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Evidence Relating (evidence + relating)
Selected AbstractsTHE LAST GLACIATION OF SHETLAND, NORTH ATLANTICGEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 1 2008N.R. GOLLEDGE ABSTRACT. Evidence relating to the extent, dynamics, and relative chronology of the last glaciation of the Shetland Islands, North Atlantic, is presented here, in an attempt to better illuminate some of the controversies that still surround the glacial history of the archipelago. We appraise previous interpretations and compare these earlier results with new evidence gleaned from the interpretation of a high resolution digital terrain model and from field reconnaissance. By employing a landsystems approach, we identify and describe three quite different assemblages of landscape features across the main islands of Mainland, Yell and Unst. Using the spatial interrelationship of these landsystems, an assessment of their constituent elements, and comparisons with similar features in other glaciated environments, we propose a simple model for the last glaciation of Shetland. During an early glacial phase, a coalescent British and Scandinavian ice sheet flowed approximately east to west across Shetland. The terrestrial land-forms created by this ice sheet in the north of Shetland suggest that it had corridors of relatively fast-flowing ice that were partially directed by bed topography, and that subsequent deglaciation was interrupted by at least one major stillstand. Evidence in the south of Shetland indicates the growth of a local ice cap of restricted extent that fed numerous radial outlet glaciers during, or after, ice-sheet deglaciation. Whilst the absolute age of these three landsystems remains uncertain, these new geo-morphological and palaeoglaciological insights reconcile many of the ideas of earlier workers, and allow wider speculation regarding the dynamics of the former British ice sheet. [source] Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment,DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S1 2008A. R. Berendt Abstract The International Working Group on the Diabetic Foot appointed an expert panel to provide evidence-based guidance on the management of osteomyelitis in the diabetic foot. Initially, the panel formulated a consensus scheme for the diagnosis of diabetic foot osteomyelitis (DFO) for research purposes, and undertook a systematic review of the evidence relating to treatment. The consensus diagnostic scheme was based on expert opinion; the systematic review was based on a search for reports of the effectiveness of treatment for DFO published prior to December 2006. The panel reached consensus on a proposed scheme that assesses the probability of DFO, based on clinical findings and the results of imaging and laboratory investigations. The literature review identified 1168 papers, 19 of which fulfilled criteria for detailed data extraction. No significant differences in outcome were associated with any particular treatment strategy. There was no evidence that surgical debridement of the infected bone is routinely necessary. Culture and sensitivity of isolates from bone biopsy may assist in selecting properly targeted antibiotic regimens, but empirical regimens should include agents active against staphylococci, administered either intravenously or orally (with a highly bioavailable agent). There are no data to support the superiority of any particular route of delivery of systemic antibiotics or to inform the optimal duration of antibiotic therapy. No available evidence supports the use of any adjunctive therapies, such as hyperbaric oxygen, granulocyte-colony stimulating factor or larvae. We have proposed a scheme for diagnosing DFO for research purposes. Data to inform treatment choices in DFO are limited, and further research is urgently needed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Procedural learning and dyslexiaDYSLEXIA, Issue 3 2010R. I. Nicolson Abstract Three major ,neural systems', specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed (Trends Neurosci.,30(4), 135,141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief overview of the increasing evidence relating to the hypothesis, noting that the framework involves two main claims: first that ,neural systems' provides a productive level of description avoiding the underspecificity of cognitive descriptions and the overspecificity of brain structural accounts; and second that a distinctive feature of procedural learning is its extended time course, covering from minutes to months. In this article, we focus on the second claim. Three studies,speeded single word reading, long-term response learning, and overnight skill consolidation,are reviewed which together provide clear evidence of difficulties in procedural learning for individuals with dyslexia, even when the tasks are outside the literacy domain. The educational implications of the results are then discussed, and in particular the potential difficulties that impaired overnight procedural consolidation would entail. It is proposed that response to intervention could be better predicted if diagnostic tests on the different forms of learning were first undertaken. Copyright © 2010 John Wiley & Sons, Ltd. [source] Herd Behaviour and Cascading in Capital Markets: a Review and SynthesisEUROPEAN FINANCIAL MANAGEMENT, Issue 1 2003David Hirshleifer We review theory and evidence relating to herd behaviour, payoff and reputational interactions, social learning, and informational cascades in capital markets. We offer a simple taxonomy of effects, and evaluate how alternative theories may help explain evidence on the behaviour of investors, firms, and analysts. We consider both incentives for parties to engage in herding or cascading, and the incentives for parties to protect against or take advantage of herding or cascading by others. [source] How many cisplatin administration protocols does your department use?EUROPEAN JOURNAL OF CANCER CARE, Issue 1 2010A.P. GREYSTOKE bsc, mbchb, registrar medical oncology GREYSTOKE A.P., JODRELL D.I., CHEUNG M., RIVANS I. & MACKEAN M.J. (2009) European Journal of Cancer Care19, 80,90 How many cisplatin administration protocols does your department use? The introduction, 30 years ago, of the co-administration of appropriate hydration and ensuring a diuresis occurs during the administration of cisplatin was important in its development, allowing clinically significant doses to be given with acceptable rates of toxicity. The clinical usage of cisplatin has increased and hydration protocols have been amended to increase patient comfort and reduce resource utilization. We suspected that this had led to unnecessary variations in practice both in clinical trials and subsequently in the clinic. Therefore, we reviewed practice in the Edinburgh Cancer Centre and discovered that 25 different hydration protocols were in use, with wide variation in dilution of cisplatin, total fluid administered, use of electrolyte (potassium and magnesium) supplementation and diuretics. These differences are a reflection of adoption of variations in hydration regimes published in pivotal clinical trials. A review of the available evidence relating to cisplatin associated hydration regimens was performed and recommendations will be made for the future design of evidence-based protocols. [source] Communications skills in dental education: a systematic research reviewEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2010J. A. Carey Abstract Communication is an essential element of the relationship between patient and dentist. Dental schools are required to ensure that undergraduates are adequately trained in communication skills yet little evidence exists to suggest what constitutes appropriate training and how competency can be assessed. This review aimed to explore the scope and quality of evidence relating to communication skills training for dental students. Eleven papers fitted the inclusion criteria. The review found extensive use amongst studies of didactic learning and clinical role-play using simulated patients. Reported assessment methods focus mainly on observer evaluation of student interactions at consultation. Patient involvement in training appears to be minimal. This review recommends that several areas of methodology be addressed in future studies, the scope of research extended to include intra-operative communication, and that the role of real patients in the development of communication skills be active rather than passive. [source] Unravelling the Capital Charging Riddle , Some Empirical Evidence from VictoriaFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 1 2003Tyrone M. Carlin Since 1995, the State of Victoria has been experimenting with capital charging regimes for budget sector agencies. The intent of these schemes is to allow the opportunity cost of capital to be reflected in the assessed total costs of outputs produced by agencies the subject of the charge. While literature produced by government central financial agencies has forcefully advocated this experiment, and asserted a range of resulting improvements to budget sector asset management and general financial management practices, academic examinations of the subject have been mixed in their conclusions. Empirical evidence relating to the effect and effectiveness of these schemes has been scarce. This paper seeks to contribute to the literature by providing some empirical evidence on the impact of capital charging in one jurisdiction, Victoria, Australia. [source] The epidemiology of inhibitors in haemophilia A: a systematic reviewHAEMOPHILIA, Issue 4 2003J. Wight Summary., This paper emphasizes the importance of distinguishing between the prevalence, incidence and cumulative incidence of inhibitors in haemophilia A. Incidence and cumulative incidence data will include patients with transient inhibitors or whose inhibitors have been eliminated by treatment. As these will not be included in prevalence data, prevalence studies will tend to give rise to lower figures than incidence studies. As a result, the most accurate estimates of the true risk of inhibitor development comes from prospective studies of newly diagnosed haemophiliacs who are tested regularly for the presence of inhibitors. This paper reports a systematic review of the best available evidence relating to the epidemiology of inhibitors in haemophilia A. Cohort studies, registry data reporting incidence or prevalence of inhibitors in patients with haemophilia A, and prospective studies of factor VIII (FVIII) in the treatment of previously untreated patients which reported the development of inhibitors as an outcome, were included in the review. The overall prevalence of inhibitors in unselected haemophiliac populations was found to be 5,7%. The cumulative risk of inhibitor development varied (0,39%). Incidence and prevalence were substantially higher in patients with severe haemophilia. Studies of patients using a single plasma-derived FVIII (pdFVIII) preparation reported lower inhibitor incidence than those using multiple pdFVIII preparations or single recombinant FVIII preparations. Incidence data should be used to estimate the likely demand for treatments aimed at eliminating inhibitors, whereas the best estimates of the overall burden to the National Health Service (NHS) of treating bleeding episodes in patients with continuing inhibitors will come from prevalence studies. [source] A systematic review protocol on the use of teaching portfolios for educators in further and higher educationJOURNAL OF ADVANCED NURSING, Issue 12 2009Karen McColgan Abstract Title.,A systematic review protocol on the use of teaching portfolios for educators in further and higher education. Aim., This paper is a review protocol that will be used to identify, critically appraise and synthesize the best current evidence relating to the use of teaching portfolios for educators in further and higher education. Background., While portfolio use as a means to assist students in further and higher education has undergone extensive research and review, their use as a tool to assist educators has yet to receive systematic attention. Reviews conducted on studies related to portfolio use and undergraduate students have suggested that a teaching portfolio may have a benefit for educators in higher education as a means to provide relevancy and focus to their teaching. Design., The objectives of the review are to evaluate how a teaching portfolio assists educators in teaching and learning; to evaluate the effects of maintaining a teaching portfolio for educators in relation to personal development; to explore the type of portfolio used; to determine whether a teaching portfolio is perceived more beneficial for various grades and professional types; and to determine any motivating factors or workplace incentives behind its implementation and completion. A search of the following databases will be made: MEDLINE, CINAHL, BREI, ERIC and AUEI. The review will follow the Joanna Briggs Institute guidance for systematic reviews of quantitative and qualitative research. Conclusion., The review will offer clarity and direction on the use of teaching portfolios for educators, policymakers, supervisory managers and researchers involved in further and higher education. [source] Metastatic spinal cord compression: a review of practice and careJOURNAL OF CLINICAL NURSING, Issue 13-14 2010Lynn Kilbride Aim and objectives., The aim of this review was to address: (1) How is spinal stability assessed? (2) What is the role of bracing/should braces be used? (3) When is it safe to mobilise the patient? (4) What position should the patient be nursed in? Background., Controversy surrounds the care for patients with metastatic spinal cord compression (MSCC). There is some evidence to indicate that care for patients with MSCC is based on individual clinician preference rather than evidence-based guidelines which has been shown to cause delays and discrepancies in patient treatment. Design., A structured literature review to synthesise the available evidence about the management of MSCC. Methods., The following databases were searched: Medline, EMBASE, Cochrane Systematic Reviews Database, SIGN (Scottish Intercollegiate Guidelines Network), NICE (National Institute for Clinical Excellence), AMED (Allied and Complementary Medicine), CINAHL (Cumulative Index to Nursing and Allied Health Literature) and BNI (British Nursing Index). Publications were selected from the past 10 years. The search yielded a total of 1057 hits, 755 abstracts were screened, and 73 articles were retrieved and examined. Thirty-five articles were included. Results., The findings identified a gap and evidence relating to spinal stability, bracing, patient mobilisation, and positioning is limited and may be inconclusive. It is important for patients with a poor prognosis that their preferences and quality of life are considered. Conclusion., Currently, the evidence base to underpin care is limited, and further research in this area is necessary for patients and healthcare professionals alike. Relevance to clinical practice., Patients who suffer from MSCC suffer numerous physical, psychological and social issues. Because of lack of consensus, the current guidelines to inform clinical decision-making of professional staff are of limited benefit. [source] A systematic review of nursing contributions to mobility rehabilitation: examining the quality and content of the evidenceJOURNAL OF CLINICAL NURSING, Issue 11c 2007Rosie Kneafsey BSc Aims., This paper summarizes the results of a systematic literature review to examine the quality and content of the evidence relating to nursing approaches to improving the mobility and movement of older people. Background., Older people experiencing health breakdown often develop problems with movement and mobility and nurses play a role in helping patients to either adapt to or overcome these difficulties. Methods., Electronic searches were undertaken of Medline, CINAHL, Amed and Cochrane Database of systematic reviews. Papers about nursing approaches to promoting mobility and movement were critically appraised using quality assessment checklists. Papers addressing safe moving and handling, falls prevention, health promotion, rehabilitation or teamworking in general were excluded. Results., Sixteen research and 33 informational papers were included and comprise the review. Many research papers used weak designs and small sample sizes, limiting their ability to control for important confounding variables. Although numerous studies examined effectiveness, only one used a randomised controlled trial design. Papers were grouped into four interlinked sets. These were promoting mobility and preventing immobility; walking and exercise; neuro-developmental principles; and rehabilitation patient handling. Conclusions., Specific foci for nursing assessment and interventions to promote patients' mobility have been identified. However, the fragmented nature of the evidence makes it difficult to make recommendations for nursing practice. Future research should be conducted by multi-professional research teams to identify the most effective approaches to promoting patients' mobility and to explore overlaps between different members of the rehabilitation team. Relevance to clinical practice., Regaining the ability to move and walk is often a key concern for patients who have suffered health breakdown. Although nurses provide patients with assistance the evidence available does little to direct nurses as to the best approach towards mobility rehabilitation. It is important that nurses play a role in measuring the efficacy of different interventions to promote rehabilitation. [source] Life satisfaction in teenage boys: The moderating role of father involvement and bullyingAGGRESSIVE BEHAVIOR, Issue 2 2002Eirini Flouri Abstract It has been suggested that bullying at school and low social support are related to relatively poor mental health in schoolchildren. Based on data from 1344 adolescent boys aged 13,19 years in Britain, this study explored whether father involvement, as an underestimated,in the related research,source of social support, can protect against low levels of satisfaction with life. Multiple regression analysis showed that low father involvement and peer victimization contributed significantly and independently to low levels of life satisfaction in adolescent boys. There was also evidence relating to a buffering effect of father involvement in that father involvement protected children from extreme victimization. Aggr. Behav. 28:126,133, 2002. © 2002 Wiley-Liss, Inc. [source] Older people specific health status and quality of life: a structured review of self-assessed instrumentsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2005Kirstie L. Haywood DPhil Abstract Objectives, To review evidence relating to the measurement properties of older people specific self-assessed, multi-dimensional measures of health status. Design, Systematic literature searches to identify instruments. Pre-defined criteria relating to reliability, validity, responsiveness, precision and acceptability. Results, A total of 46 articles relating to 18 instruments met the inclusion criteria. Most evidence was found for the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), CARE, Functional Assessment Inventory (FAI) and Quality of Life Profile , Seniors Version (QOLPSV). Most instruments have been evaluated in single studies. Four instruments have evidence of internal consistency and test,retest reliability , LEIPAD, Philadelphia Geriatrics Centre Multilevel Assessment Inventory, Perceived Well-being Scale, Wellness Index (WI). Two instruments lack evidence of reliability , Brief Screening Questionnaire, Geriatric Quality of Life Questionnaire (GQLQ). Older people contributed to the content of the GQLQ, QOLPSV and WI. Most instruments were assessed for validity through comparisons with other instruments, global judgements of health, or clinical and socio-demographic variables. Limited evidence of responsiveness was found for five instruments , GQLQ, OMFAQ, PGCMAI, QOLPSV, Self-Evaluation of Life Scale (SELF). Conclusion, Although most evidence was found for the OMFAQ this was largely for the ADL domain; evidence for reliability and responsiveness is limited. Limited evidence of reliability, validity and responsiveness was found for the PGCMAI, QOLPSV and SELF. The lack of evidence for measurement properties restricts instrument recommendation. Instrument content should be assessed for relevance before application and the concurrent evaluation of specific and widely used generic instruments is recommended. Several instruments, including the BSQ and EASY-Care, were developed recently and further evidence of instrument performance is required. [source] Multi-item outcome measures for lateral ligament injury of the ankle: a structured reviewJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2004K.L. Haywood BSc(Hons) DPhil MCSP Abstract Objective, To identify and review evidence relating to the measurement properties of published multi-item outcome measures for the conservative management of lateral ligament injuries of the ankle. Methods, Systematic literature searches were used to identify measures, which were then assessed against pre-defined criteria relating to development, item content, reliability, validity and responsiveness. Results, Seven disease-specific measures of ankle status [Ankle Joint Functional Assessment Tool, Clinical Trauma Severity Score, Composite Inversion Injury Scale, Kaikkonen Functional Scale (KFS), Karlsson Ankle Function Score (KAFS), Olerud and Molander Ankle Score (OMAS), and the Point System] and two generic measures of health (McGill Pain Questionnaire, Sickness Impact Profile) met the review inclusion criteria. While all measures had been used in acute injuries, only two had also been applied during later stages of recovery (>6 months). The studies covered a comprehensive range of graded ligament injuries. Expert opinion dominated item generation for all measures. All measures lack evidence of test-retest or internal consistency reliability in patients with ankle sprain. Several measures were assessed for validity through comparison with other measures, but there was limited evidence of construct validity and no formal assessment of responsiveness for any measure. Conclusion, The disappointing lack of evidence for measurement properties suggests that any measure should be used with caution until appropriate evidence is provided. On the basis of limited evidence, the KFS offers the most promising approach to a combined clinician- and patient-assessment of ankle function, and the KAFS or OMAS if a patient-assessed evaluation of function is required. [source] Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix researchJOURNAL OF NURSING MANAGEMENT, Issue 6 2009BSc (Hons), MARIA FLYNN RGN Aim, This paper revisits the published evidence relating to how nurse staffing levels impact on patient, nurse and service outcomes and considers the implications of this body of research for nurse managers in their quest to determine optimum nursing numbers. Background, Within the context of the recognized global nursing shortage and particular local pressures within international health services, questions of appropriate nurse staffing levels and skill mix are once again becoming increasingly important. It would seem that the determination of optimum nurse staffing levels and skill mix is a central issue in relation to health service governance, service user involvement, as well as in the recruitment, retention and well-being of nursing staff across the service sectors. Methods, A review of published evidence was carried out, applying key principles of the systematic method, in order to facilitate the identification of current factors and issues in nurse staffing levels research. The review did not seek to address a specific research question. The search covered 10 years from 1998 to 2008 and identified more than 500 relevant papers, giving a wide international perspective. Key issues, The majority of research in the field relates to the acute service sector and there are considerable similarities in issues that transcend international boundaries. Much of the research focuses on the impact on patients and nurses of ,poor' nurse staffing levels. More recent studies have explored the impact of nurse staffing levels on the service organization itself. However, while there may be an association between models of nurse staffing and outcomes, there is insufficient evidence to establish a causal relationship between these factors. In this context it is perhaps time to reconsider how nursing outcomes are defined and measured. Implications for nursing management and conclusion, Nurse managers, commissioners of services and workforce planners need to be cognisant of key issues and analyses in the consideration of nurse staffing levels. Not least of these is the need for a healthy degree of caution regarding the supposed objectivity, scientific basis, or evidence base, for rational calculation of optimum nurse staffing levels. [source] BSAVA's evidence to the dispensing reviewJOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2001Article first published online: 28 JUN 200 The Independent Review Group (IRG) is currently considering evidence relating to the dispensing of prescription-only medicines for veterinary use, and is due to report its findings to the Minister of Agriculture by March 31. The BSAVA has been actively involved in submitting evidence to the review. Following its written submission in October, it has given oral evidence and has taken part in two public workshops organised by the IRG. Here, Harvey Locke, the BSAVA's Senior Vice-President, provides details [source] CFOs in e-business: e-architects or foot-soldiers?KNOWLEDGE AND PROCESS MANAGEMENT: THE JOURNAL OF CORPORATE TRANSFORMATION, Issue 2 2004David O'Donnell Both the role of the CFO (chief financial officer) and the discipline of accounting can be viewed as being in transition due to developments in the e-Business world. One perspective suggests that CFOs are becoming ,e-process architects',an alternative suggests that the CFO role is becoming commoditized to ,foot-soldier' status with other roles such as CIOs (chief information officers) and CTOs (chief technology officers) staking a claim to its traditional accounting space. In this paper we present some preliminary evidence relating to this e-architect/foot-soldier question, and on levels of e-Business activity, based on data obtained from over 120 CFOs in the Irish ICT sector. Copyright © 2004 John Wiley & Sons, Ltd. [source] The Impact of Public Ownership and Competition on ProductivityKYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 4 2005José Manuel González-Páramo Summary Are private firms more efficient than public ones? Does privatisation improve performance? In order to answer these questions, it is necessary to disentangle the impact of ownership and competition upon business performance. This paper presents empirical evidence relating to the hypothesis that public ownership and competition are determinants of firms' productivity. It concludes that public ownership has a significant negative effect on productivity and also that privatisation has a positive impact on efficiency. Furthermore, increased competition is found to have a positive effect on productivity. These results are interpreted as confirming that privatisation is effective as a means of increasing firms' efficiency, at least in a non-regulated and relatively competitive sector, such as manufacturing. [source] Cognition in liver diseaseLIVER INTERNATIONAL, Issue 1 2005Alexander Collie Abstract: Background: Cognitive dysfunction has been observed in a range of liver diseases including chronic hepatitis C virus, alcoholic liver disease, primary biliary cirrhosis and Wilson's disease. Such dysfunction may range from mild cognitive changes to overt hepatic encephalopathy, and represents a significant complication of liver disease that may negatively impact the patient's quality of life, and normal activities of daily living (e.g., driving). Method: This article reviews the published evidence relating to cognitive dysfunction in liver disease. Outcome: Issues of definition, diagnosis, epidemiology, aetiology, treatment and outcome are discussed. Particular attention is devoted to identifying the mild cognitive changes that occur in liver diseases of different aetiology. [source] Bilastine in allergic rhinoconjunctivitis and urticariaALLERGY, Issue 2010C. Bachert To cite this article: Bachert C, Kuna P, Zuberbier T. Bilastine in allergic rhinoconjunctivitis and urticaria. Allergy 2010; 65 (Suppl. 93): 1,13. Abstract Allergic rhinoconjunctivitis and urticaria are increasing in prevalence in many developed countries. The role of histamine in such conditions is well documented and clinical guidelines recommend non-sedating H1 -receptor antagonists as first-line treatment choices. Bilastine is a novel non-sedating histamine H1 -receptor antagonist developed for the treatment of allergic rhinoconjunctivitis and urticaria. The aim of this review is to critique the scientific evidence relating to the pharmacological properties of bilastine and the clinical evidence regarding its potential as an antihistamine. In vitro binding studies and investigations in animal tissue have demonstrated the high specificity of bilastine for H1 -receptors, and preclinical animal studies have also yielded promising results in terms of a reduction of histamine-mediated inflammatory effects, including capillary permeability and bronchospasm. In pharmacodynamic studies bilastine was found to down-regulate histamine-induced flare and wheal responses in healthy volunteers. Preclinical and clinical pharmacokinetic studies showed that bilastine has dose-dependent kinetics following oral administration. Excretion is almost exclusively via urine and faeces as unchanged drug. Early clinical trials have shown that bilastine has similar efficacy to other second-generation H1 -receptor antagonists such as cetirizine, desloratadine, fexofenadine and levocetirizine, in terms of reducing allergic symptoms. Clinical findings also indicate that bilastine has a rapid onset of action and a 20 mg single dose is effective throughout a 24-h period. Furthermore, bilastine has been associated with improved quality of life in allergic rhinoconjunctivitis and urticaria patients. Adverse effects have generally been minimal in these studies and doses up to twice those proposed did not exhibit differences in adverse events compared to placebo. Moreover, in vivo investigations have found no evidence of accumulation of bilastine in the central nervous system, and various studies have confirmed minimal effects on psychomotor performance in healthy volunteers administered up to four times the usual dose. Clinical studies have also found no effect of bilastine on the QTc interval and other ECG parameters, even at supratherapeutic dosages, confirming the good cardiac safety profile of this newer antihistamine. Given its pharmacodynamic profile, which appears to be similar to other second-generation H1 -receptor antagonists, and its favourable safety and tolerability, bilastine has the attributes of a potentially clinically useful non-sedating antihistamine. Larger clinical studies are now necessary to fully elucidate the clinical potential of this novel antihistamine. [source] Nutritional status in pregnant adolescents: a systematic review of biochemical markersMATERNAL & CHILD NUTRITION, Issue 2 2007Victoria Hall Moran Abstract Adolescent pregnancy is a major public health challenge for many industrialized countries and is associated with significant medical, nutritional, social and economic risk for mothers and their infants. Despite this, relatively little is known about the nutritional status of this population. The aim of this paper was to conduct a systematic review of the current evidence relating to the biochemical markers of nutritional status of pregnant adolescents living in industrialized countries. Six papers were identified that fulfilled the inclusion criteria, the majority of which were conducted in the United States. The studies were of variable quality and most failed to control for potential confounders which may have strongly influenced the findings. Due to limited research, conclusions cannot be drawn about the zinc and calcium status of pregnant adolescents, and data on folate and vitamin B12 status appeared conflicting. There was some consensus among studies, however, to suggest that indicators of anaemia and iron status were compromised in pregnant adolescents, particularly during the third trimester of pregnancy. Chronological age did not appear to influence nutritional status, although there was some evidence to suggest that increasing gynaecologic age may positively influence plasma ferritin levels. Current research is limited by sampling and measurement bias, and research is urgently required to address these limitations. Further consideration should also be made of the influence of the role of socio-economic support on pregnant adolescents' nutritional status. The achievement of improved nutrition in pregnancy among adolescents requires multidisciplinary collaborations of adolescent healthcare providers, academics, professional organizations, policymakers, industry and service users. Only once this is achieved can adolescent nutrition, and adolescent nutrition in pregnancy, be significantly and sustainably optimized. [source] Zebra finch sexual differentiation: The aromatization hypothesis revisitedMICROSCOPY RESEARCH AND TECHNIQUE, Issue 6 2001Juli Wade Abstract Zebra finches have emerged as an outstanding model system for the investigation of the mechanisms regulating brain and behavior. Their song system has proven especially useful, as the function of discrete anatomical regions have been identified, and striking parallels exist between the morphology of these regions and the level of their function in males and females. That is, the structures are substantially more developed in males, who sing, compared to females, who do not. These parallels extend from higher (telencephalic) centers to the brainstem motor nucleus that innervates the muscles of the vocal organ. Other dimorphic aspects of reproduction in the zebra finch, such as copulatory behaviors and sexual partner preference, however, are not associated with known sex differences in anatomy. In many species, sex differences in neural and peripheral structures and behavior are regulated by secretions from the gonads, which of course are sexually dimorphic themselves. In birds, sex differences at all of these levels (gonad, brain, and behavior) can be mediated by steroid hormones. However, it is not entirely clear that gonadal secretions normally participate at all of the levels. This paper reviews the evidence relating to the role of gonadal steroids in the sexual differentiation of reproductive behaviors and the central and peripheral structures known to regulate them in zebra finches, with a focus on estradiol, which has been most extensively studied in the masculinization of song system morphology and function. Microsc. Res. Tech. 54:354,363, 2001. © 2001 Wiley-Liss, Inc. [source] Levodopa in the treatment of Parkinson's disease: Current controversiesMOVEMENT DISORDERS, Issue 9 2004C. Warren Olanow Abstract Levodopa is the most effective symptomatic agent in the treatment of Parkinson's disease (PD) and the "gold standard" against which new agents must be compared. However, there remain two areas of controversy: (1) whether levodopa is toxic, and (2) whether levodopa directly causes motor complications. Levodopa is toxic to cultured dopamine neurons, and this may be a problem in PD where there is evidence of oxidative stress in the nigra. However, there is little firm evidence to suggest that levodopa is toxic in vivo or in PD. Clinical trials have not clarified this situation. Levodopa is also associated with motor complications. Increasing evidence suggests that they are related, at least in part, to the short half-life of the drug (and its potential to induce pulsatile stimulation of dopamine receptors) rather than to specific properties of the molecule. Treatment strategies that provide more continuous stimulation of dopamine receptors provide reduced motor complications in MPTP monkeys and PD patients. These studies raise the possibility that more continuous and physiological delivery of levodopa might reduce the risk of motor complications. Clinical trials to test this hypothesis are underway. We review current evidence relating to these areas of controversy. © 2004 Movement Disorder Society [source] National identity and economic development: reiteration, recapture, reinterpretation and repudiation*NATIONS AND NATIONALISM, Issue 3 2003Ross Bond This article attempts to move beyond assumptions that nationalism is essentially cultural and/or narrowly political, and that it is primarily past-oriented and defensive. We do this by examining evidence relating to the creative (re)construction of the nation from a contemporary economic perspective. Paying particular attention to Scotland and Wales, we show that the mobilisation of national identity within this process of (re)construction is not exclusive to those who seek greater political autonomy. National identity is also mobilised, often in a ,banal' fashion, by non-political national institutions such as economic development agencies. We argue that, within the strategies and discourses of economic development, historic national characteristics are reconciled with contemporary needs and aspirations through four processes: reiteration, recapture, reinterpretation and repudiation. [source] Paleolithic diets: a sceptical viewNUTRITION BULLETIN, Issue 1 2000Marion Nestle Summary Some anthropologists have suggested that humans are genetically determined to eat diets quite different from those of today. Very little human evolution has occurred in the past 15,000 years. However, diets have changed dramatically and in parallel with a shift in disease patterns from infectious diseases and diseases associated with nutrient deficiencies, to chronic degenerative diseases associated with excessive and unbalanced intake of energy and nutrients. This review examines some of the archaeological evidence relating to the diets of early man and other primates, and current hunter-gatherer societies. Knowledge of the relative proportions of animal and plant foods in the diets of early humans is circumstantial, incomplete, and debatable and there are insufficient data to identify the composition of a genetically-determined optimal diet. The evidence related to Paleolithic diets is best interpreted as supporting the idea that diets based largely on plant foods promote health and longevity, at least under conditions of food abundance and physical activity. [source] Big Windows and Little Windows: Implementation in the ,Congested State'PUBLIC ADMINISTRATION, Issue 2 2004Mark Exworthy This paper argues for the need to re-assess models of policy implementation in the ,congested state'. This re-appraisal focuses on two main directions. The first involves locating implementation in the context of wider models of the policy process. We fuse three models, those of Kingdon, Wolman, and Challis et al., to form a new ,policy streams' approach. The second examines implementation in multi-level governance. In the UK and elsewhere, much of the focus of traditional implementation studies has been on the link between one central government department and a local agency. However, this vertical (central-local) dimension fails to give sufficient stress to the other horizontal dimensions of ,central-central' and ,local-local'. Paraphrasing Kingdon's terms, implementation models also need to incorporate the ,little windows' at local level as well as the ,big' windows at national level. Using evidence relating to the implementation of UK policy towards health inequalities, this paper argues successful implementation is more likely when the three policy streams are linked across the three dimensions. The model is thought to be applicable to other areas of the public sectors and complex issues facing all governments. [source] Evaluating medical grand roundsTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 2 2002Dr. Arthur I. Rothman EdD Director Abstract Introduction: Since January 2000, standard presenter evaluation forms have been made available to grand rounds organizers in the Department of Medicine, University of Toronto. During the 2000,2001 academic year, effort was directed at the accumulation of evidence for the validity of the results generated. Method: Two issues were addressed: The integrity or coherence of the form itself and the number of forms or evaluations required to achieve a stable estimate of the construct "presenter effectiveness" for an individual presenter. Results: Positive evidence relating to the integrity of the form is presented and the number of evaluations or ratings required to provide a stable estimate of presenter effectiveness is suggested. Discussion: Most presenters' ratings were distributed in a narrow range. Ranking of individual presentations would require exceptionally high precision. Separation into groups requires less precision. This type of classification appears sufficient to enable planning decisions. [source] Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniquesANAESTHESIA, Issue 6 2010M. J. Fredrickson Summary Shoulder surgery is well recognised as having the potential to cause severe postoperative pain. The aim of this review is to assess critically the evidence relating to the effectiveness of regional anaesthesia techniques commonly used for postoperative analgesia following shoulder surgery. Subacromial/intra-articular local anaesthetic infiltration appears to perform only marginally better than placebo, and because the technique has been associated with catastrophic chondrolysis, it can no longer be recommended. All single injection nerve blocks are limited by a short effective duration. Suprascapular nerve block reduces postoperative pain and opioid consumption following arthroscopic surgery, but provides inferior analgesia compared with single injection interscalene block. Continuous interscalene block incorporating a basal local anaesthetic infusion and patient controlled boluses is the most effective analgesic technique following both major and minor shoulder surgery. However, interscalene nerve block is an invasive procedure with potentially serious complications and should therefore only be performed by practitioners with appropriate experience. [source] What stresses remote area nurses?AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2009Current knowledge, future action Abstract Objective:,Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands,resources (JD-R) model. Methods:,A comprehensive literature review was conducted using the meta-databases Ovid and Informit. Setting:,Remote Australian primary health care centres. Results:,The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high-demand, low-resource context, the JD-R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems. Conclusion:,There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD-R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress. [source] A re-assessment of the taxonomy of Lens Mill. (Leguminosae, Papilionoideae, Vicieae)BOTANICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 1 2000MORAG E. FERGUSON Three taxonomic problems exist within the genus Lens. The first is the lark of agreement on classification and rank at the specific and sub-specific levels; the second involves the relationship between the recently distinguished L lamottei and L odemensis or L tomentosus and the third is the unreliability of stipule orientation as the primary character to distinguish between L odemensic and L. nigricans. The objectives of this study were to address these problems by investigating the classification of Lens in the light of evidence relating to crossability and phenetic relations, to idcntify morphological markers for taxon delimitation within the genus Lens., with special reference to L. lamottei, L nigricans and L odemensis, and to determine whether the taxon delimitation is supported by isozyme and RAPD evidence. As a result of these studies two new combinations are proposed, with L odemensis and I tamentosus being reduced to sub-species of L culinaris. A classification, key and descriptions of the accepted taxa within the genus are presented. [source] | |||||||||||||||||||||||||||||||||||||