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Common Occurrence (common + occurrence)
Selected AbstractsTwenty-five years quaternium-15 in the European baseline series: does it deserve its place there?CONTACT DERMATITIS, Issue 4 2010Anton C. De Groot For allergens to be included in the European baseline series, they should have allergy rates of at least 1%. In several studies quaternium-15 had lower scores. Also, many cases of sensitization are already detected by formaldehyde contact allergy. The aim of this study was to evaluate whether quaternium-15 deserves continued inclusion in the baseline series on the basis of current criteria: 1% positive reactions, common occurrence in the environment, many relevant reactions. We used the literature survey method in this study. Only the United Kingdom has rates consistently over 1%. The mean for all other countries together and for many individual nations is lower than 1%. At least half of the reactions are already detected by formaldehyde sensitivity, which lowers rates for allergy to quaternium-15 per se (i.e. not caused or at least detected by formaldehyde sensitivity) to less than 0.6% for all countries except the United Kingdom. Neither common occurrence in the environment nor a high percentage of relevant reactions has been ascertained. It may well be argued that quaternium-15 does not deserve its place in the European baseline series and could be incorporated in a cosmetic screening series or preservative series instead. In the United Kingdom, routine testing should be continued. [source] The Effects of Ambulance Diversion: A Comprehensive ReviewACADEMIC EMERGENCY MEDICINE, Issue 11 2006Julius Cuong Pham MD Objectives To review the current literature on the effects of ambulance diversion (AD). Methods The authors performed a systematic review of AD and its effects. PubMed, EMBASE, the Cochrane database, societal meeting abstracts, and references from relevant articles were searched. All articles were screened for relevance to AD. Results The authors examined 600 citations and reviewed the 107 articles relevant to AD. AD is a common occurrence that is increasing in frequency. AD is associated with periods of emergency department (ED) crowding (Mondays, mid-afternoon to early evening, influenza season, and when hospitals are at capacity). Interventions that redesign the AD process or that provide additional hospital or ED resources reduce diversion frequency. AD is associated with increased patient transport times and time to thrombolytics but not with mortality. AD is associated with loss of estimated hospital revenues. Short of anecdotal or case reports, no studies measured the effect of AD on ED crowding, morbidity, patient and provider satisfaction, or EMS resource utilization. Conclusions Despite its common use, there is a relative paucity of studies on the effects of AD. Further research into these effects should be performed so that we may understand the role of AD in the health system. [source] Temporal correlations and clustering of landslidesEARTH SURFACE PROCESSES AND LANDFORMS, Issue 10 2010Annette Witt Abstract This paper examines temporal correlations and temporal clustering of a proxy historical landslide time series, 2255 reported landslides 1951,2002, for an area in the Emilia-Romagna Region, Italy. Landslide intensity is measured by the number of reported landslides in a day (DL) and in an ,event' (Sevent) of consecutive days with landsliding. The non-zero values in both time series DL and Sevent are unequally spaced in time, and have heavy-tailed frequency-size distributions. To examine temporal correlations, we use power-spectral analysis (Lomb periodogram) and surrogate data analysis, confronting our original DL and Sevent time series with 1000 shuffled (uncorrelated) versions. We conclude that the landslide intensity series DL has strong temporal correlations and Sevent has likely temporal correlations. To examine temporal clustering in DL and Sevent, we consider extremes over different landslide intensity thresholds. We first examine the statistical distribution of interextreme occurrence times, ,, and find Weibull distributions with parameter , << 1·0 [DL] and , < 1·0 [Sevent]; thus DL and Sevent each have temporal correlations, but Sevent to a lesser degree. We next examine correlations between successive interextreme occurrence times, ,. Using autocorrelation analysis applied to ,, combined with surrogate data analysis, we find for DL linear correlations in ,, but for Sevent inconclusive results. However, using Kendall's rank correlation analysis we find for both DL and Sevent the series of , are strongly correlated. Finally, we apply Fano Factor analysis, finding for both DL and Sevent the timings of extremes over a given threshold exhibit a fractal structure and are clustered in time. In this paper, we provide a framework for examining time series where the non-zero values are strongly unequally spaced and heavy-tailed, particularly important in the Earth Sciences due to their common occurrence, and find that landslide intensity time series exhibit temporal correlations and clustering. Many landslide models currently are designed under the assumption that landslides are uncorrelated in time, which we show is false. Copyright © 2010 John Wiley & Sons, Ltd. [source] The Institutional Trap in the Czech Rental Sector: Nested Circuits of Power, Space, and InequalityECONOMIC GEOGRAPHY, Issue 4 2005Stefan Buzar Abstract: An "institutional trap" is a sequence of misplaced regulatory steps that have increased the costs of institutional transformation to the level at which inefficient structures can remain stable, despite changes in the external economic environment. This is a common occurrence in Central and Eastern Europe because of the path-dependent nature of the postsocialist transformation process. This article examines the organizational and territorial transformations of housing, utility, and social welfare policies in the Czech Republic through a comparative analysis of institutional power geometries and household expenditures at the national scale. The results indicate that the Czech Republic is facing an institutional trap in the restructuring of its rent control and social welfare policies. The trap operates within three nested circuits: the power geometries of postsocialist reforms, the geographies of housing prices and social welfare, and the consumption patterns of disadvantaged households. The lock-in created by the trap can be resolved only through carefully targeted and synchronized social support and housing investment programs, parallel to rent liberalization. This article argues for comprehensive, rather than partial, solutions to the institutional trap and emphasizes the need for a deeper understanding of the relationships among institutions, space, and inequality. [source] Mutational activation of the MAP3K8 protooncogene in lung cancerGENES, CHROMOSOMES AND CANCER, Issue 2 2004Adam Michael Clark The MAP3K8 protooncogene (Cot/Tpl-2) activates the MAP kinase, SAP kinase, and NF-,B signaling pathways. MAP3K8 mutations occur in the rat homologue, but activating mutations have yet to be identified in primary human tumors. We have identified MAP3K8 as a transforming gene from a human lung adenocarcinoma and characterized a 3, end mutation in the cDNA. In addition, we confirmed that the mutation occurs in the original lung tumor, and we screened a series of lung cancer cell lines to determine whether the MAP3K8 mutation is a common occurrence in lung tumorigenesis. The oncogene was isolated and identified with the NIH3T3 nude mouse tumorigenicity assay and cDNA library screening. The gene was analyzed by polymerase chain reaction (PCR), single-strand conformational polymorphism (SSCP), and 3,RACE for mutations. The mutation was localized to MAP3K8 exon 8 and confirmed in the primary tumor DNA. Both wild-type and mutant MAP3K8 cDNAs transformed NIH3T3 cells, but the transforming activity of the mutant was much greater than that of the wild type. PCR-SSCP screening of cell line cDNAs identified one silent polymorphism in cell line SK-LU-1. Although we were unable to find additional activating mutations, these data support a role for MAP3K8 activity in cellular transformation, but suggest that mutational activation of the gene is a rare event in lung cancer. © 2004 Wiley-Liss, Inc. [source] Cast titanium overlay denture for a geriatric patient with a reduced vertical dimensionGERODONTOLOGY, Issue 4 2005Satyabodh Guttal An older patient reporting to the dental surgery for his/her dental treatment is becoming a common occurrence. Improved oral hygiene has meant that teeth are retained for a longer time, along with the potential problems of attrition, decreased vertical dimension, temporomandibular joint discomfort/strain, and poor aesthetics. The case in question is that of a 65-year-old male patient who had severe attrition in the lower arch, temporomandibular joint pain and reduced vertical dimension. The maxillary arch had previously been restored with a fixed partial prosthesis. For restoration of the lower teeth, a removable cast titanium overlay denture was fabricated incorporating an increased vertical dimension. Porcelain facings were placed to restore the aesthetics of the anterior teeth. The titanium was cast in a semi-automatic electric arc, pressure type casting machine. A titanium overlay denture with porcelain facing on the anterior teeth may provide a means of restoring a patient's concerns regarding aesthetics and function. [source] Co-morbidity in the ageing haemophilia patient: the down side of increased life expectancyHAEMOPHILIA, Issue 4 2009E. P. MAUSER-BUNSCHOTEN Summary., Because of an increased life expectancy, (age-related) co-morbidity is becoming a common occurrence in haemophilia patients. In this review, haemophilia-related and non-haemophilia-related medical problems, treatment recommendations and psychosocial consequences in ageing haemophilia patients are discussed. Haemophilic arthropathy is an important cause of pain and disability, and a frequent indication for surgery in haemophilia patients. In addition, many adult patients are infected with hepatitis C or HIV, the consequences and treatment of which can add to physical and mental discomfort. Moreover, inhibitors against factor VIII can also develop in adulthood, especially in patients with mild haemophilia. Hypertension is reported to occur more often in haemophilia patients than in the general population. Other internal problems, like renal abnormalities, overweight, diabetes mellitus and hypercholesterolemia are discussed. Haemophilia seems to protect against cardiovascular disease, although the incidence is increasing. Recommendations are given on dealing with tooth extractions, surgical interventions and sexuality problems in patients with haemophilia. In addition to haemophilia in itself, co-morbidity has a major psychological impact, and an important effect on quality of life. It can also result in complex treatment regimens, in which coordination between health care workers is essential. [source] Management and prevention of postoperative Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 10 2009Miguel Regueiro MD Abstract Postoperative Crohn's disease (CD) recurrence is a common occurrence after intestinal resection. Currently, the optimal management of patients who have undergone surgical resection is unknown and treatment remains subjective. Clinicians in conjunction with patients must balance the risks of recurrence against the potential risks associated with treatment. For those at very low risk of recurrence, no therapy may be needed; however, for patients at moderate risk immunomodulators should be considered. For those at highest risk of recurrence, biologic therapy, specifically antitumor necrosis factor agents, have emerged as appropriate treatment. Any postoperative management strategy should include a colonoscopy 6,12 months after surgery to identify recurrence. This review discusses current evidence for various pharmacologic approaches in the prevention of postoperative recurrence and provides guidance for clarifying patient risk. (Inflamm Bowel Dis 2009) [source] Efficacy of urinary guidelines in the management of post-stroke incontinenceINTERNATIONAL JOURNAL OF UROLOGICAL NURSING, Issue 1 2009Stephanie Vaughn Abstract Urinary incontinence (UI) is common occurrence among stroke survivors and impacts their recovery. This mixed method study examined the effects of implementation of evidence-based urinary guidelines by the Interdisciplinary (ID) team in the management of post-stroke UI in stroke survivors in an acute rehabilitation hospital in Southern California. Essential elements of the guidelines included assessment of the bladder pattern, the urinary WBC's, the implementation of a scheduled toileting program, pelvic floor exercises, and the administration of Vitamin C 500 mg. by mouth. Functional Independent Measure (FIM) scores and urinary white blood cells (WBC's) were used to evaluate the efficacy the guidelines. Post guideline implementation FIM scores and urinary WBC's demonstrated improvement over the pre-scores. These results indicate that positive stroke outcomes were achieved following implementation. In addition, the ID team, comprised of nurses, physical therapists, speech pathologists, and occupational therapists, was queried as to the member's knowledge and perceptions of their roles in the implementation of the guidelines. Highlighted themes from the ID focus groups were communication and structure, relating that the guidelines were useful in promoting collaborative practice among the ID team members. [source] Locomotive assignment and freight train scheduling using genetic algorithmsINTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 4 2006T. Godwin Abstract This study considers the movement of freight trains through a passenger rail network, a common occurrence in many developing countries. Passenger trains run according to a fixed schedule while freight trains need to be accommodated and run on the same track, ensuring that they do not interfere with passenger train movements. Operationally, this requires the assignment of a locomotive to a freight rake and then creating a workable schedule. Accordingly, we propose to solve the problem in two phases. In the first phase, we assign locomotives with partial scheduling with the objectives of minimizing total deadheading time and total coupling delay. We use a genetic algorithm to find non-dominant locomotive assignment solutions and propose a method for evaluating its performance. The solutions are then ranked using two approaches, based on the decision maker's preferences. In the second phase, we select a locomotive assignment solution based on the ranking and find the lower bound on the arrival time of freight trains at their destinations. We use a genetic algorithm again to schedule the freight trains in the passenger rail network, with prescribed locomotive assignment precedence constraints with the objective of minimizing total tardiness. Computational results confirm the efficacy of the proposed method. [source] 5,-reductase inhibition for men with enlarged prostateJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 8 2007MBA (Associate Professor of Urology), Muta M. Issa MD Abstract Purpose: Increasingly, men with lower urinary tract symptoms (LUTS) are seeking treatment in the primary care setting. This article reviews the use of ,-blockers and 5,-reductase inhibitors (5ARIs) in the management of LUTS and enlarged prostate. Data sources: Information is based on a critical review of the published literature. Relevant studies were identified using MEDLINE and review of reference lists of published studies. Conclusions: Enlargement of the prostate is a common occurrence among aging men. Nurse practitioners (NPs) are in a unique, frontline position to evaluate symptoms and bother and to recommend appropriate treatment of patients with enlarged prostate. Both ,-blockers and 5ARIs are effective at reducing symptoms in the short term. However, only the 5ARIs impact disease progression and maintain improvement in symptoms in the long term. Implications for practice: NPs play an important role in assessing and treating LUTS in men with enlarged prostate. When treating men with LUTS, assess the severity of symptoms and the extent of prostate enlargement. For symptomatic men with enlarged prostate, long-term therapy with 5ARIs should be considered to treat symptoms as well as address the disease progression. [source] Clinical trial: the efficacy and safety of routine bowel cleansing agents for elective colonoscopy in persons with spinal cord injury , a randomized prospective single-blind studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2009H. R. ANCHA Summary Background, As difficulty with evacuation is a common occurrence in individuals with spinal cord injury, preparation prior to colonoscopy may be suboptimal and, perhaps, more hazardous. Aim, To assess the safety and efficacy of bowel cleansing regimens in persons with spinal cord injury. Methods, Randomized, prospective, single blind study comparing polyethylene glycol (PEG), oral sodium phosphosoda (OSPS) and combination of both for colonic preparation prior to colonoscopy in subjects with spinal cord injury. Results, Thirty six subjects with eGFR ,60 mL/min/1.73 m2 were randomized to PEG or OSPS or PEG+OSPS. Regardless of bowel preparation employed, >73% of subjects had unacceptable colonic cleansing. No subject in the OSPS preparation group demonstrated a decrease in eGFR or an increase in serum creatinine concentration from the baseline. OSPS and PEG+OSPS preparations caused a transient change in serum potassium, phosphate and calcium concentrations, but no change in electrolytes was noted in the PEG group. Conclusions, Neither OSPS alone, PEG alone nor their combination was sufficient to prepare adequately the bowel for colonoscopy in most patients with spinal cord injury. However, administration of OSPS and/or PEG appears to be safe in the spinal cord injury population, provided adequate hydration is provided. [source] Heparin-independent activation of platelets by heparin-induced thrombocytopenia antibodies: a common occurrenceJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 1 2008I. SOCHER First page of article [source] Incidence and Clinical Relevance of Hyperglycemia in Critically Ill DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2007Danna M. Torre Background: Hyperglycemia associated with critical illness in nondiabetic human patients is a common occurrence in the intensive care unit (ICU), with a reported incidence as high as 71%. Hypothesis: Hyperglycemia in critically ill dogs increases the risk of morbidity and mortality. Animals: Two hundred forty-five dogs hospitalized in the ICU over a 2-month period were evaluated. Methods: Prospective observational study was conducted over a 2-month period. All dogs in the ICU had their highest daily blood glucose concentration recorded. All dogs with diabetes were excluded from the study. Hyperglycemia was defined as a blood glucose concentration >120 mg/dL. Dogs with hyperglycemia were monitored for persistence and resolution of hyperglycemia. Results: During the study period, 245 dogs were evaluated, of which 38 (16%) were hyperglycemic. Twenty-six percent (10/ 38) developed hyperglycemia during hospitalization, whereas 74% (28/38) were hyperglycemic at presentation. Length of hospitalization (LOH) was shorter in dogs that presented with hyperglycemia compared with those that developed hyperglycemia during hospitalization (P= .001). Seventy-one percent (27/38) of dogs were discharged from the hospital, whereas the remaining 29% (11/38) died or were euthanatized. Nonsurvivors had significantly higher median glucose concentration (median, 176 mg/dL; range 122,310 mg/dL) than did survivors (median, 139 mg/dL; 121,191 mg/dL; P= .021). Conclusions and Clinical Importance: The incidence of hyperglycemia in this population of dogs was 16%. Dogs that developed hyperglycemia had longer LOH and nonsurvivors had more pronounced hyperglycemia than did survivors. [source] Phylogenetic reconstruction of carnivore social organizationsJOURNAL OF ZOOLOGY, Issue 1 2007F. Dalerum Abstract It is generally assumed that carnivore social organizations evolved directionally from a solitary ancestor into progressively more advanced forms of group living. Although alternative explanations exist, this evolutionary hypothesis has never been tested. Here, I used literature data and maximum likelihood reconstruction on a complete carnivore phylogeny to test this hypothesis against two others: one assuming directional evolution from a non-solitary ancestor, and one assuming parallel evolutions from a socially flexible ancestor, that is, an ancestor with abilities to live in a variety of social organizations. The phylogenetic reconstructions did not support any of the three hypotheses of social evolution at the root of Carnivora. At the family level, however, there was support for a non-solitary and socially flexible ancestor to Canidae, a socially flexible or solitary ancestor to Mustelidae, a solitary or socially flexible ancestor to Mephitidae, a solitary or group living ancestor to Phocidae, a group living ancestor to Otariidae and a solitary ancestor to Ursidae, Felidae, Herpestidae and Viverridae. There was equivocal support for the ancestral state of Procyonidae and Hyaenidae. It is unclear whether the common occurrence of a solitary ancestry at the family level was caused by a solitary ancestor at the root of Carnivora or by multiple transitions into a solitary state. The failure to support a solitary ancestor to Carnivora calls for caution when using this hypothesis in an evolutionary framework, and I suggest continued investigations of the pathways of the evolution of carnivore social organizations. [source] Global gene expression analysis of bovine somatic cell nuclear transfer blastocysts and cotyledonsMOLECULAR REPRODUCTION & DEVELOPMENT, Issue 5 2009K.I. Aston Low developmental competence of bovine somatic cell nuclear transfer (SCNT) embryos is a universal problem. Abnormal placentation has been commonly reported in SCNT pregnancies from a number of species. The present study employed Affymetrix bovine expression microarrays to examine global gene expression patterns of SCNT and in vivo produced (AI) blastocysts as well as cotyledons from day-70 SCNT and AI pregnancies. SCNT and AI embryos and cotyledons were analyzed for differential expression. Also in an attempt to establish a link between abnormal gene expression patterns in early embryos and cotyledons, differentially expressed genes were compared between the two studies. Microarray analysis yielded a list of 28 genes differentially expressed between SCNT and AI blastocysts and 19 differentially expressed cotyledon genes. None of the differentially expressed genes were common to both groups, although major histocompatibility complex I (MHCI) was significant in the embryo data and approached significance in the cotyledon data. This is the first study to report global gene expression patterns in bovine AI and SCNT cotyledons. The embryonic gene expression data reported here adds to a growing body of data that indicates the common occurrence of aberrant gene expression in early SCNT embryos. Mol. Reprod. Dev. 76: 471,482, 2009. © 2008 Wiley-Liss, Inc. [source] Precessing warped accretion discs in X-ray binariesMONTHLY NOTICES OF THE ROYAL ASTRONOMICAL SOCIETY, Issue 4 2001G. I. Ogilvie We study the radiation-driven warping of accretion discs in the context of X-ray binaries. The latest evolutionary equations are adopted, which extend the classical alpha theory to time-dependent thin discs with non-linear warps. We also develop accurate, analytical expressions for the tidal torque and the radiation torque, including self-shadowing. We investigate the possible non-linear dynamics of the system within the framework of bifurcation theory. First, we re-examine the stability of an initially flat disc to the Pringle instability. Then we compute directly the branches of non-linear solutions representing steadily precessing discs. Finally, we determine the stability of the non-linear solutions. Each problem involves only ordinary differential equations, allowing a rapid, accurate and well-resolved solution. We find that radiation-driven warping is probably not a common occurrence in low-mass X-ray binaries. We also find that stable, steadily precessing discs exist for a narrow range of parameters close to the stability limit. This could explain why so few systems show clear, repeatable ,superorbital' variations. The best examples of such systems, Her X-1, SS 433 and LMC X-4, all lie close to the stability limit for a reasonable choice of parameters. Systems far from the stability limit, including Cyg X-2, Cen X-3 and SMC X-1, probably experience quasi-periodic or chaotic variability as first noticed recently by Wijers and Pringle. We show that radiation-driven warping provides a coherent and persuasive framework but that it does not provide a generic explanation for the long-term variabilities in all X-ray binaries. [source] Why some regions will decline: A Canadian case study with thoughts on local development strategies,PAPERS IN REGIONAL SCIENCE, Issue 1 2006Mario Polèse Regional development; local development; periphery; location; economic decline Abstract., The authors present the case of five Canadian peripheral regions, which they argue are destined to decline. The explanation of the reasons why future decline (in absolute population and employment numbers) is inevitable constitutes the article's central focus. The authors suggest that regional decline will become an increasingly common occurrence in nations at the end of the demographic transition whose economic geographies display centre-periphery relationships. Such broad structural trends cannot be easily altered by public policy. The authors reflect on the implications of regional decline for the formulation of local economic development strategies. Local economic development strategies should not, they argue, be advanced as a means of arresting population and employment decline. To suggest that the regions studied in this article will decline because of a lack of social capital or insufficient number of local entrepreneurs, is not only misleading but may also be counterproductive. [source] A New Apparatus for Particle Impact TestsPARTICLE & PARTICLE SYSTEMS CHARACTERIZATION, Issue 4 2003Yevgeny Petukhov Abstract Breakage and chipping of particles due to collision with a hard surface is a common occurrence in many conveying and handling systems, such as pneumatic conveying and jet-mills. Studies of the breakage mechanism of particles due to impact and the effect of impact velocity and the number of impacts have been investigated in depth both experimentally and theoretically. In this paper, a new concept and apparatus are introduced for conducting particle impact tests. In most of the published test rigs, particles were accelerated towards a target. In our apparatus, the target moves and hits the particles. Using this concept, the machine can operate in a vacuum, which will reduce errors caused by air streams and turbulence. The performance of the new apparatus is analyzed and the breakage phenomenon is discussed, to some extent, for two materials. The results are presented in terms of the increase in the weight percentage of the feed broken and the decrease in the weight median size as the impact velocity or number of impacts increases. [source] Leaf Epidermal Hydathodes and the Ecophysiological Consequences of Foliar Water Uptake in Species of Crassula from the Namib Desert in Southern AfricaPLANT BIOLOGY, Issue 2 2000C. E. Martin Abstract: Epidermal hydathodes were found on leaves of 46 of 48 species of Crassula collected from the Namib Desert in southern Africa. The possibility that these structures might allow the absorption of surface water was investigated in 27 species (including subspecies). The presence of hydathodes on leaf epidermi correlated, in most cases, with increases in leaf thickness and enhanced rates of nocturnal, and sometimes diurnal, CO2 uptake following wetting of the leaves during the night. The precise nature of these responses varied depending on the species. In addition, wetting only the older leaves on the lower portion of the shoot of C. tetragona ssp. acutifolia not only resulted in increased thickness of these leaves, but also effected an increase in leaf thickness and stimulation of CO2 uptake rates in the distal, younger portion of the shoot that was not wetted. Overall, foliar hydathodes were implicated in the absorption of surface water in many species of Crassula such that the ecophysiology of these desert succulents was positively affected. Although rainfall in the Namib Desert is infrequent, surface wetting of the leaves is a more common occurrence as a result of nighttime dew or fog deposition. Presumably, species with hydathodes benefit directly from this source of moisture. These findings have important implications in understanding a relatively unexplored adaptation of some xerophytes to an extremely arid environment. [source] Relational Aggression and Adverse Psychosocial and Physical Health Symptoms Among Urban AdolescentsPUBLIC HEALTH NURSING, Issue 6 2009Jessica Roberts Williams ABSTRACT Objectives: The purpose of this study was to examine relational aggression and its relationship with adverse psychosocial and physical health symptoms among urban, African American youth. Design and Sample: Quantitative, cross-sectional survey design. The sample consisted of 185 predominantly African American (95.1%) seventh-grade students (mean age: 13.0; female: 58%) attending 4 urban middle schools. Measures: The Children's Social Behavior Scale and Social Experience Questionnaire were used to measure relational aggression and relational victimization. The Pediatric Symptom Checklist was used to assess psychosocial difficulties, including internalizing behaviors, externalizing behaviors, and attention problems. Physical health symptoms were measured with questions about colds/flu, headaches, and stomach aches. Results: 2-way multivariate analysis of variance revealed significant differences in externalizing behavior, with perpetrators reporting higher levels than nonperpetrators. Victims reported more internalizing behavior than nonvictims; however, this was only significant for males. For females, significant negative effects on health outcomes were found, resulting from the interaction of perpetration and victimization. Conclusions: Findings suggest that relational aggression is a common occurrence among urban, minority adolescents and may result in adverse health outcomes. These results provide several avenues for future research and implications for healthcare practice. Intervention strategies are needed to prevent relational aggression and continual or subsequent adverse health symptoms. [source] A Special Orogenic-type Rare Earth Element Deposit in Maoniuping, Sichuan, China: Geology and GeochemistryRESOURCE GEOLOGY, Issue 3 2001Denghong WANG Abstract: The Maoniuping REE deposit is the second largest light rare earth elements deposit in China, explored recently in the northern Jinpingshan Mountains, a Cenozoic intracontinental orogenic belt in southwestern China. It is a vein-type deposit hosted within, and genetically related to, carbonatite-alkalic complex. Field investigation and new geochemical data of the carbonatites from the carbonatite-alkalic complex support an igneous origin for the Maoniuping carbonatites and related REE mineralization. Carbonatite itself carries rare earth elements which were enriched by hydrothermal solution. It is known that most of the REE deposits related to carbonatite-alkalic complexes were formed in relatively stable tectonic setting such as cratonic or rifting environment. The Maoniuping deposit, however, was formed during the processes of Cenozoic orogeny. Although the Maoniuping deposit is located in the north sector of the Panxi paleo-rift zone, the rift had been closed before early Cenozoic and evolved into an intracontinental orogenic belt, i.e., the Jinpingshan Orogen, which was formed since later Mesozoic to early Cenozoic. Geochronological and geochemical data also prove that the Maoniuping REE deposit was formed in an intracontinental orogenic belt instead of rift system or stationary block. The Maoniuping REE deposit is similar to the Mountain Pass REE deposit in many respects such as the high contents of bastnaesite and barite, the low content of niobium, and the common occurrence of sulfides. The discovery of the Maoniuping deposit and other REE deposits during the past two decades suggest a good potential for prospecting REE deposits along the alkalic complex belt located on the eastern side of the Qinghai,Xizang,West Sichuan Plateau. [source] Hereditary Breast Cancer: Part I. Diagnosing Hereditary Breast Cancer SyndromesTHE BREAST JOURNAL, Issue 1 2008Henry T. Lynch MD Abstract:, Hereditary breast cancer (HBC) accounts for as much as 10% of the total BC burden. Most of these cases will be found to be due to a BRCA germline mutation. An estimated additional 15,20% of those affected with BC will have one or more first- and/or second-degree relatives with BC. Therefore, when these numbers are combined, familial BC risk accounts for approximately 20,25% of the total BC burden. However, because of the often limited information on family history in the etiologic assessment of BC, this may be an underestimate. Confounding factors include its phenotypic and genotypic heterogeneity, given the association of HBC with a plethora of differing cancer syndromes. Its most common occurrence is its association with ovarian cancer in the so-called hereditary breast-ovarian cancer syndrome due to BRCA1 and BRCA2 mutations. More rarely, it occurs in the Li-Fraumeni syndrome, caused by a p53 germline mutation, in which markedly early-onset BC is found in association with brain tumors, sarcomas, leukemia, lymphoma, malignant melanoma, and adrenal cortical carcinoma. Importantly, the age-adjusted incidence of BC in women in the United States fell sharply, by 6.7%, in 2003, when compared with the rate identified in 2002. We postulate that increasing knowledge about the genetics of BC may have partially contributed to the identification of high-risk patients who thereby may have benefited significantly from early diagnosis. [source] Doubly adaptive biased coin designs with delayed responsesTHE CANADIAN JOURNAL OF STATISTICS, Issue 4 2008Feifang Hu Abstract In clinical studies, patients are usually accrued sequentially. Response-adaptive designs are then useful tools for assigning treatments to incoming patients as a function of the treatment responses observed thus far. In this regard, doubly adaptive biased coin designs have advantageous properties under the assumption that their responses can be obtained immediately after testing. However, it is a common occurrence that responses are observed only after a certain period of time. The authors examine the effect of delayed responses on doubly adaptive biased coin designs and derive some of their asymptotic properties. It turns out that these designs are relatively insensitive to delayed responses under widely satisfied conditions. This is illustrated with a simulation study. Plans aléatoires non équilibrés doublement adaptatifs avec délais de réponse Dans les études cliniques, les patients arrivent souvent séquentiellement. Aussi souhaite-t-on disposer de plans adaptatifs permettant d'assigner des traitements aux nouveaux patients au vu des résultats observés jusque-là. À cet égard, les plans aléatoires non équilibrés doublement adaptatifs sont avantageux dans la mesure où un test permet d'observer sans délai l'effet d'un traitement. Toutefois, il arrive aussi qu'un traitement ne fasse effet qu'après un temps. Les auteurs examinent les répercussions de tels délais sur les plans aléatoires non équilibrés doublement adaptatifs, dont ils dégagent certaines propriétés asymptotiques. Il s'avère que sous des conditions assez générales, ces plans sont plutôt insensibles aux délais. Une étude de simulation illustre le propos. [source] What can we learn from psychoanalysis and prospective studies about chemically dependent patients?THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS, Issue 2 2004Sérgio de Paula Ramos Despite the common occurrence of drug abusers in the psychoanalytic clinic, contemporary literature on the subject, particularly among publications in the IJP, is sparse. This paper aims to review the most important psychoanalytic contributions on drug dependency in the past 100 years, then attempts to compare their postulations to the findings ofpertinent prospective studies. In these patients, a persistent symbiotic object relationship is found, which ties them to narcissistic functioning, where drug use is viewed in the light of both pleasure without object and omnipotently controlled need. The author also discusses the possible contribution of the mother and father in the genesis of this condition, focusing on the compromise of the paternal function as the deciding factor. The theoretical and technical implications of this approach are illustrated by clinical material. [source] Understanding fire fighting in new product development,THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 5 2001Nelson P. Repenning Despite documented benefits, the processes described in the new product development literature often prove difficult to follow in practice. A principal source of such difficulties is the phenomenon of fire fighting-the unplanned allocation of resources to fix problems discovered late in a product's development cycle. While it has been widely criticized, fire fighting is a common occurrence in many product development organizations. To understand both its existence and persistence, in this article I develop a formal model of fire fighting in a multiproject development environment. The major contributions of this analysis are to suggest that: (1) fire fighting can be a self-reinforeing phenomenon; and (2) multiproject development systems are far more susceptible to this dynamic than is currently appreciated. These insights suggest that many of the current methods for aggregate resource and product portfolio planning, while necessary, are not sufficient to prevent fire fighting and the consequent low performance. [source] Unplanned extubation in a paediatric intensive care unit: impact of a quality improvement programmeANAESTHESIA, Issue 11 2008P. S. L. Da Silva Summary Unplanned tracheal extubation is an important quality issue in current medical practice as it is a common occurrence in paediatric intensive care units. We have assessed the effectiveness of a continuous quality improvement programme in reducing the incidence of unplanned extubation over a 5-year period. After a 2-year baseline period, we developed action plans to address the issues identified. Following implementation of the programme, the overall incidence of unplanned extubation decreased from 2.9 unplanned extubations per 100 intubated patient days in the first year to 0.6 in the last year (p = 0.0001). This reduction was the result of a decrease in unplanned extubation in children younger than 2 years of age. Although mortality was similar to that of children who did not experience an unplanned extubation, those with an unplanned extubation had a significantly longer duration of mechanical ventilation, longer stay in the intensive care unit, and longer hospital stay. We found that the implementation of a continuous quality improvement programme is effective in reducing the overall incidence of unplanned extubations. [source] Fate of the infrapatellar branch of the saphenous nerve post total knee arthroplastyANZ JOURNAL OF SURGERY, Issue 9 2005Dinshaw Mistry Background:, The infrapatellar branch of the saphenous nerve is a known cause of morbidity following knee surgery. The incidence of sensory changes following total knee arthroplasty, and its effect on patient satisfaction with arthroplasty surgery remain undocumented. Our aim was to document the incidence of infrapatellar nerve palsy following total knee arthroplasty and its effect on patient satisfaction. Methods:, Between 1 January 2002 and 31 December 2003 all patients attending outpatients clinic for primary total knee joint arthroplasty were prospectively tested for sensory defects. Patients were then assessed postoperatively and satisfaction was measured using the British Orthopaedic Satisfaction Score and a visual analogue scale. Results:, Thirty-one patients satisfied inclusion criteria of which 21 agreed to participate. One patient was excluded later in the study leaving 20 patients. Seventy per cent of patients had sensory changes in the area supplied by the infrapatellar branch of the saphenous nerve. Patient satisfaction scores did not correlate to the presence of a sensory deficit. Two patients stated that the sensory deficit was a significant factor in their dissatisfaction with their arthroplasty surgery. Conclusions:, Sensory changes due to damage to the infrapatellar branch of the saphenous nerve during total knee joint arthroplasty is a common occurrence and can interfere with patient satisfaction. Patients should be informed of this risk in the preoperative discussion. [source] Postoperative confusion assessed with the Short Portable Mental Status QuestionnaireANZ JOURNAL OF SURGERY, Issue 9 2003Amirarsalan Eissa Background: Confusion is a common occurrence after cardiac surgery. However, there is great variability in the reported incidence of confusion in patients following cardiac surgery, mainly due to the diagnostic methods and instruments employed in assessing confusion. Methods: Forty-eight cardiac surgery patients were assessed for postoperative confusion by a non-structured physician interview, and by the short portable mental status questionnaire (SPMSQ) administered by a medical student. Results: The non-structured ward interviews detected confusion in one of the 48 patients (2%), whereas the SPMSQ diagnosed confusion in 15 of the 48 patients (31%). Conclusion: Unlike a subjective ward interview, the SPMSQ is a brief and objective diagnostic tool that can be used to measure accurately both the presence and severity of confusion in postoperative cardiac surgery patients. [source] Delirium in Older Emergency Department Patients: Recognition, Risk Factors, and Psychomotor SubtypesACADEMIC EMERGENCY MEDICINE, Issue 3 2009Jin H. Han MD Abstract Objectives:, Missing delirium in the emergency department (ED) has been described as a medical error, yet this diagnosis is frequently unrecognized by emergency physicians (EPs). Identifying a subset of patients at high risk for delirium may improve delirium screening compliance by EPs. The authors sought to determine how often delirium is missed in the ED and how often these missed cases are detected by admitting hospital physicians at the time of admission, to identify delirium risk factors in older ED patients, and to characterize delirium by psychomotor subtypes in the ED setting. Methods:, This cross-sectional study was a convenience sample of patients conducted at a tertiary care, academic ED. English-speaking patients who were 65 years and older and present in the ED for less than 12 hours at the time of enrollment were included. Patients were excluded if they refused consent, were previously enrolled, had severe dementia, were unarousable to verbal stimuli for all delirium assessments, or had incomplete data. Delirium status was determined by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) administered by trained research assistants (RAs). Recognition of delirium by emergency and hospital physicians was determined from the medical record, blinded to CAM-ICU status. Multivariable logistic regression was used to identify independent delirium risk factors. The Richmond Agitation and Sedation Scale was used to classify delirium by its psychomotor subtypes. Results:, Inclusion and exclusion criteria were met in 303 patients, and 25 (8.3%) presented to the ED with delirium. The vast majority (92.0%, 95% confidence interval [CI] = 74.0% to 99.0%) of delirious patients had the hypoactive psychomotor subtype. Of the 25 patients with delirium, 19 (76.0%, 95% CI = 54.9% to 90.6%) were not recognized to be delirious by the EP. Of the 16 admitted delirious patients who were undiagnosed by the EPs, 15 (93.8%, 95% CI = 69.8% to 99.8%) remained unrecognized by the hospital physician at the time of admission. Dementia, a Katz Activities of Daily Living (ADL) , 4, and hearing impairment were independently associated with presenting with delirium in the ED. Based on the multivariable model, a delirium risk score was constructed. Dementia, Katz ADL , 4, and hearing impairment were weighed equally. Patients with higher risk scores were more likely to be CAM-ICU positive (area under the receiver operating characteristic [ROC] curve = 0.82). If older ED patients with one or more delirium risk factors were screened for delirium, 165 (54.5%, 95% CI = 48.7% to 60.2%) would have required a delirium assessment at the expense of missing 1 patient with delirium, while screening 141 patients without delirium. Conclusions:, Delirium was a common occurrence in the ED, and the vast majority of delirium in the ED was of the hypoactive subtype. EPs missed delirium in 76% of the cases. Delirium that was missed in the ED was nearly always missed by hospital physicians at the time of admission. Using a delirium risk score has the potential to improve delirium screening efficiency in the ED setting. [source] | |||||||||||||||||||||||||||||||