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Current Goals (current + goal)
Selected AbstractsDiabetes management in the new millennium using insulin pump therapyDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S1 2002Bruce W. Bode Abstract Current goals of therapy of type 1 and 2 diabetes are to achieve near normal glycemia, minimize the risk of severe hypoglycemia, limit excessive weight gain, improve quality of life and delay or prevent late vascular complications. As discussed in this review, insulin pump or continuous subcutaneous insulin infusion (CSII) therapy provides a treatment option that can dramatically aid in achieving all of these goals. In comparison to multiple daily injections (MDI), CSII uses only rapid-acting insulin, provides greater flexibility in timing of meals and snacks, has programmable basal rates to optimize overnight glycemic control, can reduce the risk of exercise-induced hypoglycemia, and enhances patients' ability to control their own diabetes. Most important, in adults and adolescents with type 1 diabetes, CSII has been shown to lower HbA1c levels, reduce the frequency of severe hypoglycemia and limit excessive weight gain versus MDI without increasing the risk of diabetic ketoacidosis. Similarly positive results are being seen with CSII in adults with type 2 diabetes. The effectiveness of CSII and improvements in pump technology have fueled a dramatic increase in the use of this therapy. Practical guidelines are presented for selection of patients, initiation of treatment, patient education, follow-up assessments and troubleshooting. The recent introduction of methods for continuous glucose monitoring provides a new means to optimize the basal and bolus capabilities of CSII and offers the hope of the development of a feedback-controlled artificial pancreas. Copyright © 2002 John Wiley & Sons, Ltd. [source] Top-down influences on lexical selection during spoken word production: A 4T fMRI investigation of refractory effects in picture namingHUMAN BRAIN MAPPING, Issue 11 2006Greig de Zubicaray Abstract Spoken word production is assumed to involve stages of processing in which activation spreads through layers of units comprising lexical-conceptual knowledge and their corresponding phonological word forms. Using high-field (4T) functional magnetic resonance imaging (fMRI), we assessed whether the relationship between these stages is strictly serial or involves cascaded-interactive processing, and whether central (decision/control) processing mechanisms are involved in lexical selection. Participants performed the competitor priming paradigm in which distractor words, named from a definition and semantically related to a subsequently presented target picture, slow picture-naming latency compared to that with unrelated words. The paradigm intersperses two trials between the definition and the picture to be named, temporally separating activation in the word perception and production networks. Priming semantic competitors of target picture names significantly increased activation in the left posterior temporal cortex, and to a lesser extent the left middle temporal cortex, consistent with the predictions of cascaded-interactive models of lexical access. In addition, extensive activation was detected in the anterior cingulate and pars orbitalis of the inferior frontal gyrus. The findings indicate that lexical selection during competitor priming is biased by top-down mechanisms to reverse associations between primed distractor words and target pictures to select words that meet the current goal of speech. Hum Brain Mapp, 2006. © 2006 Wiley-Liss, Inc. [source] Cultures and Comparisons: Strategies for LearnersFOREIGN LANGUAGE ANNALS, Issue 3 2005Sandra J. Savignon Abstract: This article suggests a set of strategies for developing the sociocultural competence of language learners. These strategies extend the notion of coping strategies, or strategic competence (Savignon, 1972, 1983, 1997), to include the intercultural dimension articulated in current goals for U.S. world language education. Adopting the integrative, communicative perspective of language development reflected in the Standards for Foreign Language Learning in the 21st Century (National Standards, 1999), this article offers classroom strategies for teaching and learning with particular reference to the goal areas of "cultures" and "comparisons." This proposal is grounded in a theory of language inseparable from culture,one that views ability in both a first language (L1) and subsequent languages as the result of socialization and the language classroom as a site of exploration in the development of communicative competence. Suggestions for classroom implementation of strategy training are supported by classroom research (Savignon & Sysoyev, 2002). [source] Detection of in vitro demineralization of primary teeth using quantitative light-induced fluorescence (QLF)INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2002I. A. Pretty Summary. Introduction. With the advent of remineralizing therapies and the new, conservative approach to restoration placement, interest in detecting and monitoring subclinical, precavitated lesions has increased. The increased understanding of clinicians about the processes of primary and secondary prevention and the detection of lesions to which these therapies may be applied, is one of the current goals in caries management. Quantitative light-induced fluorescence (QLF) is a new method for the detection of very early caries. Objectives. To determine the ability of QLF to detect and longitudinally monitor in vitro enamel demineralization. To present the device to the paediatric community and present future in vivo uses of the device. Design. An in vitro study with combined in vivo pilot. Sample and methods. Twelve previously extracted, caries free, primary molars were selected and prepared. Two teeth were randomly selected as controls. Teeth were prepared by gentle pumicing and coating in an acid-resistant nail-varnish, except for an exposed window on the buccal surface. QLF baseline images were taken and the teeth then exposed to a demineralizing solution. Teeth were removed at regular intervals (24, 48, 72, 96, 120, and 144 h), air-dried and QLF images taken. QLF images were analysed by a single, blinded examiner (to control, to length of exposure). Mineral loss, as measured by ,Q, was recorded. Results. Demineralization was noted in all experimental teeth by 48 h, and within 24 h in six teeth. The QLF successfully monitored the increase in mineral loss over time (P < 0·05). The detected lesions were not visible clinically until 144 h and then in only the most severe lesions. No demineralization was detected by QLF in control teeth. The device was user- and patient-friendly in vivo, detecting subclinical lesions. Conclusion. Detection of very early mineral loss and subsequent monitoring of this loss is possible in primary teeth using QLF. The device is well suited to use in paediatric dentistry and offers applications for both clinicians and researchers. The determination of the status of carious lesions (active/inactive) will be possible with readings taken at recall appointments. [source] Moving from Public Housing to Homeownership: Perceived Barriers to Program Participation and SuccessJOURNAL OF URBAN AFFAIRS, Issue 3 2004Anna M. Santiago Despite numerous federal policies aimed at enhancing resident self-sufficiency and homeownership through programs run by local public housing authorities, little is known about who participates and who succeeds. This study explores barriers to participation and success in an innovative resident self-sufficiency/homeownership program developed by the Housing Authority of the city and county of Denver. We conduct surveys of participants in the Foundations for Homeownership program, eliciting their perceptions regarding willingness and ability to participate in the program and, thereafter, completing it successfully. We find that at time of entry into the program, participants reported, on average, 4.6 major barriers that they perceive would limit their ability to achieve current goals. OLS and logistic regression analyses were conducted to ascertain the degree to which perceived barriers were associated with participants' demographic, economic, or attitudinal characteristics. [source] Has Time Come for New Goals in Human Islet Transplantation?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2008R. Lehmann The enthusiasm regarding clinical islet transplantation has been dampened by the long-term results. Concerns about the associated risks of life-long immunosuppression and the striking imbalance between potential recipients and available donor pancreata warrant changes in some of the current goals. Islet transplantation will never be a cure of type 1 diabetes in the majority of patients with no secondary complications, but is a valid option for a limited number of patients with brittle diabetes waiting for an organ or after organ transplantation. Furthermore, insulin independence should not be the main goal of islet transplantation, but avoidance of severe hypoglycemia and good glycemic control, which can be achieved with a relatively small functional beta-cell mass. Therefore, initially one islet infusion is sufficient. Retransplantation at a later time point remains an option, if glucose control deteriorates. Efforts to improve islet transplantation should no longer focus on islet isolation and immunosuppression, but rather on the low posttransplant survival rate of islets caused by activation of the coagulation pathway and the limited oxygen delivery to the islets. Transplantation of smaller islets be it naturally small or size tailored reaggregated islets has the potential to facilitate these processes. [source] | |||||||||||||