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Contemporary Practice (contemporary + practice)
Selected AbstractsCommunity Nutrition: Applying Epidemiology to Contemporary Practice, 2nd editionMATERNAL & CHILD NUTRITION, Issue 3 2009Mieke Faber [source] Clinical Outcomes for Single Stent and Multiple Stents in Contemporary PracticeCLINICAL CARDIOLOGY, Issue 9 2009Qiao Shu Bin MD Background Stents had been demonstrated to be safe and effective in the treatment of severe coronary artery disease (CAD); however, the current knowledge on percutaneous coronary intervention (PCI) in treating patients requiring 2 or more stents placements is still limited. Hypothesis Patients who required 2 or more stents might have worse clinical outcomes. Methods A total of 2371 patients who underwent stenting were divided into a single stenting group (n = 1233) and a multiple stenting group (n = 1138). We assessed the cumulative incidence of major adverse cardiac events (death, acute myocardial infarction, and target-vessel revascularization) and stent thrombosis during 1-year follow-up. Results The 1-year unadjusted cumulative incidence of major adverse cardiac events was 7.7% in the multiple stenting group and 5.4% in the single stenting group (P = 0.02 by log-rank test). After adjustment, there was a trend toward a lower rate of 1-year major adverse cardiac events in the single stenting group than in the multiple stenting group (P = 0.09). A nonsignificant trend was also detected in favor of the single stenting group, as compared with the multiple stenting group, at the rate of acute myocardial infarction (1.3% vs 1.7%, P = 0.89) and at the rate of target-vessel revascularization (4.5% vs 5.4%, P = 0.08). Conclusions Although the use of a single stent in coronary artery disease has less incidence of adverse cardiac events at 1 year as compared with the use of multiple stents, the difference was not statistically significant. Copyright © 2009 Wiley Periodicals, Inc. [source] The impact of the 2005 International Society of Urological Pathology (ISUP) consensus on Gleason grading in contemporary practiceHISTOPATHOLOGY, Issue 4 2009Piotr Zareba Aims:, To investigate the impact of the 2005 International Society of Urological Pathology (ISUP) Gleason grading consensus in contemporary practice. Methods and results:, The Gleason scores (GS) were compared in two consecutive patient cohorts with matched biopsies and prostatectomies: (i) 908 patients evaluated before the ISUP consensus (July 2000,June 2004) and (ii) 423 patients evaluated after the ISUP consensus (October 2005,June 2007). All biopsies and prostatectomies were performed and scored in one institution and were sampled and processed identically. There was a higher percentage of biopsy and prostatectomy specimens with GS , 7 after the ISUP consensus (GS , 7 on biopsy in 32% before ISUP versus 46% after ISUP; GS , 7 on prostatectomy in 53% before ISUP versus 68% after ISUP; P < 0.001). No significant difference in the complete and ±1 unit Gleason agreement was found before and after the ISUP consensus. There was a trend towards better complete agreement for GS , 7 after the ISUP consensus. Conclusions:, There was a shift towards higher GS on biopsy and prostatectomy in our practice after the ISUP consensus, although , there was no significant impact on the biopsy,prostatectomy Gleason agreement. The significance of this shift for patient management and prognosis is uncertain. [source] D2 gastrectomy , a safe operation in experienced hands,INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2005R.S. Date Summary In the contemporary practice, surgery is the only potentially curative treatment available for gastric cancer. However, there is no consensus on the extent of surgical resection. Advantages of D2 gastrectomy in terms of morbidity, mortality, local recurrence and survival are confirmed in Japanese as well as some European trials. In our hospital, all patients with operable gastric cancer are treated with D2 gastrectomy along with splenectomy and distal pancreatectomy followed by jejunal pouch reconstruction. The study was undertaken to evaluate our practice in terms of postoperative morbidity and mortality. All the patients who had total gastrectomy for gastric carcinoma from January 1995 to December 2000 were included in the study. During this 6-year period, 33 patients underwent potentially curative D2 gastrectomy. Postoperative morbidity and mortality were 18 and 9%, respectively. There were no anastomotic leaks. Three (9%) patients developed dysphasia, of which two (6%) had anastomotic stricture requiring dilatation. We feel D2 gastrectomy with splenectomy and distal pancreatectomy when performed electively is a safe procedure in experienced hands. Oesophago-jejunal anastomosis can be safely performed using circular stapler. [source] From the outside looking in: the praxis dilemma of linking psychopolitical validity with community policingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2008Brian N. Williams The author applies the concept of psychopolitical validity beyond the confines of the academy to the contemporary practice of American community policing. As such, it presents the promise and pitfalls of this potential union by highlighting points of linkage and places of conflict and tension and provides a commentary on the praxis dilemma of grafting the theoretical with the practical. © 2008 Wiley Periodicals, Inc. [source] Managerial Dimensions of Organizational Health: The Healthy Leader at Work*JOURNAL OF MANAGEMENT STUDIES, Issue 2 2007James Campbell Quick abstract This introductory article recollects The Call for this Special Issue, which framed the development of the work and the review process. In addition, the article discusses the concept of organizational health, addressing both issues of healthy individuals and healthy organizations. The heart of the article is a discussion of the Goolsby Leadership Model, one healthy model of leadership. We suggest that the healthy leader is the touchstone for organizational health. The article includes a section which introduces the six competitively selected manuscripts included in the special issue. An agenda for closing gaps in scientific knowledge and in contemporary practice provides the conclusion for the article. [source] What is the Slowest-Yet-Normal Cervical Dilation Rate Among Nulliparous Women With Spontaneous Labor Onset?JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2010Jeremy L. Neal ABSTRACT Objective: To integrate research literature that has provided insights into the cervical dilation rate that may best describe the slowest-yet-normal dilation rate among nulliparous women when beginning with criteria commonly associated with active labor onset. Data Sources: A literature search from 1950 through 2008 was conducted using the Medline electronic database, reference lists from identified articles, and other key references. Study Selection: Research reports written in English with a focus on the cervical dilation and/or labor duration of low-risk, nulliparous women with spontaneous labor onset. Data Extraction: Classic and contemporary research literature was reviewed and organized under the following subheadings: Friedman Studies, Partograph Studies, Active Management of Labor Studies, Additional Studies. Data Synthesis: An integrative review of the literature approximated the slowest-yet-normal cervical dilation rate for nulliparous women when beginning with criteria commonly associated with active labor. Conclusions: The slowest-yet-normal linear dilation rate approximates 0.5 cm/hour for low-risk, nulliparous women with spontaneous labor onset when starting at dilatations traditionally associated with active labor onset. However, this linear rate must be evaluated judiciously in light of the physiological acceleration of dilation that occurs during typical labor. Given this, cervical dilation for this population is likely slower than 0.5 cm/hour in earlier active labor and faster in more advanced active labor. Faster dilation expectations (e.g., 1 cm/hour) likely contribute to an overdiagnosis of dystocia ("slow, abnormal progression of labor") in contemporary practice and, subsequently, to an overuse of interventions aimed at accelerating labor progress. [source] RAINING, DROWNING AND SWIMMING: FU BAOSHI AND WATERART HISTORY, Issue 1 2006DAVID CLARKE Water is a prominent element in the media of Chinese ink painting and, in the form of clouds, rivers, floods and mist, it is a major subject of Chinese painting. In the culturally distinctive modernist practice of Fu Baoshi (1904,1965), these two identities of water self-consciously encounter one another. The artist's attention to watery themes in his work is unprecedented, and he is one of the first painters to focus on the direct depiction of falling rain. The essay considers Fu's representations of rain, the theme of water in his images of the poet-statesman Qu Yuan and (after the founding of the People's Republic in 1949) in paintings illustrating the poems of Chinese leader Mao Zedong. Fu's water-themed works are examined here with reference to the inherited stock of Chinese cultural meanings as well as to recent artistic practice in the People's Republic and to the Maoist state ideology which informed it. The potential meanings of these water-themed works are considered, and politically subversive connotations are discovered. The essay concludes by reflecting on the theme of water in contemporary practice, particularly in Song Dong's performance art work of 1996, Printing on Water. [source] Women's Views of Pregnancy Ultrasound: A Systematic ReviewBIRTH, Issue 4 2002Jo Garcia MSc ABSTRACT: Background: Ultrasound has become a routine part of care for pregnant women in most countries with developed health services. It is one of a range of techniques used in screening and diagnosis, but it differs from most others because of the direct access that it gives parents to images of the fetus. A review of women's views of ultrasound was commissioned as part of a larger study of the clinical and economic aspects of routine antenatal ultrasound use. Methods: Studies of women's views about antenatal screening and diagnosis were searched for on electronic databases. Studies about pregnancy ultrasound were then identified from this material. Further studies were found by contacting researchers, hand searches, and following up references. The searches were not intentionally limited by date or language. Studies that reported direct data from women about pregnancy ultrasound were then included in a structured review. Studies were not excluded on the basis of methodological quality unless they were impossible to understand. They were read by one author and tabulated. The review then addressed a series of questions in a nonquantitative way. Results: The structured review included 74 primary studies represented by 98 reports. Studies from 18 countries were included, and they employed methods ranging from qualitative interviewing to psychometric testing. The review included studies from the very early period of ultrasound use up to reports of research on contemporary practice. Ultrasound is very attractive to women and families. Women's early concerns about the safety of ultrasound were rarely reported in more recent research. Women often lack information about the purposes for which an ultrasound scan is being done and the technical limitations of the procedure. The strong appeal of diagnostic ultrasound use may contribute to the fact that pregnant women are often unprepared for adverse findings. Conclusions: Despite the highly varied study designs and contexts for the research included, this review provided useful information about women's views of pregnancy ultrasound. One key finding for clinicians was the need for all staff, women, and partners to be well informed about the specific purposes of ultrasound scans and what they can and cannot achieve. (BIRTH 29:4 December 2002) [source] Bleeding Complications in Acute Coronary Syndromes and Percutaneous Coronary Intervention: Predictors, Prognostic Significance, and Paradigms for Reducing RiskCLINICAL CARDIOLOGY, Issue S2 2007Steven V. Manoukian M.D. Abstract In clinical trials up to 30% of patients with acute coronary syndromes (ACS) or undergoing percutaneous coronary intervention (PCI) experience bleeding complications, and even higher rates have been reported in contemporary practice. A growing body of data suggests a strong correlation between bleeding and both short- and long-term adverse outcomes, including mortality, which is independent of baseline characteristics and remains evident in most trials, despite variations in the definition of major bleeding. Although the value of antithrombin and antiplatelet therapy in reducing the risk of ischemic events is well established, the mechanisms of action that confer the benefits of these therapies have an inherent tendency to increase the risk of bleeding complications. As a result, characterization of baseline hemorrhagic risk is critical and must be accomplished before selecting an antithrombotic therapy. Risk factors for bleeding may be divided into two categories: nonmodifiable (including age, gender, race, weight, renal insufficiency, anemia, and acuity of presentation) and modifiable (including choice of antithrombotic therapy and PCI procedural characteristics). Of these predictive factors, the choice, dosage, and duration of the antithrombin and/or antiplatelet regimen are perhaps the most readily modifiable, especially in patients with an increased risk of bleeding. This review explores the nature of the association between bleeding and adverse outcomes, including mortality; evaluates risk factors for bleeding; and examines mechanisms for reducing bleeding complications through the selection of appropriate antithrombotic therapy. Copyright © 2007 Wiley Periodicals, Inc. [source] THE IMPULSE OF PHILANTHROPYCULTURAL ANTHROPOLOGY, Issue 4 2009ERICA BORNSTEIN ABSTRACT In practices of philanthropy and charity, the impulse to give to immediate others in distress is often tempered by its regulation. Although much of what is written on charity and philanthropy focuses on the effects of the gift, I suggest more attention be paid to the impulse of philanthropy. To coerce the impulse to give into rational accountability is to obliterate its freedom; to render giving into pure impulse is to reinforce social inequality. The only solution is to allow both to exist, and to create structures to encourage them. This essay examines the power of the spontaneous and fleeting impulse to give and its regulation through an analysis of contemporary practices of philanthropy and their relation to sacred conceptions of d,n (donation) in New Delhi. When scriptural ideas of disinterested giving intersect with contemporary notions of social responsibility, new philanthropic practices are formed. On the basis of ethnographic research with philanthropists who built temples, started NGOs, and managed social welfare programs, as well as families who gave d,n daily out of their homes, this essay documents how both NGO and government efforts to regulate one of the most meritorious forms of d,n, gupt d,n (or, anonymous d,n) expresses critical issues in philanthropy between the urge to give in response to immediate suffering and the social obligation to find a worthy recipient for the gift. [source] Heritage, Identity and Belonging: African Caribbean Students and Art EducationINTERNATIONAL JOURNAL OF ART & DESIGN EDUCATION, Issue 3 2006Paul Dash This article addresses the issue of Caribbean cultural under-representation in school art departments. It argues that diasporic subjects are not seen and their cultures not recognised precisely because their contributions to the way we live are indivisible from the mainstream. This in contradistinction to some groups whose cultures and heritages are relatively distinct and separate from Western mores. Our ways of understanding culture do not take this into account. Yet diasporic contributions to the way we live have buttressed Western lifestyles since the beginning of the slave trade. The article argues that this relationship, characterised by multiple entanglements, must be recognised if Caribbean cultural identities are to be seen and valued. In doing so it challenges the way we construct notions of cultural heritage and belonging, and promotes the adoption of more risk-taking pedagogies possibly based on contemporary practices. [source] The Underrepresentation of Indigenous Peoples on Canadian Jury PanelsLAW & POLICY, Issue 1 2003Mark Israel Under common law, Canadian jury panels, or arrays, are supposed to be broadly representative. In the early 1980s, the Law Reform Commission and, in the early 1990s, the Supreme Court claimed that provincial legislation virtually guaranteed that this was the case. However, evidence presented to various provincial and federal commissions and a series of court cases has pointed to the continuing underrepresentation of Indigenous Canadians resulting from both the content and the administration of provincial laws. In this article, I examine evidence of underrepresentation and review various political and legal attempts to challenge bias in out-of-court selection. I suggest that contemporary practices in some jurisdictions have not consistently provided a representative jury pool or panel. As a result, the jury selection process has not always appeared to offer justice to Indigenous people and, in doing so, may not have served the Canadian legal system well. [source] Local governance and water resource management: experiences from Northern NamibiaPUBLIC ADMINISTRATION & DEVELOPMENT, Issue 3 2008Farhad Hossain Abstract Like many semi-arid countries in Africa, Namibia has been experiencing water shortage for a long period of time. Prior to its independence in 1990, most of Namibia's water points,namely, the boreholes,served white-Namibians (about 7% of the national population of predominantly German descent) and their commercial farming areas. But their water needs have been satisfied at the expense of those indigenous Namibians and their communal areas (where some 80% of the national population originates). Independence, however, brought with it a new hope for the indigenous population: since 1990, the government has been working diligently to reform the country's local governance, and make local government agencies more effective, efficient and responsive to common people and their needs. This article sheds light on how, within the background of the government's decentralisation efforts, the management and distribution of water resources have changed in an independent Namibia, reporting findings from research conducted in a newly emerged village council in the north of the country. Drawing on historical and contemporary practices, we describe and analyse the role of decentralised local government in water resource management in northern Namibia, where today, more than 50% of the national population (i.e. the indigenous Oshiwambo-speaking people) resides. Copyright © 2008 John Wiley & Sons, Ltd. [source] | |||||||||||||