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Initial Concern (initial + concern)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Current treatment of non-alcoholic fatty liver disease

DIABETES OBESITY & METABOLISM, Issue 3 2009
Mohamed H. Ahmed
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in Western World and frequently associated with insulin resistance and overweight and occurs often with type 2 diabetes. Interestingly, NAFLD is not only regarded as a hepatic component of the metabolic syndrome but also as an independent risk factor and a marker for increase in cardiovascular disease (CVD). Significantly, NAFLD is associated with an increased risk of all-cause mortality and predicts future CVD events independent of age, sex, LDL-cholesterol and features of metabolic syndrome. Although there was initial concern about drug toxicity with NAFLD, increasing evidence suggests that commonly used drugs such as metformin and statins do not cause harm and the thiazolidinediones (TZDs) may even confer a therapeutic benefit in NAFLD. Interestingly, medical and surgical treatments of obesity show potential benefit in treating NAFLD. In this review, we have focused on the safety and therapeutic impact of TZDs, statins, metformins and obesity medications in NAFLD. The potential benefit of bariatric surgery and the role of weight loss per se in treating NAFLD are also discussed. [source]

Closing the open sea: Development of fishery management in four Icelandic fisheries

NATURAL RESOURCES FORUM, Issue 1 2003
Thórólfur Matthíasson
The article outlines the development of Iceland's fishery rights and the extension of its territorial waters between the 1950s and the mid-1970s, whereby Iceland gained exclusive control and use of the marine resources of the waters within 12, later 50, and ultimately 200 nautical miles around the island. The article concentrates on four of Iceland's main fisheries: shrimp, herring, capelin and cod. These four fisheries are discussed separately and in depth, presenting the beginnings and growth of the industry and detailing the development of management practices and the corresponding legislation and regulatory measures. Iceland's initial concern was to gain control over the marine resources surrounding the island, but once this was achieved, the focus of attention shifted to managing first the economic and soon also the ecological aspects of its tremendous resource. Informed mainly by indigenous expertise, Iceland's concern was to limit overfishing, manage its fisheries sustainably both from the economic and ecological points of view, and find the best ways to distribute the revenues from the marine harvest. The article looks at each of the four fisheries to clarify how the individual transferable quota (ITQ) system came into being, how initial quota holdings were allotted, and analyses the circumstances under which the ITQ system became the management tool of choice. For each fishery, the process of regulatory evolution was quite unique. At the same time, there is a common pattern to all the fisheries, which may be summarized as follows. Firstly, serious attempts to reform management practices only got underway when the fishery had collapsed or was close to collapse. Secondly, stakeholders invariably started the process of regulation by limiting access to the fishery. Thirdly, a variety of rules were implemented to allocate rights to participate in the fishery to additional entrants once membership had been closed. Finally, prior to the invention of the ITQ system, prices were used to manage fisheries in Iceland. It may be concluded that the management of fisheries by ITQs may be a historical accident, rather than the end point of a logical evolution. [source]

Clinician attitudes towards early psychosis intervention: the first 4 years

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2002
J. Gorrell
Objectives, A questionnaire was administered with an aim to assess the attitudes of mental health clinicians towards the adoption of an early intervention approach and to monitor attitudinal change during the introduction of this approach. Method, The perceptions of Early Psychosis Intervention (PEPI) questionnaire was developed and then completed by clinicians at three time points over 4 years during the introduction of a best practice early intervention approach (n=143, 178, 102, respectively). Results, Indicate that at all three time points clinicians generally agreed with the potential advantages of early intervention but were unsure about their own readiness to implement such intervention. Responses to an open-ended question regarding concerns about the new approach indicated a positive shift up the developmental process of change, from initial concerns about personal skills, resources and workload, to a gradually more specific focus on particular aspects of clinical interventions and on the impact of the new approach. Conclusions, Our services have introduced early psychosis intervention. Clinicians have moved up the developmental process of change. The questionnaire has provided a means for clinicians to influence the change process. [source]

Cardiopulmonary resuscitation training for undergraduate medical students: a five-year study

MEDICAL EDUCATION, Issue 3 2002
Colin A Graham
Background Cardiopulmonary resuscitation (CPR) training for undergraduate medical students and junior doctors has been noted to be poor in the past. Attempts have been made over the last decade to improve CPR training for all health professionals. Aim This study aimed to determine if CPR training for undergraduate medical students in a single institution improved after initial concerns in 1992, and to observe trends in CPR training over five years. Methods Prospective single centre observational cohort survey by means of a 2-page self completed questionnaire to final year undergraduate medical students at the University of Glasgow (1993,97 inclusive). Results Mean annual response rate 58% (range 48% , 67%). 99% of responders had been trained in basic life support during undergraduate training. The use of simulated arrests for training increased significantly. CPR training was concentrated in the first and final years. Training in all aspects of advanced life support increased, as did the students' confidence in these techniques. Student satisfaction with the amount of basic life support training increased very significantly and there was a small, but significant increase in student satisfaction with advanced life support training. Overall confidence at the prospect of being a member of the resuscitation team on qualification did not increase. Conclusions There has been a sustained improvement in CPR training at this institution since 1993. Improvements in the training of specific advanced life support techniques does not lead to improved overall confidence in using these skills on qualification. Advanced life support training requires further expansion. [source]