Increasing Need (increasing + need)

Distribution by Scientific Domains

Selected Abstracts

Refugee perceptions of the quality of healthcare: findings from a participatory assessment in Ngara, Tanzania

DISASTERS, Issue 4 2005
Edmund Rutta
Abstract This article describes the findings of a participatory assessment of Burundian and Rwandan refugees' perceptions of the quality of health services in camps in Ngara, Tanzania. Taking a beneficiary-centred approach, it examines a collaborative effort by several agencies to develop a generic field guide to analyse refugees' views of healthcare services. The objective was to gather information that would contribute to significant improvements in the care offered in the camps. Although the primary focus was on healthcare, several broader questions considered other general apprehensions that might influence the way refugees perceive their healthcare. Findings indicated that while refugees in Ngara were generally satisfied with the quality of healthcare provided and healthcare promotion activities, recognition of some key refugee concerns would assist healthcare providers in enhancing services. With increasing need for refugee community participation in evaluating humanitarian assistance, this assessment has relevance both in the context of Ngara and beyond. [source]

Biodiverse, a tool for the spatial analysis of biological and related diversity

ECOGRAPHY, Issue 4 2010
Shawn W. Laffan
Biodiverse is a tool for the spatial analysis of diversity using indices based on taxonomic, phylogenetic and matrix (e.g. genetic dissimilarity) relationships. The explosion in georeferenced biological specimen and survey data means there is an increasing need for such tools. Biodiverse supports four processes: 1) linked visualisation of data distributions in geographic, taxonomic, phylogenetic and matrix spaces; 2) spatial moving window analyses including richness, endemism, phylogenetic diversity and beta diversity; 3) spatially constrained agglomerative cluster analyses; and 4) randomisations for hypothesis testing. Biodiverse is open-source and supports user developed extensions. It can be used both through a graphical user interface and scripts. Biodiverse can be downloaded from . [source]

LCC,The economic pillar of sustainability: Methodology and application to wastewater treatment

Gerald Rebitzer
Industrial applications of supply chain cost management, along with life cycle costing of goods and services, are increasing. Several industrial sectors, in particular the automotive, electronics, and primary materials, have engaged in programs to coordinate upstream and downstream activities to reduce environmental burdens. At the same time, there is an increasing need to pass on information on product, material, and energy flows along the supply chain, as well as to provide data on the use and end-of-life phases of goods and services. Therefore, methods to analyze, assess, and manage these flows, from an economic as well as an environmental perspective, are of essential importance, particularly in established large-scale industries where suppliers are increasingly challenged to provide comprehensive cost and environmental information. In this context, a life cycle costing analysis (LCC), conducted as part of life cycle management activities, can provide important opportunities. Therefore, this paper focuses on a life cycle assessment (LCA)-based LCC method, which utilizes an LCA model as a basis for cost estimations in product development and planning. A case study on life cycle costing of wastewater treatment illustrates the practical use and benefits of the method. [source]

An Approach to Interdisciplinary Training in Postgraduate Education

P Brodin
Aims, A primary goal for clinical graduate training is to provide the student with the expertise required for specialist treatment in the actual discipline. At the same time there is an increasing need for a broader perspective on specialist care and the students should be aware of the limitations inherent in own specialty. In order to plan treatment in the best interest of the patient, and to be prepared to take part in treatments involving other specialties, the students should be exposed to interdisciplinary cooperation throughout the training. An approach to joint academic and clinical training with the purpose of providing graduate students with a broader perspective on specialist care is described and discussed. Material and methods, During their first year graduate students in the 7 different disciplines complete a joint Core Curriculum consisting of 8 different courses to stimulate a scientific approach to their profession and understanding of basic biologic mechanisms. To create a learning environment focusing on the development of interdisciplinary competence, a joint clinic has been established. Teams of students from different disciplines have been organized in order to establish ,partnership' for the treatment of patients with complex problems. The students also take part in the sessions held by a faculty Team of experts for assessment and treatment planning of referred patients with complex problems. Furthermore, faculty members conduct courses and seminars for students from other disciplines and students also participate in selected parts of the regular program in other disciplines. Results, Formal evaluation has so far been conducted for the Core Curriculum. Most students respond that they are satisfied with the courses, and the curriculum has also been adjusted based on the comments. The students report that treatment of patients in need of interdisciplinary treatment has been facilitated by having ,partners' in other disciplines. Participation in the Team of expert's sessions has been appreciated, and the attendance at interdisciplinary courses and seminars has been good. Conclusions, Based on the experience over the last 5 years, the interdisciplinary aspects of graduate training should be expanded to stimulate a holistic approach also to specialist treatment. [source]

Mechanical Properties of Compound Extruded Aircraft Stringer Profiles Under Cyclic Loading,

Kay A. Weidenmann
The worldwide competition in the field of aircraft structures leads to an increasing need for functionality and safety as well as for cost and weight reduction. For instance stringers could be directly welded on the aircraft's skin sheet. The requirements to be met are increased safety against crack initiation and crack growth as well as improved residual strength against failure after harmful impact of foreign objects. The application of continuously reinforced aluminium profiles which are manufactured by compound extrusion leads to increased strength and stiffness of the profiles by combining the aluminium matrix with high strength wires. Thus aircraft stringers of such profiles represent an innovative concept with improved properties. The characterisation of compound extrusions based on medium and high strength aircraft aluminium alloys EN AW-6056 and EN AW-2099 shows that a good embedding of the reinforcing high strength wires (Co-based and Fe-based) can be achieved. Furthermore the mechanical properties under cyclic loading of the profiles were measured and the S/N-curves for the different compound combinations were determined. Subsequently the crack initiation and propagation was analysed by using metallographic and SEM investigations. The fatigue resistance of reinforced specimens is increased compared to unreinforced ones. The fatigue cracks originate at the surface of unreinforced specimen while the cracks in reinforced specimens are initiated at the wire,matrix interface. [source]

Knowledge-based treatment planning for adolescent early intervention of mental healthcare: a hybrid case-based reasoning approach

EXPERT SYSTEMS, Issue 4 2007
W.M. Wang
Abstract: Treatment planning is a crucial and complex task in the social services industry. There is an increasing need for knowledge-based systems for supporting caseworkers in the decision-making of treatment planning. This paper presents a hybrid case-based reasoning approach for building a knowledge-based treatment planning system for adolescent early intervention of mental healthcare. The hybrid case-based reasoning approach combines aspects of case-based reasoning, rule-based reasoning and fuzzy theory. The knowledge base of case-based reasoning is a case base of client records consisting of documented experience while that for rule-based reasoning is a set of IF,THEN rules based on the experience of social service professionals. Fuzzy theory is adopted to deal with the uncertain nature of treatment planning. A prototype system has been implemented in a social services company and its performance is evaluated by a group of caseworkers. The results indicate that hybrid case-based reasoning has an enhanced performance and the knowledge-based treatment planning system enables caseworkers to construct more efficient treatment planning in less cost and less time. [source]

Reference Materials in Geoanalytical Research -Review for 2004 and 2005

Klaus Peter Jochum
This review gives an overview of the use and development of reference materials of geochemical and environmental interest in the literature of the years 2004 and 2005. In these years the performance of existing methods has been improved and new geochemical applications using new techniques have been developed. Accordingly, there was an increasing need for new reference materials, especially for in situ microanalysis and for precise stable isotope measurements. In addition, there was a notable trend for further characterisation of existing reference materials, mainly for the platinum-group elements. This review focuses on five topics: reference materials for platinum-group elements, reference glasses for in situ microanalysis, zircon reference materials, isotopic reference materials, and the development and certification of reference materials. [source]

Observations and recommendations for assessing patient satisfaction in a primary care setting using a previously validated questionnaire

Anné-Lise McDonald BA MSc
Abstract Within the rapidly changing climate of primary care, there is an increasing need to evaluate the reactions of patients to real and proposed changes in practice. There are a number of methodologies, both qualitative and quantitative which have been employed to do this. This article presents the methodological problems which may be encountered in evaluating patients' opinions and attitudes in a primary care setting. We begin by discussing the issues which need evaluation, then describe the research process of a recent case study which aimed to evaluate patient satisfaction using a previously validated survey instrument, including the modifications which had to be made to overcome the problems of research in a real life practice setting. We then discuss the strengths and weaknesses of applying different methodological instruments within a primary care setting, and propose a mixed methodological framework as a template for future research which combines the strengths of both large scale survey and small scale qualitative methods to give more insight into the concerns and beliefs of patients as changes occur within their local practice. [source]

Managing empowerment and control in an intranet environment

Aidan Duane
Abstract. An intranet increases in sophistication and complexity as it evolves. This evolution leads to an increasing need for control over the intranet. However, this is a contentious issue, as an intranet is deemed to be an empowering technology. Consequently, intranet control systems must balance empowerment and control so as not to negate each other. This paper investigates intranet control activities and their effect on users' perceptions of empowerment throughout the evolution of an intranet in Hewlett Packard (Ireland). The growth of the intranet is charted as a six-stage model that illustrates an evolution of purpose, control and empowerment. The control strategies for managing the intranet implemented at each stage are investigated, and their resultant effects on empowerment are evaluated. The study reveals the importance of balancing control strategies with empowerment initiatives in managing intranet environments. Based on the evidence available, the study recommends the implementation of specific controls at particular stages in the evolution of an intranet in order to achieve control systems that balance empowerment and control. [source]

Tracking accuracy of a semi-Lagrangian method for advection,dispersion modelling in rivers

S. Néelz
Abstract There is an increasing need to improve the computational efficiency of river water quality models because: (1) Monte-Carlo-type multi-simulation methods, that return solutions with statistical distributions or confidence intervals, are becoming the norm, and (2) the systems modelled are increasingly large and complex. So far, most models are based on Eulerian numerical schemes for advection, but these do not meet the requirement of efficiency, being restricted to Courant numbers below unity. The alternative of using semi-Lagrangian methods, consisting of modelling advection by the method of characteristics, is free from any inherent Courant number restriction. However, it is subject to errors of tracking that result in potential phase errors in the solutions. The aim of this article is primarily to understand and estimate these tracking errors, assuming the use of a cell-based backward method of characteristics, and considering conditions that would prevail in practical applications in rivers. This is achieved separately for non-uniform flows and unsteady flows, either via theoretical considerations or using numerical experiments. The main conclusion is that, tracking errors are expected to be negligible in practical applications in both unsteady flows and non-uniform flows. Also, a very significant computational time saving compared to Eulerian schemes is achievable. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Finite element modelling of free-surface flows with non-hydrostatic pressure and k,, turbulence model

C. Leupi
Abstract Validation of 3D finite element model for free-surface flow is conducted using a high quality and high spatial resolution data set. The commonly numerical models with the conventional hydrostatic pressure still remain the most widely used approach for the solution of practical engineering problems. However, when a 3D description of the velocity field is required, it is useful to resort to a more accurate model in which the hydrostatic assumption is removed. The present research finds its motivation in the increasing need for efficient management of geophysical flows such as estuaries (multiphase fluid flow) or natural rivers with the presence of short waves and/or strong bathymetry gradient, and/or strong channel curvature. A numerical solution is based on the unsteady Reynolds-averaged Navier,Stokes equations on the unstructured grid. The eddy viscosity is calculated from the efficient k,, turbulence model. The model uses implicit fractional step time stepping, and the characteristics method is used to compute the convection terms in the multi-layers system (suitable for the vertical stratified fluid flow), in which the vertical grid is located at predefined heights and the number of elements in the water column depends on water depth. The bottommost and topmost elements of variable height allow a faithful representation of the bed and the time-varying free-surface, respectively. The model is applied to the 3D open channel flows of various complexity, for which experimental data are available for comparison. Computations with and without non-hydrostatic are compared for the same trench to test the validity of the conventional hydrostatic pressure assumption. Good agreement is found between numerical computations and experiments. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Technological strategies to improve photostability of a sunscreen agent

P. Perugini
Due to the reduction of the ozone layer, there is an increasing need of effective UV protection systems with minimized side-effects. Trans-2-ethylhexyl- p -methoxycinnamate (trans -EHMC) represents one of the most widely used sunscreen compound. Several studies demonstrated that trans -EHMC is unstable following UV irradiation both in solution and in emulsion formulations. Moreover, various reports of photocontact sensitization induced by trans -EHMC have appeared in the literature. Consequently, in order to ensure adequate efficacy and safety for this sunscreen agent, there is a need for new carrier systems to enhance trans -EHMC photostability. In the present study the photostability of the filter in different formulation types (emulsion,gel, gel and emulsion) with various ingredients is evaluated. In addition, nanoparticles based on poly- D,L -lactide-co-glycolide (PLGA) as carrier for trans -EHMC are investigated. The influence of nanoparticle matrix on the photochemical stability of the sunscreen agent is also presented. The results obtained demonstrated that PLGA nanoparticles are effective in reducing the light-induced degradation of the sunscreen agent. Moreover, the choice of formulation type and the excipients used play an important role in order to obtain a stable cosmetic product containing trans -EHMC. [source]

Food applications of trans fatty acid substitutes

Paul Wassell
Summary The review outlines the increasing need to reduce trans fatty acids, and addresses the functionality issues of various trans free solutions through discussion of hydrogenation, interesterification, and fractionation, and their influence on fat crystallisation and solid fat content. Caution is urged not to focus solely on physio-chemical aspects, but to approach trans free designing for specific food applications from a multidisciplinary angle. Examples of specific applications; margarines, shortenings and frying oils are given. The review also offers a glimpse into what the future trans free trends may hold. [source]

Role of nurses in institutional ethics policies on euthanasia

Chris Gastmans PhD
Aim., This paper reports the findings of a survey that investigated whether Flemish Catholic hospitals and nursing homes had developed written ethics policies on euthanasia and how the role of nurses was described in these policies. Background., International research shows undeniably that nurses are confronted with patients requesting euthanasia. Euthanasia has been legal in Belgium since 2002 and in Holland since 2001. Because of the vagueness in formal documents and policies on the role of nurses in euthanasia, there is an increasing need to establish institutional ethics policies that clearly describe the role of nurses in the euthanasia process. Methods., We used a cross-sectional descriptive mail questionnaire to survey the general directors of Catholic hospitals and nursing homes in Belgium (Flanders). Data were collected between October 2003 and February 2004. Results., Of the 298 institutions targeted for survey, 81% of hospitals, 62% of nursing homes returned completed questionnaires. Of these, 79% of the hospitals and 30% of the nursing homes had a written ethics policy on euthanasia. The ethics policies of 87% of the hospitals and 77% of the nursing homes explicitly addressed the role of nurses in the euthanasia process. In the majority of hospitals and nursing homes, the ethics policies addressed the conscientious objections of nurses to euthanasia. Most hospitals and nursing homes voluntarily communicated their ethics policies to the nurses they employed. Conclusion., The written ethics policies of most Catholic healthcare institutions give explicit attention to the role of nurses in the euthanasia process. However, the meaning and content of the role of nurses, as indicated in these ethics policies, continue to be an issue. Further research is needed to verify how these policies are actually implemented within the institutions and whether they contribute to better support for nurses and to ethical care for patients. [source]

Validation of the CDC biofilm reactor as a dynamic model for assessment of encrustation formation on urological device materials

Brendan F. Gilmore
Abstract Contemporary medical science is reliant upon the rational selection and utilization of devices, and therefore, an increasing need has developed for in vitro systems aimed at replicating the conditions to which urological devices will be subjected to during their use in vivo. We report the development and validation of a novel continuous flow encrustation model based on the commercially available CDC biofilm reactor. Proteus mirabilis -induced encrustation formation on test biomaterial sections under varying experimental parameters was analyzed by X-ray diffraction, infrared- and Raman spectroscopy and by scanning electron microscopy. The model system produced encrusted deposits similar to those observed in archived clinical samples. Results obtained for the system are highly reproducible with encrustation being rapidly deposited on test biomaterial sections. This model will have utility in the rapid screening of encrustation behavior of biomaterials for use in urological applications. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010 [source]

Current practice in the management of children with cerebral palsy: a national survey of paediatric dietitians

Hilary Hartley
Abstract Background Dietitians play a key role in the clinical management of children with cerebral palsy. This survey was conducted with the aim of establishing an overview of current dietetic practice in the management of these children. Method A questionnaire which asked for information on aspects of dietetic practice relating to children with cerebral palsy was circulated to members of the British Dietetic Association during May to October 2000. Results Many respondents had a small caseload size. However, a larger caseload was linked to membership of a multi-disciplinary team, a greater proportion of severely disabled children and use of a wider range of anthropometric measurements. Dietitians who were members of a multi-disciplinary team were more likely to visit children at home. Conclusions This survey provides an overview of current dietetic practice in the UK regarding the management of children with cerebral palsy. There is a potential shortfall in specialist dietitians and this survey highlights some of the gaps in service provision. Children with cerebral palsy benefit from dietetic input and there is an increasing need for specialist dietitians to be involved in their management. It will be necessary to continue to identify any gaps and find ways to overcome them. [source]

Clinical care and technical recommendations for 90yttrium microsphere treatment of liver cancer

S-C Wang
Summary Selective internal radiation therapy (SIRT) with 90yttrium microspheres is a relatively new clinical modality for treating non-resectable malignant liver tumours. This interventional radiology technique employs percutaneous microcatheterisation of the hepatic arterial vasculature to selectively deliver radioembolic microspheres into neoplastic tissue. SIRT results in measurable tumour responses or delayed disease progression in the majority of eligible patients with hepatocellular carcinoma or hepatic metastases arising from colorectal cancer. It has also been successfully used as palliative therapy for non-colorectal malignancies metastatic to the liver. Although most adverse events are mild and transient, SIRT also carries some risks for serious and , rarely , fatal outcomes. In particular, entry of microspheres into non-target vessels may result in radiation-induced tissue damage, such as severe gastric ulceration or radiation cholecystitis. Radiation-induced liver disease poses another significant risk. By careful case selection, considered dose calculation and meticulous angiographic technique, it is possible to minimise the incidence of such complications to less than 10% of all treatments. As the number of physicians employing SIRT expands, there is an increasing need to consolidate clinical experience and expertise to optimise patient outcomes. Authored by a panel of clinicians experienced in treating liver tumours via SIRT, this paper collates experience in vessel mapping, embolisation, dosimetry, microsphere delivery and minimisation of non-target delivery. In addition to these clinical recommendations, the authors propose institutional criteria for introducing SIRT at new centres and for incorporating the technique into multidisciplinary care plans for patients with hepatic neoplasms. [source]

Progress and limitations in the use of in vitro cell cultures to serve as a permeability screen for the blood-brain barrier

Mark Gumbleton
Abstract A relatively simple, widely applicable, and robust in vitro method of predicting blood-brain barrier (BBB) permeability to central nervous system-acting drugs is an increasing need. A cell-based model offers the potential to account for transcellular and paracellular drug diffusional processes, metabolism, and active transport processes, as well as nondefined interactions between a drug and cellular material that may impact upon a membrane's overall permeability profile. Any in vitro BBB cell model to be utilized for the transendothelial BBB permeability screening of potential central nervous system drugs must display reproducible solute permeability, and a number of other general criteria including: a restrictive paracellular barrier; a physiologically realistic cell architecture; the functional expression of key transporter mechanisms; and allow ease of culture to meet the technical and time constraints of a screening program. This article reviews the range of in vitro cell-based BBB models available, including the primary/low passage bovine and porcine brain endothelial cultures as well as the spectrum of immortalized brain endothelial cell lines that have been established. The article further discusses the benefits and limitations of exploiting such systems as in vitro BBB permeability screens. © 2001 Wiley-Liss, Inc. and the American Pharmaceutical Association J Pharm Sci 90:1681,1698, 2001 [source]

Ageing to arrhythmias: conundrums of connections in the ageing heart

Sandra A. Jones
The proportion of the population that is elderly continues to increase, leading to an increasing need to address problems chiefly associated with old age. Progressive ageing of the heart is associated with an increasing incidence of arrhythmias and disorders of the normal origin of the heartbeat, the sinoatrial node. This intrinsic pacemaker of the heart has an increasing tendency with age to lose its dominant role in pacing the heart, and regulation of heart rate becomes erratic. This ,sick sinus syndrome' is associated with fainting, palpitations, shortness of breath and sudden death. Current treatment of this condition is by implantation of an artificial pacemaker, an intervention increasingly required with age. The current evidence suggests that the normal heartbeat fails due to changes in the expression of critical proteins that ensure the correct production and conduction of the cardiac action potential. Depletion of a protein directly responsible for providing electrical connections between the cells of the heart, connexin 43, appears to leave the normal cardiac pacemaker disconnected and unable to drive the heart. This process may be associated with age-dependent changes in stress-related signalling. Simple interventions such as exercise could impact on the processes hypothesized to be involved and may offer a means to preserve the stability of the electrical activity of the heart into old age without pharmacological manipulation. [source]

Synthesis of high fluorescent silica hybrid materials by immobilization of orange peel extract in silica-silsesquioxane matrix

I. Lacatusu
Abstract Sol,gel chemistry can be easily modified to the changing needs of society to produce fine-tuned sol,gel nanostructured materials for relevant applications. In this context, there is an increasing need for natural and versatile raw materials as well as biocompatible compounds that could be extensively used as biomarkers for bioimaging in diagnosis or therapy. Silica-based materials are widely used in the field of biomedicine due to their chemical inertness and biocompatibility. In the present paper, orange peel extract was immobilized inside inorganic silica and hybrid silica-silsesquioxane polymeric networks. Silica and organo-modified silica matrices were synthesized through a templated sol,gel route of TEOS and an organosilsesquioxane (octaisobutyltetracyclo[,11] octasiloxane- endo -3,7-diol), with D -glucose as template, and for comparison a non-ionic surfactant (tetraethylene glycol mono-hexadecyl ether) was also used. The bioactive properties of the molecules from orange peel extract were preserved after immobilization in both silica and silica-silsesquioxane networks. Moreover, the fluorescence properties were amplified by 10,20 times more than the native orange peel extract. The structural properties of the final materials have been studied by FT-IR, UV,Vis-NIR, and fluorescence spectroscopy. Dynamic light scattering measurements and transmission electron microscopy were used to estimate the size and morphology of the hybrid materials with orange peel extract immobilized in silica networks. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Psychometric Properties of the Brazilian Version of the Drug Use Screening Inventory

ALCOHOLISM, Issue 10 2002
Denise De Micheli
Background Adolescent involvement with alcohol and other drugs is rising in Brazil, and there is an increasing need for psychometrically sound assessment tools to detect early drug involvement. Methods The psychometric properties of the Brazilian version of the Drug Use Screening Inventory (DUSI) were examined in a sample composed of 71 non,drug-dependent adolescents and 142 adolescents who met DSM-III-R criteria for drug dependence. Results With a cutoff score of 13% or lower for the absolute density index of the substance use area, DUSI correctly classified 80% of the drug-dependent adolescents and 90% of the non,drug-dependent adolescents, thus correctly classifying 83.6% of the sample. Factor analysis applied to each of the 10 DUSI areas indicated their unidimensionality, with substantial percentages of variance on the first factor. The Brazilian version of DUSI presented strong internal consistency reliability for the whole sample (drug-dependents and non,drug-dependent adolescents) with an average across all 10 scales for Cronbach's , reliability coefficient of 0.96 (standard deviation = 0.02) and for the split-half reliability coefficient of 0.88 (standard deviation = 0.08). Conclusions These results suggest that the Brazilian version of DUSI preserves its original psychometric properties and is a sensitive and useful screening instrument for drug use. [source]

Primary care health issues among men who have sex with men

Royal Gee MSN
Abstract Purpose: The purpose of the article is to examine "appropriate" health care for men who have sex with men (MSM), which is not to suggest "special" health care. As a group, MSM are at increased risk for sexually transmitted infections, anal cancer, and mental health disorders. Focus areas in this article will address health issues that the primary care nurse practitioner (NP) may encounter in clinical practice: anal carcinoma, sexually transmitted diseases (STDs), high-risk sexual practices, depression, and substance abuse were topics chosen for inclusion in this article. These topics were among those highlighted in the Healthy People 2010 Companion Document for LGBT Health, which served to examine the healthcare disparities and lack of access to needed services related to sexual orientation. Data source: Extensive literature review of research articles, journals, clinical practice guidelines, books, and public health department Internet Web sites. Conclusions: There are unique health disparities that exist for MSM related to social, emotional, and mental health factors, in addition to physical issues such as STDs. There is an increasing need for primary care providers to be aware of these disparities, as well as the factors that influence these disparities, in order to provide multidimensional care and health counseling that is unique to NP practice. Implications for practice: Both the primary care NP and the patient should be aware of the unique healthcare issues among MSM that should be incorporated into the patient's routine health maintenance program. As primary care providers, it is within the standards of practice for NPs to provide culturally competent care, along with health promotion and disease prevention for MSM. [source]

Nature versus nurture in two highly enantioselective esterases from Bacillus cereus and Thermoanaerobacter tengcongensis

Stephan Grosse
Summary There is an increasing need for the use of biocatalysis to obtain enantiopure compounds as chiral building blocks for drug synthesis such as antibiotics. The principal findings of this study are: (i) the complete sequenced genomes of Bacillus cereus ATCC 14579 and Thermoanaerobacter tengcongensis MB4 contain a hitherto undescribed enantioselective and alkaliphilic esterase (BcEST and TtEST respectively) that is specific for the production of (R)-2-benzyloxy-propionic acid ethyl ester, a key intermediate in the synthesis of levofloxacin, a potent antibiotic; and (ii) directed evolution targeted for increased thermostability of BcEST produced two improved variants, but in either case the 3,5°C increase in the apparent melting temperature (Tm) of the mutants over the native BcEST that has a Tm of 50°C was outperformed by TtEST, a naturally occurring homologue with a Tm of 65°C. Protein modelling of BcEST mapped the S148C and K272R mutations at protein surface and the I88T and Q110L mutations at more buried locations. This work expands the repertoire of characterized members of the ,/,-fold hydrolase superfamily. Further, it shows that genome mining is an economical option for new biocatalyst discovery and we provide a rare example of a naturally occurring thermostable biocatalyst that outperforms experimentally evolved homologues that carry out the same hydrolysis. [source]

Cerebrospinal fluid brain-derived proteins in the diagnosis of Alzheimer's disease and Creutzfeldt,Jakob disease

A. J. E. GreenArticle first published online: 24 NOV 200
The differential diagnosis of dementia can be difficult in the early stages of disease, and with the emergence of new therapeutic agents for Alzheimer's disease (AD) there is an increasing need for reliable and accurate diagnostic tests. The concept of brain-specific proteins was first proposed in the 1960s and, since that time, methods have developed to measure these proteins in the cerebrospinal fluid (CSF). The concentration of individual brain-specific proteins can be altered in disease, and these changes are thought to reflect the underlying pathology. CSF tau protein and amyloid peptide A,42 concentrations are altered in AD and have been proposed as early diagnostic tests for this disease. The data from a number of studies suggest that these proteins may be of value, but are less specific than previously thought and further studies with neuropathological confirmation are required before these tests can be introduced into clinical practice. The detection of 14-3-3 in the CSF is an accurate test for sporadic Creutzfeldt,Jakob disease (CJD) and this accuracy has lead the World Health Organization to revise the clinical criteria for probable sporadic CJD to include a positive CSF 14-3-3. However, CSF 14-3-3 is less useful in the diagnosis of variant CJD, where studies are underway investigating the value of other CSF proteins. [source]

A Collaborator Profile for Executives of Nonprofit Organizations

Samuel Goldman
This study involving ninety-two nonprofit executive directors who engaged in separate interorganizational collaborations investigated the relationship between a select number of individual characteristics (personality and demographic) and perceived collaboration outcome (successful or unsuccessful). The collaborator profile that resulted suggests that directors who are predisposed to perceiving their respective collaborations as successful are extravert, feeling males who have high role ambiguity and low role boundary occupational stress. Given the increasing need for nonprofit organizations to collaborate with other organizations, it is important for nonprofit executives and their boards to be cognizant of some key factors that can lead to successful interorganizational collaborations. [source]

Improving the Quality of Information Flows in the Backend of a Product Development Process: a Case Study

Jaring Boersma
Abstract Considerable research has gone into designing effective product development processes. This, coupled with the increasing need for products that are able to deliver reliable, complex functionality with a high degree of innovation, presents a major challenge to modern day industries in the business of developing products. In order to incorporate relevant field experience in the design and manufacturing of new products, increasingly detailed information needs to be retrieved from the market in a very short amount of time. In one particular consumer electronics industry, business process models describing the information flow in the backend of the product development process indicated massive data loss and also serious data quality degradation. This paper attempts to show how such losses can be mitigated and also proposes a business model that can adequately capture information of a higher quality and in a more structured manner. The end result will be a product development process that provides better feedback on current product performance and is more responsive to future market needs. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Targeted lipidomics using electron capture atmospheric pressure chemical ionization mass spectrometry

Seon Hwa Lee
There is an increasing need to be able to conduct quantitative lipidomics analyses as a complement to proteomics studies. The highest specificity for proteomics analysis can be obtained using methodology based on electrospray ionization (ESI) or atmospheric pressure chemical ionization (APCI) coupled with liquid chromatography/tandem mass spectrometry (LC/MS/MS). For lipidomics analysis it is often necessary to be able to separate enantiomers and regioisomers. This can be very challenging when using methodology based on conventional reversed-phase chromatography. Normal-phase chromatography using chiral columns can provide dramatic improvements in the resolution of enantiomers and regioisomers. However, conventional ESI- and APCI-MS/MS has limited sensitivity, which makes it difficult to conduct studies in cell culture systems where only trace amounts of non-esterified bioactive lipids are present. The use of electron capture APCI-MS/MS overcomes this problem. Enantiomers and regioisomers of diverse bioactive lipids can be quantified using stable isotope dilution methodology coupled with normal-phase chiral chromatography and electron capture APCI-MS/MS. This methodology has allowed a lipidomics profile from rat epithelial cells maintained in culture to be delineated and allowed the effect of a non-selective lipoxygenase inhibitor to be assessed. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Comprehensive evaluation of an online tobacco control continuing education course in Canada

Kirsten E. Sears MHSc
Abstract Introduction: To respond to the increasing need to build capacity for planning, implementing, and supporting tobacco control strategies, an evidence-based, online continuing education (CE) course aimed at Canadian public health professionals was developed. The purpose of this study was to comprehensively evaluate the course, Tobacco and Public Health: From Theory to Practice ( Methods: Rossett and McDonald's revision of Kirkpatrick's four-level evaluation model for training programs guided the evaluation design. A pre-, post-, and follow-up single group design assessed immediate reactions to course modules, knowledge change and retention, practice change, and overall perceived value of the course. Six external peer reviewers evaluated course module content. Results: Fifty-nine participants completed all three course modules and the final online questionnaire at time 3, representing a response rate of 78%. Significant knowledge gains occurred between times 1 and 2 (p < 0.001). Although time 3 scores remained higher than time 1 scores for each module (p < 0.001), they decreased significantly between times 2 and 3 (p < 0.001). The majority of participants (93%) felt the topics covered were useful to their daily work. All but one participant felt the course was a good investment of their time, and nearly all participants (97%) stated they would recommend the course to others. Peer reviewers found that module content flowed well and was comprehensive. Discussion: This comprehensive evaluation was valuable both for assessing whether course goals were achieved and for identifying areas for course improvement. We expect this design would be a useful model to evaluate other online continuing education courses. [source]

Phenological growth stages of Cynara cardunculus: codification and description according to the BBCH scale

S.V. Archontoulis
Cynara cardunculus is a herbaceous perennial crop known from ancient times. During the last three decades this thistle has intensively been researched and recently became a commercial crop for biofuel production. As there is an increasing need for more information on this crop, we present here the phenological growth stages based on the Biologische Bundesanstalt, Bundessortenamt, CHemische Industrie (BBCH) scale and its associated decimal code. Nine principal growth stages have been defined and each principal stage has been subdivided into secondary growth stages. Descriptive keys with illustrations are also provided. A practical use of the scale is proposed, with particular reference to harvest time and management treatments. This scale aims to support farmers and researchers to efficiently plan management practices and experimental treatments. [source]

Verfüllung des Rodewischhafens in Hamburg , Zur Technik der Flächenaufhöhung auf Weichschichten

BAUTECHNIK, Issue 12 2005
Reiner Knies Dipl.-Ing.
Der wachsende Flächenbedarf der Wirtschaft im Hamburger Hafen einerseits und die Flächenknappheit im Ballungsraum andererseits zwingen zu einem äußerst sorgsamen Umgang mit der Ressource Fläche. Eine Optimierung bereits in Nutzung befindlicher Flächen im Hamburger Hafen mit dem Ziel, den veränderten Ansprüchen gerecht zu werden, kann auch die Auffüllung ehemaliger, teilweise mit Schlick aufgefüllter, Hafenbecken erfordern. Die Überbauung stellt aufgrund der sehr geringen Tragfähigkeit des Schlicks hohe Anforderungen an die Entwurfsbearbeitung und die Bauausführung. In diesem Beitrag werden das Tragwerkskonzept unter Verwendung besonderer Geokunststoffe sowie die dafür erforderlichen Baugrunduntersuchungen und Bemessungen vorgestellt. Die ingenieurtechnische Entwurfsbearbeitung mündete in Empfehlungen zur Anwendung der Beobachtungsmethode während der Bauausführung. Die Ergebnisse der durchgeführten Verformungsbeobachtungen werden abschließend erläutert. Backfilling of the Rodewischhafen in Hamburg , to the technology of land reclaiming on soft layers. Concerning the increasing need of store and transportation areas of the economy in Hamburg on the one hand and the surface scarceness in the population centre on the other hand force to extremely careful handling with the surface resources. An optimization of already in use present surfaces in Hamburg port with the goal of becoming changed requirements fairly more and more land reclamation activities are necessary on former harbor basins, which had been partly filled up with dredged mud. The coverage of these basins makes high requirements to the geotechnical design and the execution of construction due to the very low bearing capacity of the mud. In this contribution the load bearing concept is presented by using special geosynthetic reinforcement products as well as the necessary ground investigations and construction designs. The engineering design lead into recommendations regarding the application of the observation method during the execution of construction. Finally the results of the deformation observations are described. [source]