the Schick CDR system were compared with 50 recorded using Digora Optime. For the second and third phases 50 radiographs for each phase were evaluated with images generated by the Schick system with training provided between the phases. Results, Images produced by the Schick system showed an inferior quality compared with the images generated by the Digora method. Both systems failed to reach the desired quality FGDP standard of 70% excellent (Schick 55% Digora 69%). Comparison of the results in the second and third phases showed that training the operator improved the quality but recommended the purchase of a size 1 or 0 Schick sensors to improve positioning errors. Conclusions, This study was carried out in order to minimise the ionising radiation dose to patients and to maximise the clinical and administrative benefits of using a digital system. It demonstrated an improvement in the quality of radiographs across all criteria measured up to and beyond the desired standard, from 55% of radiographs scoring excellent in the first phase to 80% in the third phase. As a result of the study it was decided to install the Schick CDR system because of the speed it produced images even though the first phase of this study demonstrated inferior image quality. The audit had clear, measurable standards with explicit targets. The audits have been through the entire audit cycle, data collection, change and a further data collection to provide evidence of the benefit of the change. A third data collection, demonstrated an ongoing commitment to quality. [source] The Arade 1 Shipwreck: Preliminary Results of the 2004 and 2005 Field SeasonsINTERNATIONAL JOURNAL OF NAUTICAL ARCHAEOLOGY, Issue 2 2008Vanessa Loureiro Lost after partial destruction by dredging in 1970, Arade 1 was a priority for the Centro Nacional de Arqueologia Náutica e Subaquática (CNANS). The upper part of the hull, lying over a 7-m-long area of the bed of the Arade river, was fully observed and recorded during the first two seasons (2001 and 2002) and dismantled in a third phase (2003). The 2004 and 2005 seasons aimed at the excavation, full recording and dismantling of the lower hull, briefly observed at the end of 2002. This second, detached, portion of the hull, was buried in the sediment and corresponds to midships. © 2008 The Authors [source] Bioactive and mechanically strong Bioglass®-poly(D,L -lactic acid) composite coatings on surgical suturesJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2006Q. Z. Chen Abstract New coating processes have been investigated for degradable (Vicryl®) and nondegradable (Mersilk®) sutures with the aim to develop Bioglass® coated polymer fibers for wound healing and tissue engineering scaffold applications. First, the aqueous phase of a Bioglass® particle slurry was replaced with a poly(D,L -lactic acid) (PDLLA) polymer dissolved in solvent dimethyle carbonate (DMC) to act as third phase. SEM observations indicated that this alteration significantly improved the homogeneity of the coatings. Second, a new coating strategy involving two steps was developed: the sutures were first coated with a Bioglass®,PDLLA composite film followed by a second PDLLA coating. This two-step process of coating has addressed the problem of poor adherence of Bioglass® particles on suture surfaces. The coated sutures were knotted to determine qualitatively the mechanical integrity of the coatings. The results indicated that adhesion strength of coatings obtained by the two-step method was remarkably enhanced. A comparative assessment of the bioactivity of one-step and two-step produced coatings was carried out in vitro using acellular simulated body fluid (SBF) for up to 28 days. Coatings produced by the two-step process were found to have similar bioactivity as the one-step produced coatings. The novel Bioglass®/PDLLA/Vicryl® and Bioglass®/PDLLA/Mersilk® composite sutures are promising bioactive materials for wound healing and tissue engineering applications. © 2005 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2006 [source] Recognising our role: improved confidence of general nurses providing care to young people with a mental illness in a rural paediatric unitJOURNAL OF CLINICAL NURSING, Issue 9-10 2010Lorna Moxham Objective., To implement and evaluate strategies suggested by general nurses to improve management of children and adolescents with mental health problems admitted to a paediatric unit of a general hospital. Background., The first phase of a study using a Participatory Action Research approach identified several concerns associated with general nurses providing care to young people with mental disorders in paediatric units of general hospitals, together with suggestions for strategies to address these issues. This paper describes the second and third phase of the Participatory Action Research study, involving the implementation and evaluation of these strategies. Design., Participatory Action Research. Methods., Actions that occurred during phase two of the Participatory Action Research study included revision and introduction of policies and procedures for mental health care in the unit, education and training sessions for paediatric nursing staff and opportunities to strengthen communication between existing mental health services. In phase three, two focus groups were conducted to explore current perceptions of mental health care delivery in the unit and evaluate change, following phase two. Results., Changes in clinical practice for paediatric mental health care were acknowledged by participants. Reflection has assisted nurses to better understand their strengths and weaknesses and to acknowledge and challenge the assumptions on which their ideas, feelings and actions about patients with mental health issues are based. Participants also recognised the existing skills and expertise they possess that are relevant to the management of young people with a mental health problem, although they continue to seek ongoing education and support in this field. Conclusions., This study demonstrates that through Participatory Action Research it is possible to enhance mental health nursing care in a rural paediatric unit. Relevance to clinical practice., Such changes have the potential to improve the experience of young people and their families whilst receiving treatment for mental health conditions in a general paediatric unit. [source] An evaluation of nursing practice models in the context of the severe acute respiratory syndrome epidemic in Hong Kong: a preliminary studyJOURNAL OF CLINICAL NURSING, Issue 6 2006Engle Angela Chan PhD Aim and objective., Like other health-care workers, Hong Kong nurses had their professional knowledge and skills seriously challenged during the SARS outbreak. Could current nursing practices support the care of SARS or SARS-like patients in the future? If not, alternative practices would be needed. Providing a preliminary understanding, this paper compares the conventional with different nursing delivery models in a simulated SARS ward and focuses on nurses' efficiency, infection control practices and views of the two models. Design and methods., This study was conducted in three phases. First, a baseline understanding of nursing practices was achieved through four workflow observations. In an eight-hour day, four research assistants observed nursing activities in the medical and fever wards. These data were used in the second phase to construct two sets of clinical vignettes, pertaining to SARS patient care in both conventional and alternative practice models. These scripts were discussed with nine nurses of various ranks from the hospital under study for their expert validation and input. In the third phase, nurse participants and patient actors enacted the vignettes in a simulated setting. Video-taped observations and four nurse participant interviews were employed. Observational data were analysed through descriptive statistics and independent t -tests. Textual data were coded and categorized for common meanings. Results., Conventional practice from the findings consisted of cubicle and named nurse nursing. While the former reflected modified team and functional nursing, it did not confine patient care within a cubicle as suggested by its name. The latter depicted a modified primary nursing approach in a team, with delegation of care. Preliminary findings concerning infection control and nurse satisfaction revealed that the alternative model had an advantage over the conventional. Relevance to clinical practice., This study findings lay the foundation for clinical trials, which would evaluate the significance of patient-care quality, cost-effectiveness and better human resource management by restructuring current nursing practices. [source] An additional phase in PCr use during sustained isometric exercise at 30% MVC in the tibialis anterior muscleNMR IN BIOMEDICINE, Issue 4 2002C. J. Houtman Abstract The occurrence of an abrupt acceleration in phosphocreatine hydrolysis in the tibial anterior muscle during the last part of a sustained isometric exercise at 30% maximal voluntary contraction until fatigue is demonstrated in seven out of eight healthy subjects by applying in vivo31P NMR spectroscopy at 1.5,T field strength. This additional third phase in PCr hydrolysis, is preceded by a common biphasic pattern (first fast then slow) in PCr use. The NMR spectra, as localized by a surface coil and improved by proton irradiation, were collected at a time resolution of 16 s. Mean rates of PCr hydrolysis during exercise were ,0.44,±,0.19% s,1, ,0.07,±,0.04% s,1, and ,0.29,±,0.10% s,1 for the three successive phases. The increased rate of PCr hydrolysis, and also the loss of fine force control evident in the force records are consistent with increased involvement of large, fast-fatiguable units later in the contraction. Copyright © 2002 John Wiley & Sons, Ltd. [source] Liberal Democrat Leadership: The Cases of Ashdown and KennedyTHE POLITICAL QUARTERLY, Issue 1 2007DUNCAN BRACK Effective leadership of the Liberal Democrats requires a combination of strengths: communications skills, a clear agenda, the ability to manage the party and personal abilities, including stamina, self-confidence and a love for the party itself. This article assesses Paddy Ashdown's and Charles Kennedy's periods as leader. It concludes that the first two phases of Ashdown's leadership were successful: he first ensured the party's survival and then positioned it so that it was able to benefit from the rise in support for the centre-left without being squeezed out by Labour. In the third phase, however, the attempt to deliver a common agenda with Labour was a failure, and Ashdown increasingly lost touch with his own party. Kennedy's first two years as leader were also relatively successful, but after that his leadership fell apart, suffering from a lack of an agenda, a failure of party management, a weakness in communication skills and a lack of self-confidence. His underlying problem was not alcoholism; it was that he was not capable of being an effective leader. [source] Purely electronic transport and localization in the Bose glassANNALEN DER PHYSIK, Issue 12 2009M. Müller Abstract We discuss transport and localization properties on the insulating side of the disorder dominated superconductor-insulator transition, described in terms of the dirty boson model. Analyzing the spectral properties of the interacting bosons in the absence of phonons, we argue that the Bose glass phase admits three distinct regimes. For strongest disorder the boson system is a fully localized, perfect insulator at any temperature. At smaller disorder, only the low temperature phase exhibits perfect insulation while delocalization takes place above a finite temperature. We argue that a third phase must intervene between these perfect insulators and the superconductor. This conducting Bose glass phase is characterized by a mobility edge in the many body spectrum, located at finite energy above the ground state. In this insulating regime purely electronically activated transport occurs, with a conductivity following an Arrhenius law at asymptotically low temperatures, while a tendency to superactivation is predicted at higher T. These predictions are in good agreement with recent transport experiments in highly disordered films of superconducting materials. [source] Isolating the evocative and abative effects of an establishing operation on challenging behaviorBEHAVIORAL INTERVENTIONS, Issue 3 2006Mark F. O'Reilly Establishing operations (EO) influence operant responding by altering the reinforcing effectiveness of consequences (reinforcer establishing or abolishing effect) and changing the frequency of behavior that has been reinforced by those consequences in the past (evocative or abative effect) (Michael, 1982, 1993). In this study we attempted to isolate the evocative and abative effects of an EO for positively reinforced challenging behavior with a person with autism and developmental disabilities. The study consisted of three phases. First, an analogue functional analysis identified attention as maintaining challenging behavior. Second, access to attention was systematically controlled (continuous access versus no access) immediately prior to functional analysis sessions in which the participant received attention on an FR1 schedule. Results of this phase indicated that challenging behavior occurred at higher levels during the functional analysis sessions when access to attention was restricted immediately prior to sessions (i.e., no access appeared to function as an EO). In the third phase, prior access to attention was again controlled as in the second phase of the study, however the participant was then placed on extinction. The results of this final phase seem to indicate that no access to the reinforcer prior to extinction had an evocative effect (produced high levels of responding) whereas access to the reinforcer had an abative effect (produced lower levels of responding) during extinction sessions. Copyright © 2006 John Wiley & Sons, Ltd. [source] Optimism, Pessimism, and Coalitional Presidentialism: Debating the Institutional Design of Brazilian DemocracyBULLETIN OF LATIN AMERICAN RESEARCH, Issue 1 2010TIMOTHY J. POWER Research on Brazil's political institutions has gone through several phases since democratisation in 1985. In the early years of democracy, pessimism prevailed with regard to governability. This view gave way in the mid-1990s to a more optimistic view that stressed two innovations of the Constitution of 1988: enhanced presidential power and centralised legislative procedure. In recent years, a third phase of research has shifted attention to the crucial role of inter-party alliances. These analytical approaches have converged into an emerging research programme on ,coalitional presidentialism', which places executive-legislative relations at the centre stage of macropolitical analysis. This article reviews the three phases of the debate and reflects on future research agendas. [source] Non-antibiotic treatment for bacterial infections: how to validate chance findingsCLINICAL MICROBIOLOGY AND INFECTION, Issue 4 2009L. Leibovici Abstract Researchers have examined in observational studies a possible influence of statins, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and ,-blockers on the prevention of infections or on their outcomes. A priori, we can suspect that biases will work in favour of chance findings, because of the motivation to publish, to publish piquant findings, and to find new niches for lucrative drugs. We should distinguish between three phases. Publication of a novel finding should raise the possibility that an intervention will work in situations other than those expected, and justify, as a second phase, the performance of rigorous, prospective, observational studies. If the results of these studies substantiate the claims for benefit, randomized controlled trials may be performed in the third phase. For all the questions examined here, we have not yet passed the threshold of evidence needed to offer patients participation in randomized controlled trials. [source] An audit of intra-oral digital radiographs for endodonticsINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2010R. Austin Aim, The aim of this study was to improve the quality of digital radiographs taken during endodontic treatment at King's College Hospital Dental Institute, UK. There were three phases. The first phase compared the Schick CDR system with Digora Optime. The second and third phases involved ways of improving the quality of the digital radiographs produced by the Schick CDR system. Methodology, The Faculty of General Dental Practitioners Royal College of Surgeons of England (FGDP) guidelines on Selection Criteria for Dental Radiography and Guidance Notes for Dental Practitioners on the Safe Use of X-Ray Equipment-National Radiological Protection Board enabled the use of a three point quality scale (one excellent, two diagnostically acceptable, three unacceptable), which took into consideration sensor angulation, positioning, contrast and focusing. The recommended FGDP guidelines are not less than 70% images scoring excellent. For the first phase 50 exposures recorded with the Schick CDR system were compared with 50 recorded using Digora Optime. For the second and third phases 50 radiographs for each phase were evaluated with images generated by the Schick system with training provided between the phases. Results, Images produced by the Schick system showed an inferior quality compared with the images generated by the Digora method. Both systems failed to reach the desired quality FGDP standard of 70% excellent (Schick 55% Digora 69%). Comparison of the results in the second and third phases showed that training the operator improved the quality but recommended the purchase of a size 1 or 0 Schick sensors to improve positioning errors. Conclusions, This study was carried out in order to minimise the ionising radiation dose to patients and to maximise the clinical and administrative benefits of using a digital system. It demonstrated an improvement in the quality of radiographs across all criteria measured up to and beyond the desired standard, from 55% of radiographs scoring excellent in the first phase to 80% in the third phase. As a result of the study it was decided to install the Schick CDR system because of the speed it produced images even though the first phase of this study demonstrated inferior image quality. The audit had clear, measurable standards with explicit targets. The audits have been through the entire audit cycle, data collection, change and a further data collection to provide evidence of the benefit of the change. A third data collection, demonstrated an ongoing commitment to quality. [source] | |||||||||||||