Distribution by Scientific Domains

Kinds of Act

  • adenosine act
  • aggressive act
  • balancing act
  • capacity act
  • care act
  • caring act
  • child act
  • civil rights act
  • clean water act
  • communicative act
  • community reinvestment act
  • control act
  • corporation act
  • creative act
  • criminal act
  • disabilities act
  • drug act
  • education act
  • endangered species act
  • european act
  • health act
  • hormones act
  • human right act
  • illocutionary act
  • legislative act
  • management act
  • mental capacity act
  • mental health act
  • only act
  • pathway act
  • practice act
  • reform act
  • rehabilitation act
  • reinvestment act
  • repatriation act
  • right act
  • rights act
  • sarbanes-oxley act
  • security act
  • selection act
  • sexual act
  • single european act
  • species act
  • speech act
  • terrorist act
  • trade practice act
  • violent act
  • water act

  • Terms modified by Act

  • act as
  • act downstream
  • act synergistically

  • Selected Abstracts

    Impact of assertive community treatment and client characteristics on criminal justice outcomes in dual disorder homeless individuals

    Dr Robert J. Calsyn PhD
    Background People with severe mental illness and substance use disorders (dual disorder) often have considerable contact with the criminal justice system. Aims To test the effects of client characteristics on six criminal justice outcomes among homeless (at intake) people with mental illness and substance misuse disorders. Methods The sample was of participants in a randomized controlled trial comparing standard treatment, assertive community treatment (ACT) and integrated treatment (IT). Data were analysed using hierarchical logistic regression. Results Half the sample was arrested and a quarter incarcerated during the two-year follow-up period. The regression models explained between 22% and 35% of the variance of the following criminal justice measures: (1) major offences, (2) minor offences, (3) substance-use-related offences, (4) incarcerations, (5) arrests, and (6) summons. Prior criminal behaviour was the strongest predictor of all of the dependent variables; in general, demographic and diagnostic variables were not. Similarly, neither the type nor the amount of mental health treatment received predicted subsequent criminal behaviour. Conclusion Elsewhere the authors have shown that ACT and IT had advantages for health and stability of accommodation but these analyses suggest that more specialized interventions are needed to reduce criminal behaviour in dual disorder individuals. Copyright © 2005 John Wiley & Sons, Ltd. [source]

    Schizophrenia treatment: content versus delivery

    J. Van Os
    Objective:, To review the evidence supporting the importance of ensuring that patients with psychiatric disorders receive an optimal and appropriate level of non-pharmacological treatment, and how Assertive Community Treatment (ACT) may be able to contribute to this aim. Method:, Analysis of data from selected individual published studies on ACT, in addition to reviews from the Cochrane Library, and other study groups. Results:, Treatment management using ACT appears to offer benefits in terms of reduction in hospitalisation, although there is some debate as to whether this is the most representative outcome measure. Preliminary indications using remission as an outcome measure have also shown promising results in favour of ACT. Conclusion:, While further investigation and validation are necessary, current data indicate that ACT may be an appropriate strategy to facilitate the delivery of treatment to patients with psychotic disorders. [source]


    ECONOMIC AFFAIRS, Issue 4 2002
    Derek Morris
    The forthcoming Enterprise Act makes the Competition Commission (CC) determinative in relation to merger and market inquiries. It also introduces new competition-based tests, the rationale for which is examined. Several procedural aspects of the new regime are explored, in particular the need for economic guidance to be published on the application of the new tests. A number of key economic considerations are then examined, including market definition, oligopoly pricing, entry and the scope for different perspectives as between economic analysis and business practice. [source]

    Can High School Achievement Tests Serve to Select College Students?

    Adriana D. Cimetta
    Postsecondary schools have traditionally relied on admissions tests such as the SATand ACT to select students. With high school achievement assessments in place in many states, it is important to ascertain whether scores from those exams can either supplement or supplant conventional admissions tests. In this study we examined whether the Arizona Instrument to Measure Standards (AIMS) high school tests could serve as a useful predictor of college performance. Stepwise regression analyses with a predetermined order of variable entry revealed that AIMS generally did not account for additional performance variation when added to high school grade-point average (HSGPA) and SAT. However, in a cohort of students that took the test for graduation purposes, AIMS did account for about the same proportion of variance as SAT when added to a model that included HSGPA. The predictive value of both SAT and AIMS was generally the same for Caucasian, Hispanic, and Asian American students. The ramifications of universities using high school achievement exams as predictors of college success, in addition to or in lieu of traditional measures, are discussed. [source]

    A Glassy Carbon Electrode Modified with Multiwalled Carbon Nanotube/Chitosan Composite as a New Sensor for Simultaneous Determination of Acetaminophen and Mefenamic Acid in Pharmaceutical Preparations and Biological Samples

    ELECTROANALYSIS, Issue 15 2010
    Ali Babaei
    Abstract A new chemically modified electrode is constructed based on multiwalled carbon nanotube/chitosan modified glassy carbon electrode (MWCNTs-CHT/GCE) for simultaneous determination of acetaminophen (ACT) and mefenamic acid (MEF) in aqueous buffered media. The measurements were carried out by application of differential pulse voltammetry (DPV), cyclic voltammetry (CV) and chronoamperometry (CA) methods. Application of DPV method showed that the linear relationship between oxidation peak current and concentration of ACT and MEF were 1,,M to 145,,M, and 4,,M to 200,,M, respectively. The analytical performance of this sensor has been evaluated for detection of ACT and MEF in human serum, human urine and a pharmaceutical preparation with satisfactory results. [source]

    Partition Behavior of Polycyclic Aromatic Hydrocarbons Between Aged Coal Tar and Water,

    Lihua Liu
    Abstract Coal tar aged in a large-scale, artificial aquifer experiment for five years was subsequently investigated for leaching behavior of polycyclic aromatic hydrocarbons (PAHs). After five years, the initially liquid coal tar had solidified and formed segregated particles with a grain size similar to that of the sandy aquifer material. The composition of the aged coal tar (ACT) with regard to PAHs was remarkably different from that of the original bulk coal tar (BCT), because most of the low-molecular-weight compounds had been depleted. Equilibrium aqueous-phase concentrations of 17 PAHs leaching from the aquifer material containing the ACT were measured from consecutive equilibration steps at increasing temperatures of between 25 and 100C using accelerated solvent extraction. The results showed 2-to 5,000-fold lower concentrations than those from BCT, indicating dramatic changes of dissolution behavior of PAHs from coal tar after the five-year aging period. Predictions based on Raoult's law with the subcooled liquid solubilities substantially overestimated the equilibrium aqueous-phase concentrations of the PAHs from ACT, whereas the estimations were reasonable if the solid solubilities were employed instead. The enthalpies of phase transfer from ACT to water were determined based on the van't Hoff equation. The resulting values agreed with the dissolution enthalpies of pure solid rather than subcooled liquid PAHs. [source]

    Acute-to-chronic species sensitivity distribution extrapolation

    Cédric Duboudin
    Abstract Seeking to make greater use of available data for risk assessment of substances, we constructed, for the situation in which chronic data are limited or even nonexistent but acute data are relatively large, an acute to chronic transformation (ACT) methodology based on the concept of species sensitivity distributions (SSDs). This ACT methodology uses a comparison of acute and chronic SSDs, separately for vertebrate data (with 22 substances) and for invertebrate data (with 15 substances). Rather than comparing an acute toxicity value with a chronic value, as when calculating an acute to chronic ratio (ACR), samples of acute and chronic data corresponding to the same category of species were compared. Starting from a sample of acute data, the ACT methodology showed relationships that enable the creation of a sample of predicted chronic values. This sample can then be used to calculate a predicted chronic hazardous concentration potentially affecting 5% of species (HC5%), just as with a sample of real chronic toxicity values. This ACT approach was tested on 11 substances. For each substance, the real chronic HC5% and the predicted chronic HC5% were calculated and compared. The ratio between chronic HC5% and ACT HC5% was, on average, 1.6 and did not exceed 4.4 for the 11 substances studied. [source]

    A case series investigating acceptance and commitment therapy as a treatment for previously treated, unremitted patients with anorexia nervosa

    M. I. Berman
    Abstract The aim of the present study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) for treatment of anorexia nervosa (AN) using a case series methodology among participants with a history of prior treatment for AN. Three participants enrolled; all completed the study. All participants had a history of 1,20 years of intensive eating disorder treatment prior to enrollment. Participants were seen for 17,19 twice-weekly sessions of manualized ACT. Symptoms were assessed at baseline, post-treatment and 1-year follow-up. All participants experienced clinically significant improvement on at least some measures; no participants worsened or lost weight even at 1-year follow-up. Simulation modelling analysis (SMA) revealed for some participants an increase in weight gain and a decrease in eating disorder symptoms during the treatment phase as compared to a baseline assessment phase. These data, although preliminary, suggest that ACT could be a promising treatment for subthreshold or clinical cases of AN, even with chronic participants or those with medical complications. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    ORIGINAL ARTICLE: Probability of emergence of antimalarial resistance in different stages of the parasite life cycle

    Wirichada Pongtavornpinyo
    Abstract Understanding the evolution of drug resistance in malaria is a central area of study at the intersection of evolution and medicine. Antimalarial drug resistance is a major threat to malaria control and directly related to trends in malaria attributable mortality. Artemisinin combination therapies (ACT) are now recommended worldwide as first line treatment for uncomplicated malaria, and losing them to resistance would be a disaster for malaria control. Understanding the emergence and spread of antimalarial drug resistance in the context of different scenarios of antimalarial drug use is essential for the development of strategies protecting ACTs. In this study, we review the basic mechanisms of resistance emergence and describe several simple equations that can be used to estimate the probabilities of de novo resistance mutations at three stages of the parasite life cycle: sporozoite, hepatic merozoite and asexual blood stages; we discuss the factors that affect parasite survival in a single host in the context of different levels of antimalarial drug use, immunity and parasitaemia. We show that in the absence of drug effects, and despite very different parasite numbers, the probability of resistance emerging at each stage is very low and similar in all stages (for example per-infection probability of 10,10,10,9 if the per-parasite chance of mutation is 10,10 per asexual division). However, under the selective pressure provided by antimalarial treatment and particularly in the presence of hyperparasitaemia, the probability of resistance emerging in the blood stage of the parasite can be approximately five orders of magnitude higher than in the absence of drugs. Detailed models built upon these basic methods should allow us to assess the relative probabilities of resistance emergence in the different phases of the parasite life cycle. [source]

    Adenylate cyclase influences filamentous haemagglutinin-mediated attachment of Bordetella pertussis to epithelial alveolar cells

    Maria L.A. Perez Vidakovics
    Abstract Attachment to epithelial cells in the respiratory tract is a key event in Bordetella pertussis colonization. Filamentous haemagglutinin (FHA) is an important virulence factor mediating adhesion to host cells. In this study, the relevance of the interaction between FHA and adenylate cyclase toxin (ACT) during bacterial attachment was investigated. Mutants lacking either FHA or ACT showed significantly decreased adherence to epithelial respiratory cells. The use of several ACT-specific monoclonal antibodies and antiserum showed that the decrease in attachment of strains lacking ACT expression could not be explained by the adhesin-like activity of ACT, or a change of any of the biological activities of ACT. Immunoblot analysis showed that the lack of ACT expression did not interfere with FHA localization. An heparin-inhibitable carbohydrate-binding site is crucial in the process of FHA-mediated bacterial binding to epithelial cells. In the presence of heparin attachment of wild-type B. pertussis, but not of the isogenic ACT defective mutant, to epithelial cells was significantly decreased. These results suggest that ACT enhances the adhesive functions of FHA, and modifies the performance of the FHA heparin-inhibitable carbohydrate binding site. We propose that the presence of ACT in the outer membrane of B. pertussis to play a role in the functionality of FHA. [source]

    College Students Classified as Having Learning Disabilities and Attention Deficit Hyperactivity Disorder and the Foreign Language Requirement

    Richard L. Sparks EdD
    College students classified as having attention deficit hyperactivity disorder (ADHD) are often assumed by educators and service providers to have problems that impair FL learning. To date, no empirical studies have investigated this assumption. In the two studies reported here, college students classified as LD or as both LD and having ADHD (LD/ADHD) who had either substituted courses for the FL requirement (petition) or had fulfilled the requirement by passing FL courses (nonpetition) were compared in terms of demographic, cognitive, and academic achievement profiles, and FL grades. In the first study, few differences were found in demographic, cognitive, and achievement profiles between petition students classified as LD or LD/ADHD. In the second study, no significant differences in demographic profiles were found among groups classified as petition LD, petition LD/ADHD, nonpetition LD, and nonpetition LD/ADHD. On cognitive and academic achievement measures, the nonpetition LD/ADHD group scored significantly higher than the petition LD group on measures of IQ, reading, math, and scholastic achievement (ACT). The results of both studies appear to be counterintuitive because students with two disabilities (LD and ADHD) were found to exhibit cognitive ability, academic achievement, and FL grades greater than or equal to students with LD alone. Findings suggest that students classified as both LD and ADHD may not necessarily experience serious problems with FL learning. [source]

    Experimental study on a new type citrate anticoagulant hemodialysate in dogs

    G. Baosong
    Objective:,In this study, we initiated a new hemodialysate with citrate buffer, observed the factors that influence the citrate concentration of solution in hollow fibers when using citrate hemodialysate, and observed the anticoagulant effect and safety of the citrate hemodialysate in the experiment in dogs. Methods:,Ten dogs were given intermittent hemodialysis and were divided into 3 groups according to hemodialysis procedures. Group 1 was saline-flush hemodialysed with bicarbonate hemodialysate; Group 2 was hemodialysed with citrate hemodialysis without any anticoagulant; Group 3 was hemodialysed with bicarbonate hemodialysate and heparin. ACT, Ca++, BUN, Cr, ALT, AST, TBIL, DBIL, Na+, Cl,, , and venous pressure were monitored in the animals of each group during hemodialysis. Results:,During the hemodialysis in Group 1, venous pressure increased lastingly, resulting in the failure of hemodialysis for 2 hours. Hemodialysis for 2 hours in Group 2 were all finished successfully. ACT was extended and Ca++ decreased obviously in the venous end during hemodialysis. And ALT, AST, Ca++, K+, Na+, Cl,, after the hemodialysis in Group 2 were not changed (P > 0.05). Moreover, the clearance rate of the dialyzers with citrate dialysate increased significantly compared with those of saline-flush and heparin anticoagulation. Conclusions:,The anticoagulant and dialytic effects of the new type citrate hemodialysis are satisfactory and better than that of saline-flush. [source]

    Specialized rules of gene transcription in male germ cells: the CREM paradigm*

    Lucia Monaco
    Summary Specialized transcription complexes that coordinate the differentiation programme of spermatogenesis have been found in germ cells, which display specific differences in the components of the general transcription machinery. The TATA-binding protein family and its associated cofactors, for example, show upregulated expression in testis. In this physiological context, transcriptional control mediated by the activator cAMP response element modulator (CREM) represents an established paradigm. Somatic cell activation by CREM requires its phosphorylation at a unique regulatory site (Ser117) and subsequent interaction with the ubiquitous coactivator CREB-binding protein. In testis, CREM transcriptional activity is controlled through interaction with a tissue-specific partner, activator of CREM in the testis (ACT), which confers a powerful, phosphorylation-independent activation capacity. The function of ACT was found to be regulated by the testis-specific kinesin KIF17b. Here we discuss some aspects of the testis-specific transcription machinery, whose function is essential for the process of spermatogenesis. [source]

    Value of prostate specific antigen ,1 -antichymotrypsin complex for the detection of prostate cancer in patients with a PSA level of 4.1,10.0ng/mL: Comparison with PSA-related parameters

    Hideaki Miyake
    Abstract Background: The aim of the present study was to evaluate the usefulness of prostate specific antigen ,1 -antichymotrypsin complex (PSA-ACT) in the differential diagnosis of prostate cancer in patients with a PSA level of 4.1,10.0 ng/mL compared to several PSA- and PSA-ACT-related parameters. Methods: Serum samples were obtained from 103 patients with no evidence of malignancy on biopsy and 29 with histologically confirmed prostate cancer. All patients had pretreatment serum PSA levels between 4.0 and 10.0 ng/mL. The different forms of serum PSA, including total PSA (tPSA), free PSA (fPSA) and PSA-ACT were measured using immunofluorometric techniques with different monoclonal antibodies against PSA and ACT. Furthermore, tPSA and PSA-ACT densities of the whole prostate (PSAD and ACTD, respectively) and the f-to-tPSA and the f-to-PSA-ACT ratios (F/T ratio and F/ACT ratio, respectively) were calculated. Results: The differences between patients with prostate cancer and benign prostatic disease were significant with respect to all six parameters examined in this study. Analysis of receiver operating characteristics revealed that the areas under the curve for PSA-ACT, ACTD and the F/ACT ratio were larger than those for tPSA, PSAD and the F/T ratio, respectively. However, there were no significant differences in discrimination between benign and malignant diseases among these six parameters. Conclusions: In patients who have an intermediate serum PSA level, PSA-ACT and its associated parameters may not be significantly superior in the differential diagnosis between prostate cancer and benign prostatic diseases compared to tPSA and its traditional relatives. [source]

    Blood Pressure and Brain Injury in Older Adults: Findings from a Community-Based Autopsy Study

    Lucy Y. Wang MD
    OBJECTIVES: To examine correlations between blood pressure (BP) and dementia-related pathological brain changes in a community-based autopsy sample. DESIGN: Prospective cohort study. SETTING: A large health maintenance organization in Seattle, Washington. PARTICIPANTS: A cohort of 250 participants aged 65 and older and cognitively normal at time of enrollment in the Adult Changes in Thought (ACT) Study and who underwent autopsy. MEASUREMENTS: BP and history of antihypertensive treatment were taken at enrollment. A linear regression model was used to examine the relationship between BP (systolic (SBP) and diastolic (DBP)) at enrollment and pathological changes in the cerebrum (cystic macroscopic infarcts, microinfarcts, neuritic plaques, neurofibrillary tangles, and cortical Lewy bodies). RESULTS: The presence of more than 2 microinfarcts, but not any other pathological change, was independently associated with SBP in younger participants (65,80, n=137) but not in older participants (>80, n=91). The relative risk (RR) for more than two microinfarcts with each 10-mmHg increase in SBP was 1.15 (95% confidence interval (CI)=1.00,1.33) in the younger participants, adjusted for age at entry, sex, and time to death. This RR was particularly strong in younger participants not taking antihypertensive medications (RR=1.48, 95% CI=1.21, 1.81); significant associations were not observed in participants treated for hypertension. Findings for DBP were negative. CONCLUSION: The association between high SBP and cerebrovascular damage in untreated older adults (65,80) suggests that adequate hypertension treatment may reduce dementia risk by minimizing microvascular injury to cerebrum. [source]

    Tax Costs and Signalling Benefits: The Impact of Surplus ACT

    Lynn Hodgkinson
    Companies with surplus ACT are faced with additional tax costs if they use dividends to signal information to investors, hence there is a trade-off between tax costs and signalling benefits. This paper provides evidence that investors' reactions to dividend surprises are influenced by the signal generated by earnings and tax planning considerations. The results indicate that in the presence of a positive earnings signal and a binding tax constraint, decreases in dividends are value enhancing. [source]

    Deep Hypothermic Circulatory Arrest and Bivalirudin Use in a Patient With Heparin-Induced Thrombocytopenia and Antiphospholipid Syndrome

    Kay B. Leissner M.D.
    Methods: Bivalirudin was used during CPB and deep hypothermic circulatory arrest (DHCA) for resection of multiple right atrial masses in a patient with HIT II and antiphospholipid antibodies syndrome (APS). Anticoagulation was monitored with the activated clotting time (ACT) and a target ACT of 450 seconds or greater was maintained. Results: Surgical removal of multiple right atrial masses was successful and there was no evidence of thromboembolic events. Clot was noticed in the cardiotomy and venous reservoir after CPB was discontinued and the system flushed. The postoperative course was uneventful. Conclusions: Anticoagulation was successfully managed with bivalirudin, a new short-acting, and direct thrombin inhibitor. Further studies are necessary to evaluate the safety of bivalirudin during DHCA. [source]

    Periprocedural Anticoagulation for Atrial Fibrillation Ablation

    Background: Catheter ablation for atrial fibrillation (AF) can increase risk of left atrial (LA) thrombi and stroke. Optimal periprocedural anticoagulation has not been determined. Objective: We report the role of administering warfarin and aspirin without low molecular weight heparin in patients undergoing AF ablation. Methods: A total of 207 patients underwent ablation for AF. Transesophageal echocardiography (TEE) guided transseptal puncture and ruled out clot in the LA. After first puncture, the sheath was flushed with heparin (5,000 Units/mL). After second puncture, a bolus of 80 units/kg of heparin was given, followed by an infusion to maintain activated clotting time (ACT) around 300,350 seconds. Warfarin was stopped and aspirin was started (325 mg/day) 3 days preprocedure. Warfarin was restarted on the day of the procedure. Both medications were continued for 6 weeks postablation. Warfarin was continued for 6 months in patients with prior history of persistent or recurrent AF. Thirty-seven patients who showed smoke in the LA on TEE were given low molecular weight heparin postprocedure until international normalized ratio (INR) was therapeutic. Results: Thirty-two patients had persistent and 175 had paroxysmal AF; 87 were cardioverted during ablation. Two patients had transient ischemic attack (TIA) on the sixth and eighth days, respectively, following ablation, with complete recovery. Both had subtherapeutic INRs. Conclusion: In patients without demonstrable clot or smoke in the LA, starting aspirin 3 days prior and warfarin immediately post-radiofrequency ablation, without low molecular weight heparin, with meticulous anticoagulation during the procedure, appears to be a safe mode of anticoagulation. [source]

    Intracardiac Ultrasound Detection of Thrombus on Transseptal Sheath: Incidence, Treatment, and Prevention

    Background: Transseptal (TS) catheterization is used for left atrial (LA) ablation procedures and a major risk is thromboembolism. The purpose of this study was to assess (1) the value of intracardiac ultrasound (ICUS) monitoring during LA ablation procedures, and (2) a new technique to reduce the risk of thrombus formation. Methods and Results: One hundred and eighty consecutive patients underwent TS catheterization under ICUS guidance with two sheaths for atrial fibrillation ablation and one for other LA procedures. Group I included the initial 90 patients in whom TS sheaths were flushed with a standard 2 U/cc concentration of heparin; group II consisted of the next 90 patients in whom sheaths were flushed with 1,000 U/cc concentration. All patients received bolus and infusion of heparin to maintain ACT between 250,300 seconds. ICUS was monitored throughout. In group I, echodense material at the tip of the sheath consistent with thrombus was observed on ICUS in 8 of 90 patients (9%) within 5,15 minutes of entering the LA. In group II, only 1 of 90 patient (1%) demonstrated thrombus (P < 0.001). There were no significant clinical differences in group I patients with and without thrombus. In all nine patients, the clot was removed with vigorous aspiration. No patients suffered a neurological event. Conclusion: Thrombus formation on TS sheath, detected by ICUS, may be more common than expected despite adequate anticoagulation. Using a higher concentration of heparin for the TS system before deployment reduced the risk. The thrombus was retrieved with aspiration without the need to abort the procedure. [source]

    Adapting and personalizing the communication in a synchronous communication tool

    A. Gogoulou
    Abstract In this paper, we present a synchronous text-based communication tool, referred to as Adaptive Communication Tool (ACT), which provides capabilities for adaptation and personalization. ACT supports both the free and the structured form of dialogue. The structured dialogue is implemented by two types of Scaffolding Sentence Templates (SST); i.e. sentence openers or communicative acts. The capability of adaptation is considered in the sense of making suggestions for the supported form of dialogue and SST type and providing the most meaningful and complete set of SST with respect to the learning outcomes addressed by the collaborative learning activity and the model of collaboration followed by the group members. Also, ACT enables learners to have control on the adaptation by selecting the form of dialogue and the SST type they prefer to use and enriching the provided SST set with their own ones in order to cover their communication needs. The results from the formative evaluation of the tool showed that (i) the proposed dialogue form, SST type and the provided set of SST cover students' communication needs, (ii) the capability of personalizing the communication by selecting the desired communication means as well as by enriching the provided SST set satisfied students, and (iii) students used adequately both types of SST resulting into on-task and coherent dialogues. [source]

    Formation of Malonaldehyde, Formaldehyde, and Acetaldehyde in Apple Juice Induced by Ionizing Radiation

    X. Fan And
    ABSTRACT: We investigated the effects of ionizing radiation on the formation of malonaldehyde (MA), formaldehyde (FA), and acetaldehyde (ACT) in apple juice. The formation of MA, FA, and ACT in both pasteurized and fresh juice increased with radiation dose. The G values (number of species formed per 100 eV absorbed) for MA, FA, and ACT in pasteurized juice were 0.0056, 0.061, and 0.044, respectively. MA concentration decreased rapidly during storage at 5°C, while ACT and FA did not. Irradiation-induced formation of MA, FA, and ACT decreased with decreasing irradiation temperature. Exclusion of oxygen during irradiation reduced formation of ACT and FA, but not MA. Adding 1000 ppm of ascorbate, sorbate, or sulfite to juice before irradiation also decreased MA formation. [source]


    Steven J. Arsenault


    Daniel M. Warner

    Assertive community treatment: development of the team, selection of clients, and impact on length of hospital stay

    A. Jones bn(hons) rmn rn(adult)
    Mental health services have been criticized for the lack of focus and response to people suffering from a serious mental illness (SMI). Assertive community treatment (ACT) offers the potential for greater partnership working between the user and provider of mental health services. The author describes one approach in developing ACT in the UK. Four criteria were developed to identify the most appropriate service users for ACT: those with SMI, illness instability, illness disability and risk to self or others. Fifty-five clients were identified using these criteria and tracked for their length of hospital stay and frequency of admission 2 years before acceptance to an ACT team and for 12 months after. Duration of hospital stay was unchanged although both the frequency and total numbers of bed days were reduced. [source]

    Clinical trial: benefits and risks of immunomodulators and maintenance infliximab for IBD-subgroup analyses across four randomized trials

    Summary Background, Benefits and risks of concomitant immunomodulators and maintenance infliximab in inflammatory bowel disease (IBD) patients have not been adequately evaluated. Aim, To assess the effect of concomitant immunomodulator and infliximab maintenance therapy using data from four prospective, randomized Phase 3 trials in IBD patients. Methods, Overall, 1383 patients from ACCENT I and ACCENT II [luminal and fistulizing Crohn's disease trials] and ACT 1 and ACT 2 [ulcerative colitis trials] were analysed. Patients were treated with placebo or infliximab 5 or 10 mg/kg at weeks 0, 2 and 6 followed by every-8-week maintenance therapy. Clinical response, clinical remission, fistula response, complete fistula response, infection and infusion reaction rates; serum infliximab concentrations and immunogenicity were summarized by baseline concomitant immunomodulator subgroup (use or non-use). Results, Overall, almost 40% of evaluated IBD patients received concomitant immunomodulators. Efficacy, infection, and serious infection rates were generally similar in patients who received maintenance therapy with or without concomitant immunomodulators. There were no consistent differences in serum infliximab concentrations with or without immunomodulators in patients who received scheduled maintenance therapy. Concomitant immunomodulators reduced infusion reactions and immunogenicity. Conclusion, Concomitant immunomodulators did not improve efficacy or pharmacokinetics in IBD patients who received maintenance infliximab. [source]

    Preliminary evaluation of hemostasis in neonatal foals using a viscoelastic coagulation and platelet function analyzer

    Barbara L. Dallap Schaer VMD, DACVECC, DACVS
    Abstract Objectives , To compare coagulation and platelet function parameters measured using a viscoelastic analyzer in 3 groups: foals presenting to a neonatal intensive care unit with presumed sepsis, normal foals, and adult horses. Design , Preliminary prospective trial. Setting , Veterinary teaching hospital. Animals , Ten clinically healthy foals, 13 clinically healthy adult horses, and 17 foals sequentially admitted for suspected sepsis. Intervention , A single citrated (3.8%) blood sample collected at admission was submitted for coagulation evaluation using a viscoelastic analyzer. Measurements and Main Results , Time to initial clot formation (ACT), clot rate (CR), platelet function, and time to peak parameters were collected from the signature generated with the associated software. Peak clot strength was collected manually from signature tracings. Signalment, presenting complaint, blood culture results, clinical progression, and outcome were collected from the medical record. Kruskal-Wallis testing was used to determine differences in coagulation parameters between groups, as well as to identify any associations between coagulation variables, foal variables, and outcome. Normal foals were more likely to have increased platelet function (P=0.04) compared with normal adult horses. Prolonged ACT (P=0.004) and decreased CR (P=0.03) were associated with foals with positive blood culture. There was a trend toward prolonged ACT and increased likelihood of death (P=0.06). Conclusions , Healthy foals differ in values measured by the viscoelastic coagulation and platelet function analyzer compared with healthy adult horses. ACT and CR abnormalities were more likely to be observed in foals with positive blood cultures. The viscoelastic coagulation and platelet function analyzer may be useful in identifying early hemostasic and platelet dysfunction in critically ill foals, particularly those that are septic. [source]

    Experience of maintenance infliximab therapy for refractory ulcerative colitis from six centres in England

    E. A. RUSSO
    Summary Background, Infliximab is used for treatment of Crohn's disease and, following the Active Ulcerative Colitis Trials (ACT) 1 and 2, it has been used as rescue and maintenance therapy in moderate and severe ulcerative colitis (UC). Aim, To report on English experience with maintenance infliximab in terms of response and colectomy rates and side-effect profile in UC. Methods, A retrospective audit conducted by using a web-based questionnaire filled in by 12 gastroenterologists from six English centres. Results, Of the 38 patients receiving induction with infliximab, 28 (73.6%) maintained an ongoing response (8-weekly infusions 5 mg/kg) for a mean duration of 16.8 months (range 4,59), with 21 (55.3%) being in remission. Three of 38 patients (7.9%) who also responded had a secondary loss of response after an average of 10 months (range 8,13); seven of 38 patients (18.4%) showed no response. The colectomy rate was seven of 38 (18.4%, five non-responders and two with secondary loss of response). Adverse effects occurred in five patients (13.2%). Two discontinued infliximab (alopecia, invasive breast cancer). The three less-severe adverse effects were acute and delayed-type hypersensitivity reactions and one persistent otitis media. Conclusion, Our experience suggests acceptable response rates, colectomy rates and side-effect profile of maintenance therapy with infliximab in moderate and severe UC. [source]

    Review article: infliximab therapy for inflammatory bowel disease , seven years on

    Summary Infliximab, the chimeric monoclonal IgG1 antibody to tumour necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease and extra-intestinal manifestations of inflammatory bowel disease. Recently, the active ulcerative colitis trials (ACT) studies have shown that infliximab is also efficacious to treat ulcerative colitis resistant to standard therapy. Induction with 5 mg/kg infliximab at weeks 0, 2 and 6 is advocated. The response to infliximab is improved when concomitant immunosuppressive therapy is given. As the majority of patients will relapse if not retreated, a long-term strategy is necessary. Although episodic therapy can be used, the optimal strategy is systematic maintenance treatment with 5 mg/kg intravenous (i.v.) every 8 weeks. Long-term maintenance therapy with infliximab results in a reduction of the rate of complications, hospitalizations and surgeries associated with Crohn's disease. Safety problems with the monoclonal antibody infliximab treatment mainly concern the formation of antibodies to infliximab, which may lead to infusion reactions, loss of response and serum sickness-like delayed infusion reactions. Latent tuberculosis needs to be screened for. The rate of other opportunistic infections is slightly increased mainly in patients treated concomitantly with immunosuppression. There is no evidence that malignancy rates in patients treated with antitumour necrosis factor strategies are increased. [source]


    METAPHILOSOPHY, Issue 1-2 2010
    Abstract: The concepts of virtue and right action are closely connected, in that we expect people with virtuous motives to at least often act rightly. Two well-known views explain this connection by defining one of the concepts in terms of the other. Instrumentalists about virtue identify virtuous motives as those that lead to right acts; virtue-ethicists identify right acts as those that are or would be done from virtuous motives. This essay outlines a rival explanation, based on the "higher-level" account of virtue defended in the author's Virtue, Vice, and Value. On this account rightness and virtue go together because each is defined by a (different) relation to some other, more basic moral concept. Their frequent coincidence is therefore like a correlation between A and B based not on either's causing the other but on their being joint effects of a single common cause. [source]


    Susan M. Denbo