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Greater Challenges (greater + challenge)
Selected AbstractsPost-Totalitarian Educational Transition: to change a label is easy, but to effect a comprehensive change in practice represents a far greater challengeEUROPEAN JOURNAL OF EDUCATION, Issue 2 2003ELIZABETH A. McLEISH First page of article [source] Trancranial Doppler Monitoring of Response to Therapy for Meningovascular SyphilisJOURNAL OF NEUROIMAGING, Issue 1 2003Roger E. Kelley MD ABSTRACT Meningovascular syphilis is now quite uncommon, but there have been increasing reports in patients immunocompromised with human immunodeficiency virus. The response of syphilis affecting the central nervous system to antibiotic therapy remains a challenge. This is an even greater challenge in patients who have underlying compromise of the immune system. The authors present a 46-year-old male with recurrent stroke who was found to have cerebrospinal fluid compatible with syphilitic involvement of the central nervous system and a cerebral arteriogram, which revealed focal narrowing of the right middle cerebral artery. The baseline transcranial Doppler study demonstrated increased mean and peak flow velocity within the right middle cerebral artery. Despite a 10-day course of intravenous penicillin, with substantial improvement in the cerebrospinal fluid results, this flow velocity elevation persisted, in a remarkably consistent pattern, over a 4-month follow-up period. Thus, the involved vessel remained patent following treatment, but no clear resolution of the stenotic lesion was observed. [source] Denaturing capillary electrophoresis for automated detection of L858R mutation in exon 21 of the epidermal growth factor receptor gene in prediction of the outcome of lung cancer therapyJOURNAL OF SEPARATION SCIENCE, JSS, Issue 15 2010Lucie Benesova Abstract The presence of activating mutations within the tyrosine kinase domain of the epidermal growth factor receptor gene has been attributed to a positive response to biological therapy of lung cancer by small-molecular tyrosine kinase inhibitors, gefitinib and erlotinib. Among the two most significant mutation types are deletions in exon 19 and a single point substitution in exon 21 (termed L858R). The exon 19 deletions can readily be examined by fragment analysis, due to the characteristic length difference between the normal and mutated PCR product. Analysis of the L858R point mutation, however, presents a greater challenge. The current paper is aimed at developing a sensitive, yet simple, low-cost mutation detection assay directed at the L858R mutation using a method based on CE of heteroduplexes under partial denaturing conditions. We perform optimization of separation conditions on different commercial instruments including ones equipped with 8, 16 and 96 capillaries. We present normalized migration reproducibility in the range from 1 (8 and 16) to 5% (96) RSD. A reliable distinction of the R836R silent polymorphism from a potential presence of the L858R mutation is also demonstrated. In its implementation, the presented assay is just another application running on a conventional CE platform without the need of dedicated instrumentation. [source] Assessing environmental risks of transgenic plantsECOLOGY LETTERS, Issue 2 2006D. A. Andow Abstract By the end of the 1980s, a broad consensus had developed that there were potential environmental risks of transgenic plants requiring assessment and that this assessment must be done on a case-by-case basis, taking into account the transgene, recipient organism, intended environment of release, and the frequency and scale of the intended introduction. Since 1990, there have been gradual but substantial changes in the environmental risk assessment process. In this review, we focus on changes in the assessment of risks associated with non-target species and biodiversity, gene flow, and the evolution of resistance. Non-target risk assessment now focuses on risks of transgenic plants to the intended local environment of release. Measurements of gene flow indicate that it occurs at higher rates than believed in the early 1990s, mathematical theory is beginning to clarify expectations of risks associated with gene flow, and management methods are being developed to reduce gene flow and possibly mitigate its effects. Insect pest resistance risks are now managed using a high-dose/refuge or a refuge-only strategy, and the present research focuses on monitoring for resistance and encouraging compliance to requirements. We synthesize previous models for tiering risk assessment and propose a general model for tiering. Future transgenic crops are likely to pose greater challenges for risk assessment, and meeting these challenges will be crucial in developing a scientifically coherent risk assessment framework. Scientific understanding of the factors affecting environmental risk is still nascent, and environmental scientists need to help improve environmental risk assessment. [source] Risk-based decision making to manage contaminated sedimentsINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2006Todd S Bridges Abstract This paper summarizes discussion among the 7 authors who served on an expert panel at the Third Battelle International Conference on Remediation of Contaminated Sediments held in New Orleans, Louisiana, USA, in January 2005. In this article, the authors review how sediment management decisions are currently made and address the question of how management decisions should be made in the future. It is arguably the case that sediment remediation presents greater challenges and more complexity than traditional land-based clean-ups. Although understanding of these challenges and complexities has grown over the last 25 y, there has been, until recently, relatively little innovation in the approaches used to manage the environmental risks posed by contaminated sediments. New methods that facilitate a more rigorous analysis of the multiple criteria considered in decision making have been developed. These methods, collectively known as multicriteria decision analysis (MCDA), coupled with the use of comparative-risk assessment and cost/benefit analysis, are proposed as an effective, efficient, and credible foundation for evaluating remedy alternatives at contaminated sediment sites. [source] Blood pressure , lower targets, greater challengesJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 6 2003A. M. A. Shehab MBChB MMED MD MRCP No abstract is available for this article. [source] Using Success Courses for Promoting Persistance and CompletionNEW DIRECTIONS FOR COMMUNITY COLLEGES, Issue 112 2000Martina Stovall Minority students often face greater challenges than their white peers in becoming integrated into the college environment. Recent research suggests that participation in a student success course could be especially beneficial for minority students who attend predominantly white community colleges. This chapter presents a model for designing and implementing a community college student success course. [source] Genetically Engineered Crops: Their Potential Use for Improvement of Human NutritionNUTRITION REVIEWS, Issue 5 2002Lin Yan Ph.D. Great success has been achieved in increasing agriculture productivity to fulfill human needs during the second half of the 20th century. However, there will be much greater challenges in the future. Based on the current population growth rate of 1.4% per year, the world's population is forecast to increase from the current level of approximately six billion to nine to twelve billion in 50 years. In addition to continuously increasing demand for agricultural production, there is an urgent need to improve the nutritional quality of human diets for this rapidly growing human population. Malnutrition is still a worldwide health issue. Macronutrient and micronutrient deficiencies are prevalent in developing countries, and over-consumption of certain nutrients in developed countries (e.g., saturated fatty acids) is associated with high incidence of certain chronic diseases. Furthermore, there will be declining natural resources such as arable land and water, and the challenges to humans must be met without further degrading the environment. Biotechnology offers a valuable tool to help achieve these goals. This review focuses on the most recent advances in biotechnology, which promise to improve human nutrition by enhancing the nutrient density of plant foods. Issues relating to the safety of food products from genetically engineered crops are also discussed. [source] Adapting to Europe: Is it Harder for Britain?BRITISH JOURNAL OF POLITICS & INTERNATIONAL RELATIONS, Issue 1 2006Vivien A. Schmidt Britain has had difficulties adapting to European integration. The problems result not so much from the EU-related changes in national policies, which have actually been rather moderate, or from the EU-related changes in governance practices, although these have been significant, affecting national institutional structures, policy-making processes and representative politics. They do not even follow from the serious challenges that the EU-related changes in governance practices pose for traditional ideas about democracy. Rather, they come from the lack of a discourse capable of legitimating such changes. To demonstrate this, the article considers Britain's problems in comparative perspective with those of France, which has had greater changes in policies and practices, greater challenges to national ideas, but a more legitimating discourse, and Germany and Italy, where changes in the practices and challenges to ideas have not been as significant. [source] Anxiety disorders in advanced cancer patientsCANCER, Issue 7 2010Correlates, predictors of end-of-life outcomes Abstract BACKGROUND: The authors explored associations between anxiety disorders and advanced cancer patients' physical performance status, physician-patient relationships, end-of-life (EOL) treatment preferences and outcomes, and quality of death. METHODS: The Coping with Cancer study was a National Cancer Institute/National Institute of Mental Health-sponsored, prospective, longitudinal, multicenter cohort study of patients with advanced cancer. Six hundred thirty-five patients completed the anxiety disorders module of the Structured Clinical Interview for the Diagnostic Statistical Manual IV. The results were compared with patients' baseline physical performance status, treatment preferences, perceptions of the physician-patient relationship, and advance care planning (ACP). RESULTS: Approximately 7.6% of patients met criteria for an anxiety disorder. Patients who were diagnosed with an anxiety disorder were more likely to be women and younger and to have a worse physical performance status. Although there were no significant differences in patients' EOL treatment preferences or care, ACP, hospice enrollment, or patients' location of death, there were significant differences in how patients with anxiety disorders perceived the physician-patient relationship. Patients with anxiety disorders had less trust in their physicians, felt less comfortable asking questions about their health, and felt less likely to understand the clinical information that their physicians presented. They also were more likely to believe that their physicians would offer them futile therapies and would not adequately control their symptoms. CONCLUSIONS: Women, patients who were more physically impaired, and younger patients with advanced cancer were more likely to meet criteria for an anxiety disorder. Patients with advanced cancer who had an anxiety disorder were more likely to experience greater challenges to the physician-patient relationship. Cancer 2010. © 2010 American Cancer Society. [source] | |||||||||||||