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Selected AbstractsGait characteristics of diabetic patients: a systematic reviewDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 3 2008L. Allet Abstract Patients with diabetes are at higher risk of experiencing fall-related injuries when walking than healthy controls. The underlying mechanism responsible for this is not yet clear. Thus we intend to summarize diabetic patients' gait characteristics and emphasize those which could be the possible underlying mechanisms for increased fall risk. This systematic review aims, in particular, to: (1) evaluate the quality of existing studies which investigate the gait characteristics of diabetic patients, (2) highlight areas of agreement and contradiction in study results, (3) discuss and emphasize parameters associated with fall risk, and (4) propose new orientations and further domains for research needed for their fall risk prevention. We conducted an electronic search of Pedro, PubMed, Ovid and Cochrane. Two authors independently assessed all abstracts. Quality of the selected articles was scored, and the study results summarized and discussed. We considered 236 abstracts of which 28 entered our full text review. Agreement on data quality between two reviewers was high (kappa: 0.90). Authors investigating gait parameters in a diabetic population evaluated in particular parameters either associated with fall risk (speed, step length or step-time variability) or with ulcers (pressure). There is agreement that diabetic patients walk slower, with greater step variability, and present higher plantar pressure than healthy controls. We concluded that diabetic patients present gait abnormalities, some of which can lead to heightened fall risk. To understand its' underlying mechanisms, and to promote efficient prevention, further studies should analyse gait under ,real-life' conditions. Copyright © 2008 John Wiley & Sons, Ltd. [source] Options in Prehospital analgesiaEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2002Meredith L Borland Abstract Background: Prehospital analgesia options for paramedics have been limited due to the difficulty in achieving safe and effective pain relief without compromising transportation to hospital. The present paper identifies the analgesia methods currently available in the prehospital setting so as to evaluate the various options and highlight areas for future research. Methods: A literature review of Medline and Embase databases from 1966 until the present was undertaken. Further hand searching of all the references identified in these papers was also performed. All current literature was analysed and categorized according to one of four levels of evidence using National Health and Medical Research Council of Australia guidelines (1999). Results: There is a paucity of randomized control trials relating to prehospital analgesia. All published literature was level III or IV prospective or retrospective studies. Drug options used included nitrous oxide/oxygen mixtures, intravenous/intramuscular nalbuphine, intravenous tramadol and intravenous pure opiate agonists. Conclusions: The evidence supporting analgesic options in the prehospital setting is limited. There are few published data in this area despite the inadequacy of pain relief being recognized as a weakness in prehospital care. Prehospital analgesia is an area worthy of innovative methods for the administration of safe and effective analgesics without significant impact on transport times. Such methods should be prospectively evaluated in well-constructed trials. [source] Functional diversity of crustacean zooplankton communities: towards a trait-based classificationFRESHWATER BIOLOGY, Issue 5 2007ALLAIN J. BARNETT Summary 1. While studies of phytoplankton and terrestrial plant communities have increasingly emphasised the use of functional traits in ecological research, few have yet to apply this approach to zooplankton communities. 2. This study reviews laboratory and observational studies on zooplankton feeding and life history and provides a series of functional trait tables for the North American freshwater zooplankton. Qualitative and quantitative trait tables highlight areas where data were more scarce and point to which types of studies could fill in gaps in our knowledge of zooplankton niches. 3. Data were most complete for the Cladocera across most traits, while feeding information for cyclopoids was most sparse. Qualitative data that distinguished congeneric species were lacking for most groups. 4. A regional community dendrogram for common north-eastern North American zooplankton species was generated and shows that taxonomic differences between species do not capture fully functional differences based on the traits of body length, habitat, trophic group and feeding type. 5. The data collected here, combined with readily measurable species attributes, can be used to generate a multivariate measure of the functional niche of each species found in a community. Armed with this information, functional relationships that are useful for ecological studies of lake ecosystems can be more easily conducted. [source] Conceptualization of mild cognitive impairment: a reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2004Heather S. Davis Abstract Background Several factors have prompted renewed interest in the concept of declines in cognitive function that occur in association with aging, in particular the area between normal cognition and dementia. We review the changing conceptualization of what has come to be known as mild cognitive impairment (MCI) in an effort to identify recent developments and highlight areas of controversy. Methods Standard MEDLINE search for relevant English-language publications on mild cognitive impairment and its associated terms, supplemented by hand searches of pertinent reference lists. Results Many conditions cause cognitive impairment which does not meet current criteria for dementia. Within this heterogenous group, termed ,Cognitive Impairment, No Dementia' (CIND), there are disorders associated with an increased risk of progression to dementia. Still, the conceptualization of these latter disorders remains in flux, with variability around assumptions about aging, the relationship between impairment and disease, and how concomitant functional impairment is classified. Amongst patients with MCI, especially its amnestic form, many will progress to Alzheimer's disease (AD). In contrast with clinic-based studies, where progression is more uniform, population-based studies suggest that the MCI classification is unstable in that context. In addition to Amnestic Mild Cognitive Impairment (AMCI), other syndromes exist and can progress to dementia. For example, an identifiable group with vascular cognitive impairment without dementia shows a higher risk of progression to vascular dementia, Alzheimer's disease and mixed dementia. Conclusions Recent attempts to profile patients at an increased risk of dementia suggest that this can be done in skilled hands, especially in people whose symptoms prompt them to seek medical attention. Whether these people actually have early AD remains to be determined. The more narrowly defined MCI profiles need to be understood in a population context of CIND. Copyright © 2004 John Wiley & Sons, Ltd. [source] Developing a Mental Health Guide for Families and Carers of People with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2007Anastasia Gratsa Background, Although there is already information available about caring for someone with a mental health problem, there is very little written for families and carers of people with intellectual disabilities. Materials and methods, This paper describes the development of a Guide as such a resource. The consultation stage involved interviews and focus groups with families, service users and paid carers (n = 20) to highlight their needs and preferred format. Additional carers (n = 12) completed structured questionnaires to evaluate the Guide. Results, The initial consultation showed that an easily accessible and user-friendly information resource was needed. The evaluation showed that family carers were satisfied with the Guide, finding it easy to read and covering most of the information required. However, they did highlight areas that needed further detail. Conclusions, The involvement of carers in the development of such resources is essential, emphasizing the benefit of carers' knowledge and experience to professionals. [source] Good, bad, or in-between: How does the daily behavior report card rate?PSYCHOLOGY IN THE SCHOOLS, Issue 2 2002Sandra M. Chafouleas Our purpose here was to define and review the daily behavior report card (DBRC) as a monitoring and/or intervention technique. We considered a measure of a DBRC to be if a specified behavior was rated at least daily, and that information was shared with someone other than the rater. In general, it has been suggested that DBRCs may be feasible, acceptable, effective in promoting a positive student, and a way to increase parent/teacher communication. In addition, DBRCs are highly adaptive in that they represent a broad array of both monitoring and intervention possibilities rather than having a single, scripted purpose. All of these characteristics make the DBRC appealing for use in applied settings. However, an extensive, methodologically sound literature base does not yet exist. Despite the appeal of using DBRCs, widespread endorsement cannot be made without caution. We conclude with implications for use in practice and highlight areas in need of further investigation. © 2002 Wiley Periodicals, Inc. [source] Immunity to vacuolar pathogens: What can we learn from Legionella?CELLULAR MICROBIOLOGY, Issue 11 2004Annie L. Neild Summary Intracellular pathogens can manipulate host cellular pathways to create specialized organelles. These pathogen-modified vacuoles permit the survival and replication of bacterial and protozoan microorganisms inside of the host cell. By establishing an atypical organelle, intracellular pathogens present unique challenges to the host immune system. To understand pathogenesis, it is important to not only investigate how these organisms create unique subcellular compartments, but to also determine how mammalian immune systems have evolved to detect and respond to pathogens sequestered in specialized vacuoles. Recent studies have identified genes in the respiratory pathogen Legionella pneumophila that are essential for establishing a unique endoplasmic reticulum-derived organelle inside of mammalian macrophages, making this pathogen an attractive model system for investigations on host immune responses that are specific for bacteria that establish vacuoles disconnected from the endocytic pathway. This review will focus on the host immune response to Legionella and highlight areas of Legionella research that should help elucidate host strategies to combat infections by intracellular pathogens. [source] Iraq: The Military CampaignINTERNATIONAL AFFAIRS, Issue 4 2003Timothy Garden This article draws together early military implications of a campaign where intensive operations lasted barely a month. The deeper insights will need much more time for the post operations reports to be written, detailed battle assessments to be made, and the key decision-makers to record their thinking. As far as is possible, the article deals with the purely military aspects of the campaign. The promise of a decade of development of high technology air power was expected by some to show a new way of fighting wars. The evidence from the campaign appears to give a more mixed message. Certainly, a higher proportion of air weapons was guided in this conflict than in any previous war. Strategic intelligence appears to have been less accurate than had been expected. The unexpected initial resistance by Iraqi forces, followed by later capitulation, required flexible coalition operations. The spectre of the use of chemical and biological weapons proved unfounded. The effectiveness of special operations will be one area for deeper study. The media strategy will need reviewing for future operations. At this stage, the article does no more than record the sequence of events, make broad judgements about the strategic and tactical approaches of both the Coalition and Iraqi forces, and highlights areas where further investigation may be useful to draw firmer conclusions. [source] Children's prescription medicines: parents' perceptions on dosing intervals, dosing devices and prescription adviceINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2007Dr. Therése Kairuz senior lecturer, pharmacy practice Objective To gather information on devices used to administer liquid medicines, dosing intervals for antibiotic administration, and parents' perceptions of the advice received from pharmacists about prescription medicines, for children up to the age of six years. Setting Six schools from different socio-economic areas were selected within the Auckland area of New Zealand. To facilitate distribution and collection of questionnaires, the headmaster or a teacher was known to the researchers. Method An anonymous questionnaire was distributed to year 1 and 2 students (aged five and six years) to take home for completion by a parent or primary caregiver. Respondents were asked to refer to their youngest child and/or to the last time they had given medicines or received a prescription for a child. Key findings A total of 299 completed questionnaires were received (48.2%); 60 questionnaires had not been distributed by school teachers in error, and the overall return rate was thus adjusted to 53.4%. The device used most frequently to administer medicines to younger children up to the age of three years was an oral medicine syringe, while nearly one-third of children aged three to six years received medicine in a ,teaspoon'. Almost half the respondents (48.8%) indicated they would be most likely to forget the midday dose of antibiotics, and dosing deviated from recommended intervals. Most respondents had received advice from a pharmacist on how to take the medicine, and had understood instructions and had the opportunity to ask questions. Conclusion This study highlights areas that pharmacists can include when advising parents and guardians about children's medicines, such as ideal dosing intervals of antibiotics and the use of accurate dosing devices. [source] Modelling the efficacy of entomopathogenic nematodes in the regulation of invertebrate pests in glasshouse cropsJOURNAL OF APPLIED ECOLOGY, Issue 2 2000A. Fenton Summary 1. ,Entomopathogenic nematodes belonging to the families Heterorhabditidae and Steinernematidae are lethal obligate parasites of a wide range of invertebrate species. These nematodes exhibit many characteristics that make them ideal candidates as biological control agents of insect pests (rapid host death, high reproductive rates, easily mass-reared in vitro, easy application techniques). 2. ,However, at present, the number of pest species to which these nematodes are applied successfully is small. Clearly, there is a need to develop existing knowledge of the nematode into a more complete understanding of the nematode,pest system as a whole. 3. ,To consider the potential of entomopathogenic nematodes as biological control agents, we adopted a generalized analytical modelling approach and, using realistic parameter estimates, determined the conditions under which these nematodes can regulate a pest population. 4. ,Stability analyses suggested that entomopathogenic nematodes may not be capable of regulating a host population to a stable equilibrium. Long-term persistence of the host and nematode population is unlikely, due to the highly destabilizing effects of the parasite,host relationship. As such, these nematodes may be better suited to short-term control through inundative application techniques rather than long-term regulation. 5. ,This preliminary generalized model highlights areas where further work is needed. This includes estimation of the probability of nematode infection in the field, the effect of host size on the transmission cycle and the influence of spatial heterogeneity on stability. [source] Criminal justice and penal populism in IrelandLEGAL STUDIES, Issue 4 2008Dr Liz Campbell In constructing criminal policy the Irish legislature seems to be driven predominantly by a pragmatic and populist approach, in contrast to the rights-oriented jurisprudence of the Supreme Court. This paper describes the conflict between the courts and the legislature in relation to criminal justice matters in Ireland, particularly in the context of bail, the exclusionary rule and sentencing, and analyses the reasons for this divergence, drawing on the concept of penal populism. Although the Irish courts serve as a valuable bulwark against punitive populist policies, this paper considers if this failure to adhere to the desires of the legislature and to public opinion is anti-democratic. Furthermore, in assessing the apparent rift between the two arms of the Irish State, this paper highlights areas of criminal justice in which this conceptualisation of the legislature as punitive and the courts as rights-enforcing is unduly simplistic and possibly inaccurate. [source] Simultaneous Controllability of PSD and MWD in Emulsion PolymerisationMACROMOLECULAR REACTION ENGINEERING, Issue 5 2008Stephen J. Sweetman Abstract A sensitivity study of particle size distribution (PSD) and molecular weight distribution (MWD) responses to perturbations in initiator, surfactant, monomer and chain transfer agent in a semi-batch emulsion polymerisation is presented. The objective is to provide a systematic study on the ability to simultaneously control both PSD and MWD, towards inferential control of end-use product properties. This would lead towards identification of the practical feasible regions of operability. All inputs appeared to have an intrinsic and simultaneous influence on end-time PSD and MWD. Trends shown in experimental results have been explained in a mechanistic sense and also compared to simulation results from a combined PSD/MWD population balance model. The preliminary comparison between experiment and simulation highlights areas to be focussed on with respect to model improvement. [source] Mechanisms of virus-induced asthma exacerbations: state-of-the-art.ALLERGY, Issue 5 2007A GA2LEN, InterAirways document Viral infections of the respiratory tract are the most common precipitants of acute asthma exacerbations. Exacerbations are only poorly responsive to current asthma therapies and new approaches to therapy are needed. Viruses, most frequently human rhinoviruses (RV), infect the airway epithelium, generate local and systemic immune responses, as well as neural responses, inducing inflammation and airway hyperresponsiveness. Using in vitro and in vivo experimental models the role of various proinflammatory or anti-inflammatory mediators, antiviral responses and molecular pathways that lead from infection to symptoms has been partly unravelled. In particular, mechanisms of susceptibility to viral infection have been identified and the bronchial epithelium appeared to be a key player. Nevertheless, additional understanding of the integration between the diverse elements of the antiviral response, especially in the context of allergic airway inflammation, as well as the interactions between viral infections and other stimuli that affect airway inflammation and responsiveness may lead to novel strategies in treating and/or preventing asthma exacerbations. This review presents the current knowledge and highlights areas in need of further research. [source] The White House Office of Management and AdministrationPRESIDENTIAL STUDIES QUARTERLY, Issue 2 2001PERI E. ARNOLD The Office of Management and Administration (OMA) grew out of President Carter's 1977 reorganization of White House administration. Its title dates to the administration of George H. W. Bush. The head of the office, the assistant to the president for management and administration, currently handles numerous White House administrative functions such as salaries, office space, and budgeting, along with the allocation of perquisites like mess privileges and parking. OMA supervises units collectively called "White House Operations," including the Travel Office, the Visitors Office, the Intern Program, and personnel security. The assistant for management and administration also oversees the White House Military Office. Drawing principally on interviews with former heads of the OMA and its predecessors, this article enumerates the great range of the office's responsibilities, highlights areas of potential controversy, considers the characteristics of a successful OMA manager, and summarizes the diverse approaches that have been taken to running the office. [source] GLPs and medical devicesQUALITY ASSURANCE JOURNAL, Issue 2 2002Linda Palagi Lynn Abstract Applying Good Laboratory Practice (GLP) regulations to studies of medical devices and combination products (drug/device products) presents some unique challenges. The complexity of medical devices , which may be internal, external, or composed of many intricate parts including software, hardware, or drugs to perform their intended task , requires interpretation of the regulations. Further, the dynamics of the conduct of non-clinical laboratory studies for medical devices can be quite complex often involving a team of scientists, engineers, computer specialists, technicians, veterinarians, physicians, pathologists and equipment from both the test facility and sponsor. This article highlights areas of the GLP regulations and provides information and suggestions for GLP compliance for medical device studies. Copyright © 2002 John Wiley & Sons, Ltd. [source] Framing Disparities Along the Continuum of Care from Chronic Kidney Disease to Transplantation: Barriers and InterventionsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2009K. Ladin Research in renal transplantation continues to document scores of disparities affecting vulnerable populations at various stages along the transplantation process. Given that both biological and environmental determinants contribute significantly to variation, identifying factors underlying an unfairly biased distribution of the disease burden is crucial. Confounded definitions and gaps in understanding causal pathways impede effectiveness of interventions aimed at alleviating disparities. This article offers an operational definition of disparities in the context of a framework aimed at facilitating interventional research. Utilizing an original framework describing the entire continuum of the transplant process from diagnosis of chronic kidney disease through successful transplant, this article explores the case of racial disparities, illustrating key factors predicting and perpetuating disparities. Though gaps in current research leave us unable to identify which stages of the transplant pathway adversely affect most people, by identifying key risk factors across the continuum of care, this article highlights areas suited for targeted interventions and presents recommendations for improvement and future research. [source] | ||||||||||||||||