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Careful Management (careful + management)
Selected AbstractsCytotoxic effects of gingival retraction cords on human gingival fibroblasts in vitroJOURNAL OF ORAL REHABILITATION, Issue 4 2004C.-M. Liu summary, The objective of this study was to determine the cytocompatibility of three different extracts of gingival retraction cords and to compare the cytotoxic effect of these materials on human gingival fibroblasts. Gingival retraction cords impregnated with aluminium sulphate (Gingi-Aid), dl -adrenaline HCl (Gingi-Pak) and non-drug-impregnated cord (Gingi-Plain) were eluted with culture medium for 10 min and 24 h. Cytotoxicity was judged using a tetrazolium bromide reduction assay. Our data demonstrated that gingival retraction cords applied alone almost completely inhibited cell viability (P < 0·05). In addition, the results also showed that the eluates from aluminium sulphate-impregnated cord, dl -adrenaline HCl-impregnated cord and non-drug-impregnated cord were cytotoxic to primary human gingival fibroblast cultures (P < 0·05). The cell viability of incubation of gingival fibroblasts containing 10-min eluates of aluminium sulphate, dl -adrenaline HCl and non-drug-impregnated cord was 61, 21 and 70%, respectively. The cell viability of incubation of gingival fibroblasts containing 24 h eluates of aluminium sulphate, dl -adrenaline HCl and non-drug-impregnated cord was 68, 58 and 72%, respectively. It was found that dl -adrenaline HCl-impregnated gingival retraction cord was the most toxic gingival retraction cord among the materials tested in all cultures (P < 0·05). The cytotoxicity decreased in an order of dl -adrenaline HCl-impregnated cord > aluminium sulphate-impregnated cord > non-drug-impregnated cord. The extent or degree of the cytotoxicity depended on the materials tested. Gingival retraction cords have significant potential for gingival toxicity. Careful management of gingiva retraction cords would lower the risk of potential gingival tissue damage during clinical application procedure and thus increase the success of prosthodontic procedures. [source] Orthodontics Using an Occlusal Splint: A Clinical ReportJOURNAL OF PROSTHODONTICS, Issue 2 2010Akit Patel BDS, MClinDent (Prostho), MFDS RCS (Eng) Abstract Careful management of the occlusion is necessary for successful prosthodontic treatment. A reorganized occlusal approach requires a more accurate registration of the desired jaw position, and where it is difficult to achieve this, an occlusal splint is indicated. This clinical report documents a 60-year-old man with a Prosthodontic Diagnostic Index Class IV dentition, who prior to a full-mouth reconstruction, underwent occlusal splint therapy with a Michigan-type splint that incorporated z-springs to allow concurrent orthodontic tooth movement of two anterior teeth to positions that would allow favorable restorations by correcting occlusal and esthetic form. [source] Managing the Budgetary Process in a Hung CouncilPUBLIC ADMINISTRATION, Issue 4 2000Steve Leach This paper examines the impact of a change in 1994 from majority control to no overall control on the operation of a strategic medium-term budget and policy plan-ning process in Kirklees MBC. Six hypotheses are set out regarding the changes that might have been anticipated in the budget process, in the light of recent trends in the approach to budgeting in British local government, and the particular political context and recent political history of the authority. Use is made of a diary kept by a participant observer (who is also one of the authors) to document and analyse key events in the budget process. The six hypotheses are examined against the evi-dence, and with some exceptions are confirmed. It is concluded that Kirklees's well-structured budget process did survive the transition to no overall control, but not without considerable difficulty. Careful management from the Executive Board, especially in brokering discussion, was a critical factor and highly advantageous to the success of the process. [source] Endodontic management of a fused mandibular third molar and distomolar: A case reportAUSTRALIAN ENDODONTIC JOURNAL, Issue 1 2010Ali Zeylabi dds Abstract Careful management of fused teeth is essential as abnormal morphology can predispose a tooth to caries and periodontal disease. In this paper, a rare case of successful endodontic management of unilateral mandibular third molar fused to a distomolar is reported. Caries was removed from the tooth complex under local anaesthesia. The pulp chambers of the third molar and supernumerary tooth were accessed and the root canals were prepared using rotary instrumentation and copious irrigation with 2.5% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed. A 1-year recall showed a good treatment result. [source] A Quantitative Conservation Approach for the Endangered Butterfly Maculinea alconCONSERVATION BIOLOGY, Issue 2 2004MICHIEL F. WallisDeVries The quality and size of habitat patches and their isolation from other patches are the main parameters for an assessment of population persistence, but translating persistence probabilities into practical measures is still a weak link in conservation management. I provide a quantitative conservation approach for the endangered myrmecophilous butterfly Maculinea alcon in the Netherlands. All 127 colonies known on heathland since 1990 were investigated for patch quality, size, and isolation. I assessed habitat quality in three 10 × 10 m plots for most colonies. Site occupancy in 1998,1999 was only 56%. Occupancy was best explained by a logistic regression including patch area, host ant presence, host plant abundance, overall heathland area, and connectivity between sites ( R2= 0.410, p < 0.0001); it correctly classified the occupied or vacant status for 82% of the sites. Connectivity contributed only 3.6% to the total explained variation of site occupancy, indicating that habitat characteristics were more important than isolation in determining population persistence at the examined scale level (>500 m). Grazing and sod cutting had a beneficial impact, but in combination these practices proved detrimental. Hydrological measures to prevent drainage were also associated with lowered occupancy. I used the different components in the logistic regression to formulate objective management recommendations. These consisted of sod cutting, reduction of management intensity, enlargement of habitat, or combinations of these recommendations. The results highlight the importance of careful management when site quality is determined by multiple factors. The quantitative conservation approach followed here can be fruitfully extended to other endangered species, provided enough is known about their ecological requirements and how management actions affect them. Resumen:,La preservación de fragmentos individuales es extremadamente importante para especies en peligro con capacidad de dispersión limitada. La calidad y tamaño de los fragmentos de hábitat y su aislamiento de otros fragmentos son los parámetros principales para la evaluación de la persistencia de la población, pero la traducción de probabilidades de persistencia en medidas prácticas aun es un eslabón débil en la gestión de conservación. Proporciono un método cuantitativo de conservación para la mariposa mirmecófila Maculinea alcon en peligro en Holanda. Se investigó a las 127 colonias conocidas en brezales desde 1990 para calidad, tamaño y aislamiento del fragmento. Evalué la calidad del hábitat en tres parcelas de 10 × 10 m en la mayoría de las colonias. La ocupación de sitios en 1998-1999 fue sólo 56%. La ocupación fue mejor explicada por regresión logística incluyendo la superficie del fragmento, presencia de hormigas huésped, abundancia de plantas huésped, superficie total del brezal y conectividad entre sitios ( R2= 0.410, p < 0.0001); clasificó el estatus de ocupado o vacante en 82% de los sitios. La conectividad contribuyó con solo 36% de la variación total de sitio de ocupación, lo que indica que las características de hábitat fueron más importantes que el aislamiento en la determinación de la persistencia de la población en el nivel de escala examinado (>500 m). El pastoreo y el corte de pasto tuvieron un impacto benéfico pero combinadas, estas prácticas fueron perjudiciales. Obras hidrológicas para prevenir la desecación también se asociaron con una disminución en la ocupación. Utilicé los diferentes componentes de la regresión logística para formular recomendaciones objetivas de gestión. Estas incluyeron el corte de pasto, reducción en la intensidad de manejo, aumento de hábitat o combinaciones de estas recomendaciones. Los resultados resaltan la importancia de la gestión cuidadosa cuando la calidad del sitio está determinada por múltiples factores. El método cuantitativo de preservación utilizado puede ser extendido exitosamente a otras especies en peligro, siempre que sean suficientemente conocidos sus requerimientos ecológicos y la forma en que le afectan las acciones de manejo. [source] Ten-year study of bacteremia in hemodialysis patients in a single centerHEMODIALYSIS INTERNATIONAL, Issue 1 2005J.A. Park Background:,The incidence of infection in patients on chronic hemodialysis in higher than that of the general population. Infection is known to be a major cause of morbidity and mortality in these patients. The vascular access is important for hemodialysis, but infection through this route is the most common source of bacteremia and can be lethal to the patients. Despite the high morbidity and mortality of bacteremia in patients on chronic hemodialysis, the clinical characteristics of bacteremia in hemodialysis patients is rarely reported yet in Korea. Methods:,We included 696 hemodialysis patients from January 1993 to December 2003 at Uijongbu St. Mary's Hospital. We investigated incidence, source, causative organisms, clinical manifestations, complication, and mortality of bacteremia. We compared clinical factors, morbidity, and mortality between arteriovenous fistula and central venous catheter groups. Results:,Total 52 cases of bacteremia occurred in 43 patients. The major source of infection was vascular access (48%). Staphylococcus aureus was most common organism isolated. Major complications were septic shock (9.6%), pneumonia (9.6%), infective endocarditis (3.8%), and aortic pseudoaneurysm (1.9%). Nine patients died from septic shock (n = 4), aspiration pneumonia (n = 2), hypoxic brain injury (n = 1), gastrointestinal bleeding (n = 1), and rupture of aortic pseudoaneurysm. The central venous catheter group (n = 22) had higher incidences of vascular access as a source of infection (81.8% vs 23.3%, p < 0.001) and staphylococcus as a causative organism (77.2% vs 50.0%, p = 0.042) than the arteriovenous group. Conclusion:, This data shows that bacteremia causes high incidence of fatal complications and mortality. Therefore, careful management of vascular access as well as early detection of bacteremia is an important factor for the prevention of infection and proper antibiotic therapy should be started early. [source] Manipulating Charges and Excitons within a Single-Host System to Accomplish Efficiency/CRI/Color-Stability Trade-off for High-Performance OWLEDsADVANCED MATERIALS, Issue 23 2009Qi Wang To reveal superior efficiency/CRI/color-stability trade-off for OWLED fabrications, a single-host concept is proposed in which the primary-color emitters are rationally arranged to render two types (R,G,B and RG,B) of OWLEDs with ultrahigh electroluminescence performance. Comprehensive experimental and theoretical evidence reveal that careful management of charges and excitons is the key to the realization of such high performances. [source] Assemblages of soil macrofauna across a Scottish land-use intensification gradient: influences of habitat quality, heterogeneity and areaJOURNAL OF APPLIED ECOLOGY, Issue 6 2005PAUL EGGLETON Summary 1Land-use intensification strongly influences biodiversity by altering habitat heterogeneity, the distribution of habitat types and their extent. This study explores these effects within mixed semi-natural/agricultural mosaic habitats in Scotland, examining the effect of land-use intensification on the soil macrofauna at point (m2), landscape (km2) and regional (> 1 km2) scales. 2The soil macrofauna in six 1-km2 sampling areas (land-use units; LUU) were sampled using a combined hand-sorting and Winkler bag extraction technique. Within each LUU, 16 1-m2 samples were taken in each of 2 successive years. Each LUU had a mixture of land-use types, representing an agricultural intensification gradient. 3The following hypotheses were tested: (i) the study area sustains a number of distinct habitats as defined by soil macrofaunal composition; (ii) a greater number of restricted range species are found in semi-natural habitats; (iii) local (point) species density is related to habitat type; (iv) overall levels of species richness per habitat at regional scales are related to species-area effects; and (v) landscape-level species density is correlated with habitat heterogeneity. 4Initial analysis revealed five distinct habitat types: Caledonian forest (semi-natural pine forest), closed canopy woodland (pine plantation and broadleaved woodland), riparian habitats (wet woodland and grassland), pasture (improved grassland) and arable (crop fields). 5As hypothesized, the Caledonian habitat contained a greater number of restricted-range species than the other habitats. However, conifer plantations contained more restricted range species than expected, given their anthropogenic origin. Species density per m2 was most strongly affected by habitat type. At the regional level, the size of the species pool was correlated with the size of habitat areas. There were more species overall in LUU with greater habitat heterogeneity. 6Synthesis and applications. Caledonian pine forests have high species densities and contain species of conservation value. Mixed conifer plantations also appear to have a surprisingly high invertebrate conservation value. In contrast, intensively managed agricultural habitats have low species densities and conservation value. Generally, mixed land-use areas have higher species densities than single land-use areas. This emphasizes the need for careful management of forest systems within the matrix of agricultural habitats to maximize landscape diversity. [source] Social entrepreneurship: understanding consumer motives for buying The Big IssueJOURNAL OF CONSUMER BEHAVIOUR, Issue 3 2005Sally A. Hibbert Abstract This paper examines consumer response to a particular social entrepreneurship initiative, The Big Issue. Focusing on consumer motivation, the research explores the utilitarian value of the product as compared to the desire to help the homeless as the primary motivation for purchase. The research found that, although the utilitarian value partly motivated purchase, consumers widely perceived there to be a helping dimension to the exchange. Consumers valued the empowerment goals espoused by The Big Issue and found it rewarding to play a part in the empowerment process. The appearance and manner of The Big Issue vendors influenced consumer reactions to the initiative, indicating a need for careful management of ,beneficiary portrayal' in this context. [source] Pregnancy complicated by Caroli's disease with polycystic kidney disease: A case report and following observationsJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4pt2 2008Mika Tsunoda Abstract Caroli's disease and Caroli's syndrome are rare congenital disorders characterized by non-obstructive cystic dilatation of the intrahepatic bile ducts. These disorders are often associated with autosomal recessive polycystic kidney disease. A young woman at 11 weeks of gestation was referred to our hospital for proper management of Caroli's disease during pregnancy. Magnetic resonance imaging and laboratory tests revealed Caroli's disease with chronic renal failure caused by polycystic kidney disease. She received diet control, erythropoietin and prophylactic oral antibiotics. Her pregnancy course was uneventful, and she gave birth at 37 weeks of gestation. Thereafter, her renal function gradually worsened. Hemodialysis was begun 5 years after parturition. Though the courses of pregnancies complicated by Caroli's disease or Caroli's syndrome are variable and can include life-threatening conditions, uneventful outcomes can be expected if careful management prevents biliary and renal infection. [source] Dairy cows trapped between performance demands and adaptability,JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 7 2009Wilhelm Knaus Abstract The tremendous increase in the lactation performance of dairy cows during the last 60 years has had dramatic consequences on fertility and vitality (fitness) of the animals. Unprecedented average lactation performance levels have resulted in an equally unprecedented reduction in longevity. Economic pressure to further reduce the age at first calving is still high, although the negative correlation between precocious maturity and longevity is well documented in the relevant literature. Ever more aggressive selection and feeding measures are being taken to shorten the rearing time of heifers in order to reduce the cost of replacement heifers. An additional decrease in the stayability of cows has to be expected when the age at first calving is lowered even further. For reasons of profitability, dairy cows should complete an average of at least four lactations. Cows from the most important dairy breeds in the United States and Bavaria, Germany, already dropped below that crucial threshold many years ago. The same phenomenon has been observed in dairy cows in Austria over the past few years. Holstein cows that were culled in Austria in 2007 had an average of only 3.3 parities. To improve this situation, dairy cattle breeding programs should put a much higher emphasis on selection for traits of longevity and lifetime performance and, in return, markedly reduce the emphasis on selection for lactation performance in general and early-lactation performance test results in particular. Over millions of years of evolutionary adaptation, cattle have acquired the ability to utilize fibrous low-quality plant substrate. Only a strongly forage-based feeding regimen is, in the long run, in accordance with their digestive and metabolic configuration. The massive use of concentrates (mostly grain) in cattle rations increases the risk of digestive and metabolic disorders in cattle and consequently leads to impaired animal welfare. Finally, the careful management of scarce resources demands that a closer look be taken at the food balance in dairy rations, i.e., an awareness of how much food that is edible for humans is being fed to livestock. Copyright © 2009 Society of Chemical Industry [source] Infant feeding in the neonatal unitMATERNAL & CHILD NUTRITION, Issue 4 2010Rhona J. McInnes Abstract Infants admitted to a neonatal unit (NNU) are frequently unable to feed by breast or bottle because of ill health or prematurity. These infants require nutritional support until they can start oral feeding. Breastfeeding is advocated for these infants, and mothers are frequently encouraged to express breast milk to be fed via the enteral tube. However, by discharge, breastfeeding rates tend to be low. Oral feeding requires careful management, and although practices may vary because of clinical need, some may be informed by unit norms. There is limited evidence for effective breastfeeding support in this environment and little exploration of the effect of routine feeding decisions. This study aimed to explore feeding decisions and considered how these might affect outcomes. The staff in the two large urban NNUs who participated in the feeding decisions were interviewed and the data were analysed using a theoretical framework. Feeding decisions were made mainly by the unit staff, with limited parental involvement. Subsequent management varied, with differences being related to staff experience and beliefs, unit norms, parent's expectations and physical constraints within the unit. The staff were overtly supportive of breastfeeding, but the need to monitor and quantify milk intake may undermine breastfeeding. Furthermore, feeding breastfed infants during the mothers' absence was controversial and provoked debate. There is a need for clear guidelines and increased parental involvement in feeding decisions. Routine practices within the system may discourage mothers from initiating and persisting with breastfeeding. A change in unit culture is required to fully support the parent's feeding choices. [source] Dental management of patients at risk of osteochemonecrosis of the jaws: a critical reviewORAL DISEASES, Issue 8 2009S Fedele Osteonecrosis of the jaw bones is a complication of bisphosphonate (BP) drug usage characterised by trans-mucosal exposure of necrotic bone, often followed by infection and pain. Osteonecrosis is observed in cancer patients on high-potency intravenous BP more frequently than in osteoporotic individuals using low-potency oral BP. The management of osteonecrosis caused by BP is often unsatisfactory and control of risk factors is considered the most effective means of prevention. Surgical manipulation and dental infection of the jawbone are the major risk factors, hence it is suggested that careful management of oral health and relevant dental procedures may decrease the risk of osteonecrosis in individuals on BP. Recommendations for dentists and oral surgeons have been suggested by different groups of clinicians but they are often controversial and there is no clear evidence for their efficacy in reducing the likelihood of osteonecrosis development. This report critically reviews current dental recommendations for individuals using BP with the aim of helping the reader to transfer them into practice as part of pragmatic and non-detrimental clinical decisions making. [source] Heparin-induced thrombocytopenia with multiple organized thrombi accompanied by unusual cholesterin deposition: Autopsy case after long-term follow upPATHOLOGY INTERNATIONAL, Issue 10 2009Masaaki Ichinoe Heparin-induced thrombocytopenia (HIT) is characterized by a reduction in the platelet count and systemic thromboembolism during heparin therapy. Herein is reported a case of HIT with characteristic thrombus formation. A 68-year-old man who had been treated for hypertension for 27 years suffered a brain infarction and was treated with heparin. After this treatment, other new infarctions occurred in multiple organs. Because serum antibodies against heparin/PF4 complex were detected, he was diagnosed as having HIT, and warfarin and argatroban were administered instead of heparin. He died, however, 119 days after the first onset. At autopsy infarction due to organized thrombi with cholesterin deposition in multiple organs were found, similar to usual atherosclerotic emboli, but different to them with regard to clinical course and distribution of thrombi. This case in which organization and frequent cholesterin deposition were found in thromboembolized lesions of multiple organs after relatively long-term follow up, is unusual. The findings suggest that HIT accompanied by marked hypercholesterolemia of long duration contributes to a characteristic form of thromboembolism that needs careful management. [source] Volunteer Support for Mothers with New Babies: Perceptions of Need and Support ReceivedCHILDREN & SOCIETY, Issue 3 2010Kristen MacPherson Semi-structured interviews were conducted with 55 mothers of infants. Some had received Home-Start during their infant's first year, others were offered the support but declined and the remainder were not offered Home-Start. Most of their support had come from informal sources, such as family and friends with less from professionals. Mothers who received Home-Start described beneficial aspects, in particular, the extent of practical support provided, preferable to calling on close relatives or friends. Difficulties related to volunteer characteristics and administrative problems. Overall volunteer support can be important to complement informal and formal support, but needs careful management. [source] Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weightCLINICAL TRANSPLANTATION, Issue 4 2010Yasumasa Shirouzu Shirouzu Y, Ohya Y, Suda H, Asonuma K, Inomata Y. Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weight. Clin Transplant 2010: 24: 520,527. © 2009 John Wiley & Sons A/S. Abstract:, Background:, There are only limited data on post-transplant ascites unrelated to small-sized grafts in living donor liver transplantation (LDLT). Methods:, The subjects were 59 adult patients who had received right lobe LDLT with a graft weight-to-recipient weight ratio (GRWR) > 0.8%. Patients were divided into either Group 1 (n = 14, massive ascites, defined as the production of ascitic fluid > 1000 mL/d that lasted longer than 14 d after LDLT) or Group 2 (n = 45, no development of massive ascites). Patients were followed for a median period of 3.0 yr (range, 0.5,7.5 yr). Results:, Group 1 had both higher Model for End-Stage Liver Disease score and Child-Pugh score than Group 2. Portal venous flow volume just after reperfusion was significantly greater in Group 1 than Group 2 (307.8 ± 268.8 vs. 176.2 ± 75.0 mL/min/100 g graft weight, respectively; p < 0.05). Post-transplant infectious complications including ascites infection developed more frequently within the first post-transplant month in Group 1. Massive ascites was significantly associated with early graft loss (p < 0.05). Conclusion:, Post-transplant massive ascites associated with portal over-perfusion into the graft liver can develop in patients with a GRWR over 0.8%. Recipients with post-transplant massive ascites require careful management to prevent infection. [source] | ||||||||||||||||