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Weakness
Kinds of Weakness Terms modified by Weakness Selected AbstractsFREEDOM AND WEAKNESS OF WILLRATIO, Issue 1 2008Paul Hoffman Can absolute freedom of will be defended by arguing that apparent cases of diminished freedom when we act out of passion are cases of weakness of will? Rogers Albritton thought so. What is intriguing about Albritton's view is that he thought when we act from desire we are making choices, yet our desires are not functioning as reasons for those choices. So our desires must be influencing our choices in some other unspecified way that does not diminish our freedom. I challenge the coherence of this position. My strategy is to examine the views of leading theorists of the will , Descartes, Aquinas and Reid , to argue that the only clear way in which passions can influence our choices so that we can accurately be described as weak-willed and yet nevertheless free is that our passions influence our choices by providing reasons for them. [source] 2-YEAR-OLD GIRL WITH RIGHT LEG WEAKNESSBRAIN PATHOLOGY, Issue 4 2008Priya Banerjee MD No abstract is available for this article. [source] 48 YEAR OLD MALE WITH SUDDEN ONSET OF RIGHT SIDED WEAKNESSBRAIN PATHOLOGY, Issue 2 2006Alexander Easton MBBS PhD No abstract is available for this article. [source] Weakness of Will as Intention-ViolationEUROPEAN JOURNAL OF PHILOSOPHY, Issue 1 2009Dylan Dodd First page of article [source] Weakness of Will and Divisions of the MindEUROPEAN JOURNAL OF PHILOSOPHY, Issue 2 2004Edmund Henden First page of article [source] Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta-AnalysisJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2004Julie D. Moreland MSc Objectives: To evaluate and summarize the evidence of muscle weakness as a risk factor for falls in older adults. Design: Random-effects meta-analysis. Setting: English-language studies indexed in MEDLINE and CINAHL (1985,2002) under the key words aged and accidental falls and risk factors; bibliographies of retrieved papers. Participants: Fifty percent or more subjects in a study were aged 65 and older. Studies of institutionalized and community-dwelling subjects were included. Measurements: Prospective cohort studies that included measurement of muscle strength at inception (in isolation or with other factors) with follow-up for occurrence of falls. Methods: Sample size, population, setting, measure of muscle strength, and length of follow-up, raw data if no risk estimate, odds ratios (ORs), rate ratios, or incidence density ratios. Each study was assessed using the validity criteria: adjustment for confounders, objective definition of fall outcome, reliable method of measuring muscle strength, and blinded outcome measurement. Results: Thirty studies met the selection criteria; data were available from 13. For lower extremity weakness, the combined OR was 1.76 (95% confidence interval (CI)=1.31,2.37) for any fall and 3.06 (95% CI=1.86,5.04) for recurrent falls. For upper extremity weakness the combined OR was 1.53 (95% CI=1.01,2.32) for any fall and 1.41 (95% CI=1.25,1.59) for recurrent falls. Conclusion: Muscle strength (especially lower extremity) should be one of the factors that is assessed and treated in older adults at risk for falls. More clinical trials are needed to isolate whether muscle-strengthening exercises are effective in preventing falls. [source] A prospective analysis of incidence and severity of quadriceps inhibition in a consecutive sample of 100 patients with complete acute anterior cruciate ligament ruptureJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2004Terese L. Chmielewski Background: Weakness of the quadriceps femoris muscle after anterior cruciate ligament injury and reconstruction has been attributed to incomplete voluntary activation of the muscle. The literature is conflicting on the incidence of incomplete voluntary quadriceps activation after anterior cruciate ligament injury because of differences in testing methods and population biases. The purpose of this study was to systematically examine the incidence and severity of quadriceps voluntary activation failure in both lower extremities after acute anterior cruciate ligament injury. We hypothesized that the incidence of quadriceps inhibition would be higher in the anterior cruciate ligament injured limbs than the uninvolved limbs, that the incidence of inhibition in the anterior cruciate ligament deficient limbs would be larger than in our historical sample of healthy young individuals tested in the same manner and that there would be no difference in inhibition by gender. Study design: Prospective, descriptive. Methods: One hundred consecutive patients with acute anterior cruciate ligament rupture (39 women and 61 men) were tested when range of motion was restored and effusion resolved, an average of 6 weeks after injury. A burst superimposition technique was used to assess quadriceps muscle activation and strength in all patients. Dependent t -tests were used to compare side-to-side differences in quadriceps strength. Independent t -tests were used to compare incidence of activation failure by gender and make comparisons to historical data on young, active individuals. Results: The average involved side quadriceps activation was 0.92, and ranged from 0.60 to 1.00. The incidence of incomplete activation in the involved side quadriceps was 33 per cent and uninvolved side quadriceps was 31 per cent after acute anterior cruciate ligament rupture. The incidence of incomplete activation bilaterally was 21 per cent. There was no difference in incidence of quadriceps inhibition by gender. Conclusion: The incidence of voluntary quadriceps inhibition on the involved side was three times that of uninjured, active young subjects, but the magnitude was not large. The incidence of quadriceps inhibition on the uninjured side was similar to the injured side. Clinical relevance: Both the incidence and magnitude of quadriceps inhibition after ACL rupture are lower than have previously been reported. The conventional wisdom, therefore, that quadriceps inhibition is a significant problem in this population is challenged by the results of this study. Differences between this study and others include sufficient practice to ensure a maximal effort contraction and rigorous inclusion criteria. The findings have implications for strength testing as well as rehabilitation. The quadriceps index, an assessment of the injured side quadriceps strength deficit may be affected by the presence of voluntary activation failure in the uninvolved side. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Patterns of muscle involvement in inclusion body myositis: Clinical and magnetic resonance imaging studyMUSCLE AND NERVE, Issue 11 2001Beverley A. Phillips PhD Abstract The differential patterns of muscle involvement in the upper and lower limbs in sporadic inclusion body myositis (sIBM) were examined in 18 patients using both quantitative and manual muscle testing as well as magnetic resonance imaging (MRI) in 9 patients. Weakness of the quadriceps femoris and the forearm flexors was present in most patients, but there was considerable variability in the patterns and severity of muscle involvement. MRI disclosed preferential patterns of muscle involvement within functional groups such as the quadriceps femoris, in which there was severe involvement of the vasti with relative sparing of the rectus femoris, and the triceps surae, in which selective involvement of the medial gastrocnemius was common. Involvement of flexor digitorum profundus on MRI was found in only one third of patients. The results emphasize the variability in the clinical phenotype and differential susceptibility of muscles to the disease process in sIBM. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1526,1534, 2001 [source] Human birth seasonality and sunshineAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010David R. CummingsArticle first published online: 20 OCT 200 The environmental light intensity/photoperiod (ELI/PP) hypothesis proposes that the seasonality of human births is primarily associated with seasonal changes in ambient atmospheric luminosity or ELI. This study tests for the presence of increased ELI during the 1 or 2-month period preceding the conceptual month. Monthly birth data for Helsinki, Finland; Kiev, Ukraine; Hanoi, Vietnam; Matlab, Bangladesh; Nashville, Tennessee; Los Angeles, California; Dallas, Texas; Denver, Colorado and Pretoria, South Africa, are correlated (Pearsonian r) to corresponding monthly meteorological data. With the exception of Matlab, birth data are adjusted for conception date, 31-day months, leap years and monthly deviation from an annual mean. Meteorological data are adjusted for a 1,2-month exposure to ELI before conception. From these correlations, Helsinki r = 0.82, Kiev r = 0.80, Hanoi r = 0.93, Matlab r = 0.91, Nashville r = 0.84, Los Angeles r = 0.71, Dallas r = 0.86, Denver r = 0.53, and Pretoria r = ,82. Weakness and strengths of the ELI/PP hypothesis are reviewed using the criteria developed by AB Hill. Substituting meteorological variables for ELI may be a weakness, whereas the specificity of ELI/PP predictions may be a strength. Increased periods of ELI precede increased periods of conceptions. Increased ELI may influence seasonality for chimpanzee, baboon, and humans. Atmospheric pollution may alter the onset of seasonality. Increased ELI may be the initial, but not the singular variable to affect seasonality. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Knee pain in the ACL-deficient osteoarthritic knee and its relationship to quality of lifePHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2003Michael Hartwick Abstract Background and Purpose Pain during activities of daily living is a common presenting complaint of individuals with knee osteoarthritis and anterior cruciate ligament injury. Knee pain is also associated with a decrease in quality of life for people with osteoarthritis. The purpose of the present study was to examine the dose,response relationship between knee joint forces and painful symptoms, and whether the acute symptoms, were associated with individuals' quality of life. Method This was a cross-sectional cohort correlation study. Seventeen individuals with anterior cruciate ligament (ACL)-deficient knees diagnosed with ipsilateral knee osteoarthritis completed the ACL quality of life questionnaire (ACL-QOL). The subjects also rated pain associated with each of five incremental isometric knee extension tests, proportional to their body weight. Analysis of variance was used to assess the association between pain and normalized torque. Linear regression was used to assess the correlation between the ACL-QOL score and the total pain experienced during the graded test. Results A strong relationship was found between the level of perceived knee pain and the amount of isometric torque produced (Pearson's r = 0.98; p<0.001). There was a statistically significant relationship between pain during the graded isometric test and the ACL-QOL (Pearson's r = ,0.56; p = 0.016). Conclusions Since knee joint compression is a function of active isometric knee extension torque, increased painful symptoms were associated with increased compression forces at the knee joint for these subjects. The relationship between pain provocation and disease-specific quality of life provides evidence for the proposed joint provocation test for this subject population. Weakness caused by osteoarthritis (OA) may, in part, be a negative conditioning response that would need to be overcome in rehabilitation. Copyright © 2003 Whurr Publishers Ltd. [source] Central facial palsy revisited: A clinical-radiological study,ANNALS OF NEUROLOGY, Issue 3 2010Luigi Cattaneo MD We investigated the pattern of volitional facial motor deficits in acute stroke patients. We assessed the strength of single facial movements and correlated it to the site of infarct classified on computed tomography scans. Exclusion criteria were previous stroke, cerebral hemorrhage, and subcortical stroke. Results showed that weakness in eyelid closure was associated with anterior cerebral artery (ACA) stroke. Weakness in lip opening was associated with middle cerebral artery (MCA) stroke. We suggest that sparing of upper facial movements in MCA stroke is due to the presence of an upper face motor representation in both the MCA and ACA territories. ANN NEUROL 2010;68:404,408 [source] Clinicopathological Conference: A Case of a 26-year-old Male with Diarrhea, Weakness, and DizzinessACADEMIC EMERGENCY MEDICINE, Issue 5 2009Ram Parekh MD First page of article [source] 35-year-old Woman with Progressive Bilateral Leg WeaknessBRAIN PATHOLOGY, Issue 2 2006Kyle J. Mangels MD No abstract is available for this article. [source] Spain's greatest and most recent mine disasterDISASTERS, Issue 1 2008Flor Ma. On 25 April 1998, the mineral waste retaining wall at the Swedish-owned pyrite mine at Aznalcóllar (Seville, Spain) burst,2 causing the most harmful environmental and socio-economic disaster in the history of the River Guadiamar basin. The damage was so great that the regional government decided in May 1998 to finance a comprehensive, multidisciplinary research initiative with the objective of eradicating or at least minimising all of the negative social, economic and environmental impacts. This paper utilises a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis to identify eight strategic measures aimed at providing policymakers with key guidelines on implementing a sustainable development model, in a broad sense. Empirical evidence, though, reveals that, to date, major efforts to tackle the negative impacts have centred on environmental concerns and that the socio-economic consequences have not been completely mitigated. [source] A systematic review of work-place interventions for alcohol-related problemsADDICTION, Issue 3 2009Gloria Webb ABSTRACT Aims The aims of this study were to (1) gauge any improvement in methodological quality of work-place interventions addressing alcohol problems; and (2) to determine which interventions most effectively reduce work-place-related alcohol problems. Methods A literature search was undertaken of the data bases, Ovid Medline, PsychINFO, Web of Science, Scopus, HSELINE, OSHLINE and NIOSHTIC-2 for papers published between January 1995 and September 2007 (inclusive). Search terms varied, depending on the database. Papers were included for analysis if they reported on interventions conducted at work-places with the aim of reducing alcohol problems. Methodological adequacy of the studies was assessed using a method derived from the Cochrane Collaboration guidelines. Results Ten papers reporting on work-place alcohol interventions were located. Only four studies employed randomized controlled trials (RCT), but all these had methodological problems. Weaknesses in all studies related to representativeness of samples, consent and participation rates, blinding, post-test time-frames, contamination and reliability, and validity of measures used. All except one study reported statistically significant differences in measures such as reduced alcohol consumption, binge drinking and alcohol problems. Conclusions The literature review revealed few methodologically adequate studies of work-place alcohol interventions. Study designs, types of interventions, measures employed and types of work-places varied considerably, making comparison of results difficult. However, it appears from the evidence that brief interventions, interventions contained within health and life-style checks, psychosocial skills training and peer referral have potential to produce beneficial results. [source] Students' evaluation of online course materials in Fixed Prosthodontics: a case studyEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2001Elizabeth S. Pilcher Purpose: The purpose of this study was to assess a new online course format for dental students. Preclinical Fixed Prosthodontics I is a didactic and laboratory course given in the first year of the dental school curriculum. In the spring semester of 1999, the didactic portion of the course was offered in a web-based format as a supplement to the traditional lecture format. Methods: The study population was 53 first year dental students at one school. The study design was a one group post test without a control group. The online questionnaire consisted of multiple choice questions, Leikert scale questions and open-ended questions. Data were collected using Filemaker Pro and analyzed using EpiInfo. Results: Student response rate was 96% (52/53). All of the students responded that they felt comfortable with their computer skills in utilizing this course format. Most (96%) responded that the online materials were either very helpful or helpful to them. About half, (54%) recommended that the online format be continued as a supplement to traditional lectures, while 28% recommended replacing traditional lectures with the new format in order to provide more laboratory time in the course. The syllabus, lecture materials, bulletin board and handouts were found to be the most helpful online features. The least helpful features were the listserve, decision tree, and e-mail options. Most frequently mentioned strengths of the online material were listed as 1) the ability to view material at their own pace and at a time convenient to them, 2) quality photographs in lecture materials and 3) online quizzes. Weaknesses of the course were ranked by students as 1) problems with access to the materials and the intranet system, 2) taking quizzes online and 3) difficulty in printing the web-based lecture materials. Conclusions: The delivery of web-based material as a course supplement in Fixed Prosthodontics I was determined to be an overall success. Fine tuning of problems with access to the materials took place throughout the course. The student feedback will help direct future development of web-based course materials in the dental school curriculum. [source] Profiles of executive function in parents and siblings of individuals with autism spectrum disordersGENES, BRAIN AND BEHAVIOR, Issue 8 2006D. Wong Delineation of a cognitive endophenotype for autism is useful both for exploring the genetic mechanisms underlying the disorder and for identifying which cognitive traits may be primary to it. This study investigated whether first-degree relatives of individuals with autism spectrum disorders (ASDs) demonstrate a specific profile of performance on a range of components of executive function (EF), to determine whether EF deficits represent possible endophenotypes for autism. Parents and siblings of ASD and control probands were tested on EF tasks measuring planning, set-shifting, inhibition and generativity. ASD parents showed poorer performance than control parents on a test of ideational fluency or generativity, and ASD fathers demonstrated a weakness in set-shifting to a previously irrelevant dimension. ASD siblings revealed a mild reduction in ideational fluency and a weakness in non-verbal generativity when compared with control siblings. Neither ASD parents nor siblings displayed significant difficulties with planning or inhibition. These results indicated that the broad autism phenotype may not be characterized primarily by impairments in planning and cognitive flexibility, as had been previously proposed. Weaknesses in generativity emerged as stronger potential endophenotypes in this study, suggesting that this aspect of EF should play a central role in cognitive theories of autism. However, discrepancies in the EF profile demonstrated by parents and siblings suggest that factors related to age or parental responsibility may affect the precise pattern of deficits observed. [source] Examination of the analytic quality of behavioral health randomized clinical trialsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 1 2007Bonnie Spring Adoption of evidence-based practice (EBP) policy has implications for clinicians and researchers alike. In fields that have already adopted EBP, evidence-based practice guidelines derive from systematic reviews of research evidence. Ultimately, such guidelines serve as tools used by practitioners. Systematic reviews of treatment efficacy and effectiveness reserve their strongest endorsements for treatments that are supported by high-quality randomized clinical trials (RCTs). It is unknown how well RCTs reported in behavioral science journals fare compared to quality standards set forth in fields that pioneered the evidence-based movement. We compared analytic quality features of all behavioral health RCTs (n = 73) published in three leading behavioral journals and two leading medical journals between January 2000 and July 2003. A behavioral health trial was operationalized as one employing a behavioral treatment modality to prevent or treat an acute or chronic physical disease or condition. Findings revealed areas of weakness in analytic aspects of the behavioral health RCTs reported in both sets of journals. Weaknesses were more pronounced in behavioral journals. The authors offer recommendations for improving the analytic quality of behavioral health RCTs to ensure that evidence about behavioral treatments is highly weighted in systematic reviews. © 2006 Wiley Periodicals, Inc. J Clin Psychol 63: 53,71, 2007. [source] "Revenue Accounting" in the Age of E-Commerce: A Framework for Conceptual, Analytical, and Exchange Rate ConsiderationsJOURNAL OF INTERNATIONAL FINANCIAL MANAGEMENT & ACCOUNTING, Issue 1 2002Jonathan C. Glover This paper explores "revenue accounting" in contrast to traditional "cost accounting". Revenue accounting serves the information needs of managers and investors in planning and controlling a firm's sales activities and their financial consequences, especially in the age of e-commerce. Weaknesses of traditional accounting have become particularly evident recently, for example, the lack of 1) revenue mileposts, 2) revenue sustainability measurements, and 3) intangibles capitalization. The paper emphasizes the need to develop a conceptual framework of revenue accounting and, as a tentative measure, proposes five basic postulates and five operational postulates of revenue accounting. On the side of analytical frameworks, the paper explores some tentative remedies for the weaknesses. Several revenue mileposts are explored to gauge progress in earning revenues and a Markov process is applied to an example involving mileposts. Revenue momentum, measured by the exponential smoothing method, is examined as a way of getting feedback on revenue sustainability; and the use of the sustainability concept in the analysis of "fixed and variable revenues" is illustrated. A project-oriented approach in a manner similar to capital budgeting and to Reserve Recognition Accounting is proposed by treating each customer as a project. Standardization of forecasts are also considered as an important way of bypassing the capitalization issue. Finally, while e-commerce is inherently global, issues specific to global operations are highlighted, namely, exchange rate issues when venture capitalists and the start-up company use different currencies producing different rates of return on the same project. [source] The institutional environment in the strategic decision of the emerging companies: the case of the Algerian sugar industryJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 5-6 2009Mohamed Akli Achabou Abstract During these last years, Algeria, like some other developing countries, is undergoing important institutional changes. The structural adjustment plan (1990s) and the association agreement signed with the European Union (2005) are some of the political tools that guide these profound changes that have considerable impacts on the strategic behaviour of local enterprises. Beyond these mutations at national level, important policy changes are observed at the international level, like the recent reform of the European sugar policy that constitutes a considerable shifter on the behaviour of enterprises operating in the Algerian sugar refining industry. The present research aims to measure the weight of the institutional criteria on the strategic decision of sugar refining companies in Algeria, by the combination of the Strengths, Weaknesses, Opportunities, and Threats analysis and the analytical hierarchy process. The ultimate purpose is to contribute to the analysis of interactions that exist between institutional changes induced by the globalization process and the strategic choices of local enterprises in an emergent economy. Copyright © 2010 John Wiley & Sons, Ltd. [source] The Unified Parkinson's Disease Rating Scale (UPDRS): Status and recommendationsMOVEMENT DISORDERS, Issue 7 2003Article first published online: 18 MAR 200 Abstract The Movement Disorder Society Task Force for Rating Scales for Parkinson's Disease prepared a critique of the Unified Parkinson's Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non-motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age-groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, "minimal," "mild," "moderate," and "severe" PD. Whereas the presence of non-motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments. © 2003 Movement Disorder Society [source] The Emperor Has No Clothes: How Digital Sampling Infringement Cases Are Exposing Weaknesses in Traditional Copyright Law and the Need for Statutory ReformAMERICAN BUSINESS LAW JOURNAL, Issue 3 2006Lucille M. Ponte First page of article [source] Current status, future trends, and issues in human performance technology, part 1: Influential domains, current status, and recognition of HPTPERFORMANCE IMPROVEMENT, Issue 1 2008James A. Pershing Fifteen human performance technology experts participated in a survey investigating HPT's current status, future trends, and issues. Although HPT is not fully recognized in many organizations, such strengths as systems thinking and multidisciplinary approaches to performance problems are valued. Weaknesses reported are the rare use of HPT in small organizations, falling for quick fixes, and shortcomings in evaluation. HPT professionals need to do better at clarifying HPT principles, communicating HPT values, and demonstrating HPT's organizational impact. [source] Weaknesses of goodness-of-fit tests for evaluating propensity score models: the case of the omitted confounder,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2005Sherry Weitzen PhD Abstract Purpose Propensity scores are used in observational studies to adjust for confounding, although they do not provide control for confounders omitted from the propensity score model. We sought to determine if tests used to evaluate logistic model fit and discrimination would be helpful in detecting the omission of an important confounder in the propensity score. Methods Using simulated data, we estimated propensity scores under two scenarios: (1) including all confounders and (2) omitting the binary confounder. We compared the propensity score model fit and discrimination under each scenario, using the Hosmer,Lemeshow goodness-of-fit (GOF) test and the c-statistic. We measured residual confounding in treatment effect estimates adjusted by the propensity score omitting the confounder. Results The GOF statistic and discrimination of propensity score models were the same for models excluding an important predictor of treatment compared to the full propensity score model. The GOF test failed to detect poor model fit for the propensity score model omitting the confounder. C-statistics under both scenarios were similar. Residual confounding was observed from using the propensity score excluding the confounder (range: 1,30%). Conclusions Omission of important confounders from the propensity score leads to residual confounding in estimates of treatment effect. However, tests of GOF and discrimination do not provide information to detect missing confounders in propensity score models. Our findings suggest that it may not be necessary to compute GOF statistics or model discrimination when developing propensity score models. Copyright © 2004 John Wiley & Sons, Ltd. [source] Outcomes and Efficacy of Newborn Hearing Screening: Strengths and Weaknesses (Success or Failure?),THE LARYNGOSCOPE, Issue 7 2008S. Korres MD Abstract Objective: To assess the outcomes of neonatal hearing screening with regard to the final diagnosis in a very large number of newborns and investigate related strengths and weaknesses of the program. Subjects: In this study, 76,560 newborns were assessed. Method: All neonates were assessed using transient evoked otoacoustic emissions (TEOAEs). Results: From the 76,560 neonates screened, 1,564 (2%) failed the test. According to the screening protocol, all parents of failed neonates were asked to bring their children 1 month following discharge to repeat the test. Of the 541 (34.6%) newborns who repeated the test, 303 (56%) were found normal and 238 (44%) again failed TEOAE. The latter children were referred to two special public centers for full audiology evaluation. In addition, 124 neonates were also referred due to other reasons revealed in the screening process (family history, high levels of bilirubin, etc.). Of the 362 children who were referred to the two special audiology centers, 113 (31.2%) were evaluated by these two centers. In addition, 42 children who had failed initial screening and did not show up for a follow-up appointment to repeat TEOAE were also assessed in the same centers. Of the 155 children who had a special audiologic evaluation, 56 (36.1%) were found to have hearing loss (HL) and 99 (63.9%) normal hearing. In detail, 28 had bilateral sensorineural HL greater than 40 dB, 10 had unilateral sensorineural HL greater than 40 dB, and 18 had otitis media with effusion or other conductive HL. Conclusions: Derived from the present study: 1) repeated testing of "failed" newborns in the maternity hospital and before discharge leads to an acceptable referral rate of 2%; 2) the 1-month follow-up of "failed" newborns further limits the false positive results but leads to high rate of newborns lost to follow-up; 3) a dedicated secretariat system should be implemented to follow-up each "failed" newborn and remind parents about their follow-up appointments; and 4) additional measures such as detailed educational material and parental friendly approach should also be implemented. [source] Structure and Function of Emergency Care Research Networks: Strengths, Weaknesses, and ChallengesACADEMIC EMERGENCY MEDICINE, Issue 10 2009Linda Papa MD Abstract The ability of emergency care research (ECR) to produce meaningful improvements in the outcomes of acutely ill or injured patients depends on the optimal configuration, infrastructure, organization, and support of emergency care research networks (ECRNs). Through the experiences of existing ECRNs, we can learn how to best accomplish this. A meeting was organized in Washington, DC, on May 28, 2008, to discuss the present state and future directions of clinical research networks as they relate to emergency care. Prior to the conference, at the time of online registration, participants responded to a series of preconference questions addressing the relevant issues that would form the basis of the breakout session discussions. During the conference, representatives from a number of existing ECRNs participated in discussions with the attendees and provided a description of their respective networks, infrastructure, and challenges. Breakout sessions provided the opportunity to further discuss the strengths and weaknesses of these networks and patterns of success with respect to their formation, management, funding, best practices, and pitfalls. Discussions centered on identifying characteristics that promote or inhibit successful networks and their interactivity, productivity, and expansion. Here the authors describe the current state of ECRNs and identify the strengths, weaknesses, and potential pitfalls of research networks. The most commonly cited strengths of population- or disease-based research networks identified in the preconference survey were access to larger numbers of patients; involvement of physician experts in the field, contributing to high-level study content; and the collaboration among investigators. The most commonly cited weaknesses were studies with too narrow a focus and restrictive inclusion criteria, a vast organizational structure with a risk of either too much or too little central organization or control, and heterogeneity of institutional policies and procedures among sites. Through the survey and structured discussion process involving multiple stakeholders, the authors have identified strengths and weaknesses that are consistent across a number of existing ECRNs. By leveraging the strengths and addressing the weaknesses, strategies can be adopted to enhance the scientific value and productivity of these networks and give direction to future ECRNs. [source] The Current State and Future Direction of Counseling Psychology in AustraliaAPPLIED PSYCHOLOGY, Issue 1 2007Robert G.L. Pryor Cet article décrit l'état actuel de la psychologie du counseling en Australie en termes de forces, faiblesses, opportunités et menaces. Parmi les forces identifiées, on trouve un champ professionnel très énergique, un large éventail d'activités de plus en plus acceptées de la part du public, des revues à comité de lecture, et une activité de recherche significative s'appuyant sur un engagement manifeste dans une démarche basée sur la preuve et appliquée au counseling. Les faiblesses soulignent l'accès inéquitable en termes de coût et d'éloignement géographique aux services de counseling de larges parties de la population australienne. La technologie fournit une occasion de relever des défis d'accès, de coût et d'implantation. En outre, les rapides changements économiques fournissent des opportunités pour les counselors de travailler activement avec des clients confrontés à des changements rapides et inattendus. Clairement, la psychologie du counseling se différencie comme champ théorique, de recherche et de pratique. Simultanément, elle peut mettre à disposition les compétences des psychologues du counseling lors d'investigations transdisciplinaires et d'applications ce qui constitue l'un des plus grands défis pour les psychologues australiens du counseling. Les développements futurs de la psychologie du counseling en Australie sont dépeints. This article outlines the current state of counseling psychology in Australia in terms of its strengths, weaknesses, opportunities, and threats. Strengths identified include a vibrant field of professional activity, a wide range of activities, increasing levels of public acceptance, successful peer-reviewed journals, and significant research activity that underlies a widespread commitment to an evidence-based approach to counseling. Weaknesses include the inequitable access to counseling services both in terms of cost and the geographic remoteness of parts of the Australian population. Technology provides an opportunity to address access, cost, and delivery challenges. Furthermore, the rapidly changing economic landscape provides opportunities for counselors to work proactively with clients who are confronted by rapid and unplanned change. Clearly differentiating counseling psychology as a field of theory, research, and practice while at the same time being able to integrate the skills of counseling psychologists within cross-disciplinary investigations and applications constitute the greatest challenges for Australian counseling psychologists. A vision of the future development of counseling psychology in Australia is proffered. [source] China as a Net Creditor: An Indication of Strength or Weaknesses?CHINA AND WORLD ECONOMY, Issue 6 2007Xin Wang E44; F21; F31; F41 Abstract China's international investment position is characterized by large net foreign assets, a dominance of low-return foreign exchange reserves and costly foreign direct investment in foreign assets and foreign liabilities. In addition, China's foreign investment positions are facing potentially large exchange risks. These features reflect entrenched institutional and structural problems in China, including underdeveloped capital markets, biased resource allocation and a defective social security system. China's net creditor status might actually be an indication of weakness rather than strength. To improve its international investment position, China must speed up economic reforms and allow the market to play a fundamental role in resource allocation. [source] Immediate and Delayed Benefits of Play Behaviour: New Evidence from Chimpanzees (Pan troglodytes)ETHOLOGY, Issue 12 2004E. Palagi Evidence for the anticipation of competition at feeding time has been previously documented in both Pan species. Chimpanzees seem to cope with competitive tendency through behavioural mechanisms of tension reduction, and grooming is certainly one of these. Social play and grooming are often matched because they bring animals into close physical contact for long periods, and they have an important role in social cohesion. Our goal was to investigate the occurrence of play behaviour during the pre-feeding period, before a basic maintenance activity is about to take place, in the chimpanzee colony housed in the ZooParc de Beauval (St Aignan sur Cher, France). The group was composed of 10 adults and nine immature individuals. By scan animal sampling (344 h of observation), we recorded play and grooming interactions in all age-class combinations during four different periods (pre-feeding, feeding, post-feeding, control). We found peak levels of grooming interactions among adults during the pre-feeding time. A peak frequency at the pre-feeding time was also found in social play between adults and unrelated immature subjects. This finding suggests that during high tension periods, grooming and play might share similar functions in conflict management. Like grooming, play might have an important role to limit aggression and increase tolerance around food (immediate benefits). Immature animals showed a higher frequency of play in the pre-feeding than in any other condition (feeding, post-feeding, and control). During high excitement periods social play probably represents a safe mechanism for immature subjects to test their personal abilities (self-assessment), the strength/weakness of playmates, and the degree of cooperation/competition with them (social-assessment). In the light of this new evidence, we can assert that play behaviour is far from being a purposeless activity, at least in the chimpanzee colony under study. [source] Differential age-related changes in motor unit properties between elbow flexors and extensorsACTA PHYSIOLOGICA, Issue 1 2010B. H. Dalton Abstract Aim:, Healthy adult ageing of the human neuromuscular system is comprised of changes that include atrophy, weakness and slowed movements with reduced spinal motor neurone output expressed by lower motor unit discharge rates (MUDRs). The latter observation has been obtained mostly from hand and lower limb muscles. The purpose was to determine the extent to which elbow flexor and extensor contractile properties, and MUDRs in six old (83 ± 4 years) and six young (24 ± 1 years) men were affected by age, and whether any adaptations were similar for both muscle groups. Methods:, Maximal isometric voluntary contraction (MVC), voluntary activation, twitch contractile properties, force,frequency relationship and MUDRs from sub-maximal to maximal intensities were assessed in the elbow flexors and extensors. Results:, Both flexor and extensor MVCs were significantly (P < 0.05) less (,42% and ,46% respectively) in the old than in the young. Contractile speeds and the force,frequency relationship did not show any age-related differences (P > 0.05). For the elbow flexors contraction duration was ,139 ms and for the extensors it was ,127 ms for both age groups (P > 0.05). The mean MUDRs from 25% MVC to maximum were lower (,10% to ,36%) in the old than in the young (P < 0.01). These age-related differences were larger for biceps (Cohen's d = 8.25) than triceps (Cohen's d = 4.79) brachii. Conclusion:, Thus, at least for proximal upper limb muscles, mean maximal MUDR reductions with healthy adult ageing are muscle specific and not strongly related to contractile speed. [source] | |||||||||||||||||||||||||||||||||||||||||||