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Increasing Use (increasing + use)
Selected AbstractsIncreasing Use of the Scapula Osteocutaneous Free Flap ,THE LARYNGOSCOPE, Issue 9 2000Sean C. Coleman MD Abstract Objectives To determine the appropriate use of the scapula osteocutaneous free flap (SOFF) and to document donor site morbidity. Study Design Retrospective review and prospective physical therapy evaluation. Methods A computer database of all free flap procedures performed at a single institution was created. Specific clinical and operative details from cases involving a bone flap were extracted from the database. Rates of usage of the various osteocutaneous flaps were compared over four successive 2-year intervals (1992,1999). A single physical therapist performed a structured evaluation of the donor site. Results Overall, 64 bone flap procedures were performed, of which 24 (37.5%) were SOFF procedures. The SOFF utilization has increased from 6.6% to 63.6%, while fibula and iliac crest utilization has fallen significantly. This is in part because of the greater versatility of the SOFF, with the possibility of separate skin paddles and adequate bone length. The mean cutaneous area harvested with the SOFF was 110 cm2 (range, 48,200 cm2) compared with 55.4 cm2 (range, 25,102 cm2) and 77.6 cm2 (range, 50,120 cm2) for the fibula and iliac crest, respectively. Mean bone flap lengths were 8.37, 7.65, and 10.1 cm, respectively, for the SOFF, fibula, and iliac crest. Dual skin paddles were used in 50% of the SOFF procedures versus 2.8% for the fibula flap procedures. There were no significant complications of the donor site in any patient, and there was only one flap failure (4.1%). Related to the SOFF, donor site morbidity was subjectively judged as "mild," for pain, mobility, and strength. There were no complaints of poor appearance of the donor site. Activities of daily living were judged as "not limited" or "limited a little" in the majority of patients. Objective measurements of range of motion revealed an average reduction of 1° to 12° in five different shoulder functions. Elbow and arm ranges of motion were not limited. Strength was minimally reduced in the shoulder, while the arm and forearm showed no reduction in strength. Conclusions The SOFF is a versatile osteocutaneous free flap that can be used for a multitude of reconstructive problems. This and its relative lack of significant donor site morbidity have caused its use to increase significantly. [source] Capitation funding in the public sectorJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 2 2001Peter C. Smith A fundamental requirement of government at all levels,national and local,is to distribute the limited funds that it wishes to spend on particular public services between geographical areas or institutions, which are effectively competitors for such funds. Increasing use is now being made of capitation methods for such purposes, in which a standard estimate of expected expenditure is attached to a citizen with given characteristics. Statistical methods are playing an important role in determining such capitations, but they give rise to profound methodological problems. This paper examines the rationale for capitation and discusses the associated methodological issues. It illustrates the issues raised with two examples taken from the UK public sector: in personal social services and hospital care. Severe limitations of the data mean that small area data are used as the unit of observation, giving rise to considerable complexity in the model to be estimated. As a result, a range of methodologies including two-stage least squares and multilevel modelling methods are deployed. The paper concludes with a suggestion for an approach which would represent an improvement on current capitation methods, but which would require data on individuals rather than on small areas. [source] Dynamic or Static Capabilities?THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 5 2009Process Management Practices, Response to Technological Change Whether and how organizations adapt to changes in their environments has been a prominent theme in organization and strategy research. Within this research, there is controversy about whether organizational routines hamper or facilitate adaptation. Organizational routines give rise to inertia but are also the vehicles for change in recent work on dynamic capabilities. This rising interest in routines in research coincides with an increase in management practices focused on organizational routines and processes. This study explores how the increasing use of process management practices affected organizational response to a major technological change through new product developments. The empirical setting is the photography industry over a decade, during the shift from silver-halide chemistry to digital technology. The advent and rise of practices associated with the new ISO 9000 certification program in the 1990s coincided with increasing technological substitution in photography, allowing for assessing how increasing attention to routines through ISO 9000 practices over time affected ongoing responsiveness to the technological change. The study further compares the effects for the incumbent firms in the existing technology with nonincumbent firms entering from elsewhere. Relying on longitudinal panel data models as well as hazard models, findings show that greater process management practices dampened response to new generations of digital technology, but this effect differed for incumbents and nonincumbents. Increasing use of process management practices over time had a greater negative effect on incumbents' response to the rapid technological change. The study contributes to research in technological change by highlighting specific management practices that may create disconnects between firms' capabilities and changing environments and disadvantage incumbents in the face of radical technological change. This research also contributes to literature on organizational routines and capabilities. Studying the effects of increasing ISO 9000 practices undertaken in firms provides an opportunity to gauge the effects of systematic routinization of organizational activities and their effects on adaptation. This research also contributes to management practice. The promise of process management is to help firms adapt to changing environments, and, as such, managers facing technological change may adopt process management practices as a response to uncertainty and change. But managers must more fully understand the potential benefits and risks of process management to ensure these practices are used in the appropriate contexts. [source] Towards a New Articulation of Alternative Development: Lessons from Coca Supply Reduction in BoliviaDEVELOPMENT POLICY REVIEW, Issue 4 2004Noam Lupu Once heralded as the success story of coca supply reduction, Bolivia is now witnessing an increase in coca cultivation. Even as coca fields in Bolivia were forcibly destroyed in the past decade, new fields were being planted elsewhere, leaving coca production in the Andean region at a roughly constant level. This begs a rethinking of alternative development programmes, the policies being rendered ineffectual by the increasing use of force. This article seeks renewed momentum for alternative development by gleaning lessons from its earlier failures. Moreover, it suggests a new articulation of alternative development that emphasises the socio-economic cause of coca cultivation , the demand by the rural poor of Bolivia for income and food security. [source] Managing young people with Type 1 diabetes in a ,rave' new world: metabolic complications of substance abuse in Type 1 diabetesDIABETIC MEDICINE, Issue 4 2009P. Lee Abstract The taxing transition from adolescence towards adulthood intensifies the impact of a chronic illness such as Type 1 diabetes. It is not uncommon for young people with Type 1 diabetes to use recreational drugs for emotional relief to escape the day-to-day burden of chronic disease. Despite increasing use, especially in the setting of ,rave' parties, there is professional lack of understanding of the impact of recreational drug use on glycaemia and metabolic complications. The current review describes the prevalence of substance abuse in Type 1 diabetes and the acute impact of designer drugs on its management. We propose a practical approach to improve care of young people with Type 1 diabetes using designer drugs. [source] Pregnancy outcome in Type 1 diabetes mellitus treated with insulin lispro (Humalog)DIABETIC MEDICINE, Issue 1 2003E. A. Masson Abstract Aims The use of insulin lispro in pregnancy has not been systematically investigated despite its increasing use. Pooled data from seven centres with experience in the use of insulin lispro were accumulated to evaluate pregnancy outcome in women with Type 1 diabetes. Methods Seven units with specialist obstetric diabetes services were recruited to describe their total experience with insulin lispro in pregnancy. Outcomes with respect to the rate of miscarriage, congenital abnormality, perinatal mortality and maternal parameters were recorded in a standardized format. Results Outcomes on 71 babies from 76 pregnancies were documented. There were six (7.8%) early miscarriages. All 71 babies were liveborn with a mean gestational age of 37.2 weeks, and median birthweight of 3230 g. Seven babies weighed > 4 kg. There were four congenital abnormalities (5.6%). There was a 72% increase in the mean insulin dose (0.75,1.29 IU/kg per day). Maternal glycaemic control improved throughout pregnancy. No women developed retinopathy de novo during pregnancy and six with established retinopathy required laser therapy during pregnancy. Conclusions The use of insulin lispro in Type 1 diabetes during pregnancy results in outcomes comparable to other large studies of diabetic pregnancy. [source] Global use of alcohol, drugs and tobaccoDRUG AND ALCOHOL REVIEW, Issue 6 2006PETER ANDERSON Abstract Humans have always used drugs, probably as part of their evolutionary and nutritional heritage. However, this previous biological adaptation is unlikely to be so in the modern world, in which 2 billion adults (48% of the adult population) are current users of alcohol, 1.1 billion adults (29% of the adult population) are current smokers of cigarettes and 185 million adults (4.5% of the adult population) are current users of illicit drugs. The use of drugs is determined largely by market forces, with increases in affordability and availability increasing use. People with socio-economic deprivation, however measured, are at increased risk of harmful drug use, as are those with a disadvantaged family environment, and those who live in a community with higher levels of substance use. Substance use is on the increase in low-income countries which, in the coming decades, will bear a disproportionate burden of substance-related disability and premature death. [source] The Multicenter Study of Epilepsy Surgery: Recruitment and Selection for SurgeryEPILEPSIA, Issue 11 2003Anne T. Berg Summary:,Purpose: Multiple studies have examined predictors of seizure outcomes after epilepsy surgery. Most are single-center series with limited sample size. Little information is available about the selection process for surgery and, in particular, the proportion of patients who ultimately have surgery and the characteristics that identify those who do versus those who do not. Such information is necessary for providing the epidemiologic and clinical context in which epilepsy surgery is currently performed in the United States and in other developed countries. Methods: An observational cohort of 565 surgical candidates was prospectively recruited from June 1996 through January 2001 at six Northeastern and one Midwestern surgical centers. Standardized eligibility criteria and protocol for presurgical evaluations were used at all seven sites. Results: Three hundred ninety-six (70%) study subjects had resective surgery. Clinical factors such as a well-localized magnetic resonance imaging (MRI) abnormality and consistently localized EEG findings were most strongly associated with having surgery. Of those who underwent intracranial monitoring (189, 34%), 85% went on to have surgery. Race/ethnicity and marital status were marginally associated with having surgery. Age, education, and employment status were not. Demographic factors had little influence over the surgical decision. More than half of the patients had intractable epilepsy for ,10 years and five or more drugs had failed by the time they initiated their surgical evaluation. During the recruitment period, eight new antiepileptic drugs were approved by the Food and Drug Administration for use in the United States and came into increasing use in this study's surgical candidates. Despite the increased availability of new therapeutic options, the proportion that had surgery each year did not fluctuate significantly from year to year. This suggests that, in this group of patients, the new drugs did not provide a substantial therapeutic benefit. Conclusions: Up to 30% of patients who undergo presurgical evaluations for resective epilepsy surgery ultimately do not have this form of surgery. This is a group whose needs are not currently met by available therapies and procedures. Lack of clear localizing evidence appears to be the main reason for not having surgery. To the extent that these data can address the question, they suggest that repeated attempts to control intractable epilepsy with new drugs will not result in sustained seizure control, and eligible patients will proceed to surgery eventually. This is consistent with recent arguments to consider surgery earlier rather than later in the course of epilepsy. Postsurgical follow-up of this group will permit a detailed analysis of presurgical factors that predict the best and worst seizure outcomes. [source] Testing of insulation systems with respect to high-frequency voltage stressEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 5 2002M. Paede Due to the increasing use of power electronics high frequency working voltages are occurring rather frequently. This means a very high stress for any kind of insulatation. This situation is further aggravated by decreasing dimensions due to miniaturization. Therefore this situation has to be taken into account during dimensioning and testing. Different test methods with respect to withstand and partial discharge inception are described. The necessary test equipment and the dimensioning of the test circuits are specified. The aspects of periodic non-sinusoidal voltages are taken into account by harmonic analysis. [source] Myths and moderation in marine ,metapopulations'?FISH AND FISHERIES, Issue 1 2002R Kent Smedbol Abstract The metapopulation concept is appearing with increasing frequency in the marine population dynamics and genetics literature, though its applicability to marine systems remains an open question. Moreover, in recent years, the meaning of the term ,metapopulation' has become blurred, concomitant with its increasing use. In this paper, we summarize the concept of metapopulation dynamics and the associated theoretical assumptions. We call for a stricter definition and use of the term ,metapopulation', critically evaluate the applicability of metapopulation theory to marine population dynamics and its use in the related literature, and consider two published case-studies that investigate metapopulation structuring in specific marine populations. Finally, we urge scientists to carefully articulate what is meant by the term ,metapopulation' and to use appropriate citations in the primary literature to circumvent the potential for nebulous (and possibly damaging) conclusions in the future. [source] Reference Minerals for the Microanalysis of Light ElementsGEOSTANDARDS & GEOANALYTICAL RESEARCH, Issue 2-3 2001M. Darby Dyar tourmaline; danburite; spodumène; muscovite; isotopes The quantitative determination of light element concentrations in geological specimens represents a major analytical challenge as the electron probe is generally not suited to this task. With the development of new in situ analytical techniques, and in particular the increasing use of secondary ion mass spectrometry, the routine determination of Li, Be and B contents has become a realistic goal. However, a major obstacle to the development of this research field is the critical dependence of SIMS on the availability of well characterized, homogeneous reference materials that are closely matched in matrix (composition and structure) to the sample being studied. Here we report the first results from a suite of large, gem crystals which cover a broad spectrum of minerals in which light elements are major constituents. We have characterized these materials using both in situ and wet chemical techniques. The samples described here are intended for distribution to geochemical laboratories active in the study of light elements. Further work is needed before reference values for these materials can be finalized, but the availability of this suite of materials represents a major step toward the routine analysis of the light element contents of geological specimens. La détermination quantitative des concentrations en éléments légers dans les échantillons géologiques représente un défi analytique majeur, la sonde électronique ne convenant généralement pas pour ce travail. Avec le développement de nouvelles techniques analytiques in situ, en particulier l'utilisation grandissante de la spectrométrie ionique secondaire, la détermination en routine des teneurs en Li, Be et B est devenue un objectif réaliste. Toutefois, un obstacle majeur dans le développement de cette recherche subsiste : la technique SIMS est dépendante de la disponibilité de matériaux de référence bien caractérisés et homogènes proches en composition et en structure de l'échantillon étudié. Nous rapportons ici les premiers résultats obtenus à partie d'un groupe de grands cristaux de qualité gemme recouvrant un large spectre de minéraux composés essentiellement d'éléments légers. Nous avons caractérisé ces matériaux en utilisant à la fois des techniques in situ et par voie humide. Les échantillons décrits ici vont être distribués dans les laboratoires de géochimie spécialisés dans l'étude des éléments légers. Avant la conclusion des valeurs de référence de ces matériaux, des travaux ultérieurs seront nécessaires, mais la disponibilité de l'ensemble de ces matériaux représente une étape importante vers l'analyse en routine des teneurs en éléments légers d'échantillons géologiques. [source] Shared patients: multiple health and social care contactHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2001J. Keene PhD Abstract The paper describes results from the ,Tracking Project', a new method for examining agency overlap, repeat service use and shared clients/patients amongst social and health care agencies in the community. This is the first project in this country to combine total population databases from a range of social, health care and criminal justice agencies to give a multidisciplinary database for one county (n = 97 162 cases), through standardised anonymisation of agency databases, using SOUNDEX, a software programme. A range of 20 community social and health care agencies were shown to have a large overlap with each other in a two-year period, indicating high proportions of shared patients/clients. Accident and Emergency is used as an example of major overlap: 16.2% (n = 39 992) of persons who attended a community agency had attended Accident and Emergency as compared to 8.2% (n = 775 000) of the total population of the county. Of these, 96% who had attended seven or more different community agencies had also attended Accident and Emergency. Further statistical analysis of Accident and Emergency attendance as a characteristic of community agency populations (n = 39 992) revealed that increasing frequency of attendance at Accident and Emergency was very strongly associated with increasing use of other services. That is, the patients that repeatedly attend Accident and Emergency are much more likely to attend more other agencies, indicating the possibility that they share more problematic or difficult patients. Research questions arising from these data are discussed and future research methods suggested in order to derive predictors from the database and develop screening instruments to identify multiple agency attenders for targeting or multidisciplinary working. It is suggested that Accident and Emergency attendance might serve as an important predictor of multiple agency attendance. [source] Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2010Bernardo Dell'Osso Abstract Anxiety disorders are common psychiatric conditions that typically require long-term treatment. This review summarizes current knowledge of the pharmacological treatment of anxiety disorders with serotonin norepinephrine reuptake inhibitors (SNRIs) with specific emphasis on the findings of recent randomized clinical trials and relevant neurobiological investigations. It is now well established that gabaergic, noradrenergic and serotonergic systems play a critical role in the pathophysiology of anxiety disorders, abnormalities in these systems being related to structural and functional alterations in specific brain areas such as the amygdala, prefrontal cortex, locus coeruleus and hippocampus, as repeatedly shown by neuroimaging studies. SNRIs selectively inhibit norepinephrine and serotonin reuptake and have shown to be efficacious and generally well tolerated treatments in patients with anxiety disorders, with some potential clinical advantages over selective serotonin reuptake inhibitors (SSRIs), which are considered by many to represent first-line pharmacological treatments in patients with anxiety disorders. Anxiety disorders are characterized by a typically chronic course, high rates of comorbidity and frequent partial response to standard treatments, and the increasing use of SNRIs reflects currently unmet clinical need, in terms of overall response, remission rates and treatment tolerability. Copyright © 2009 John Wiley & Sons, Ltd. [source] Association between ulcerative colitis and multiple sclerosisINTERNAL MEDICINE JOURNAL, Issue 10 2007C. S. Pokorny Abstract An association between inflammatory bowel disease (IBD) and multiple sclerosis (MS) has been described. The current study was undertaken to explore this association further. Personal records of patients with IBD and MS were reviewed. In addition, a search of medical records at a large tertiary teaching hospital in Sydney was carried out for the years 1996,2006. Four patients (three women and one man) with both ulcerative colitis and MS were identified. MS did not occur in any of our patients with Crohn's disease. The association between ulcerative colitis and MS appears to be real and may help identify common factors involved in the cause of these two diseases. No association was found in this study between MS and Crohn's disease, sparking consideration why such difference should occur. With the increasing use of biological therapies in IBD and their reported propensity to cause demyelination, recognition of an association is all the more important. [source] New malignancies following childhood cancer in the United States, 1973,2002INTERNATIONAL JOURNAL OF CANCER, Issue 10 2007Peter D. Inskip Abstract The objectives of our study were to quantify risks for developing new malignancies among childhood cancer survivors, identify links between particular types of first and subsequent cancer, and evaluate the possible role of treatment. A cohort of 25,965 2-month survivors of childhood cancer diagnosed in the U.S. during 1973,2002 was identified and followed through SEER cancer registries. Observed-to-expected ratios (O/E) were calculated, and Poisson regression was used to compare risks among treatment groups. Childhood cancer survivors were at nearly 6-fold risk of developing a new cancer relative to the general population (O/E = 5.9, 95% CI: 5.4,6.5). Most common were subsequent primary cancers of the female breast, central nervous system, bone, thyroid gland and soft tissue, as well as cutaneous melanoma and acute non-lymphocytic leukemia (ANLL). The greatest risks of subsequent cancers occurred among patients diagnosed previously with Hodgkin lymphoma (HL), Ewing sarcoma, primitive neuroectodermal tumor, or retinoblastoma. Risk of subsequent solid cancers was higher among persons whose initial treatment for childhood cancer included radiotherapy, whereas the excess of subsequent ANLL was strongly related to chemotherapy. The O/E for subsequent ANLL increased with increasing calendar year of initial cancer diagnosis among survivors of cancers other than HL, most likely due to increasing use of leukemogenic drugs for solid cancers and non-Hodgkin lymphoma. Childhood cancer survivors are at markedly increased risk of developing a variety of new cancers relative to the general population, but the magnitude of excess risk and specific types of second cancer vary widely by type of first cancer. © 2007 Wiley-Liss, Inc. [source] Heritage attractions and tourism development in Asia: a comparative study of Hong Kong and SingaporeINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 5 2002Joan C. Henderson Abstract The paper compares the principal Asian city destinations of Hong Kong and Singapore with specific reference to heritage attractions and their contribution to tourism development, revealing contrasts and similarities that offer an insight into more general practices and processes. Authorities are actively pursuing tourism marketing and development initiatives incorporating the promotion of selected forms of heritage in order to stimulate visitor arrivals, but also employing heritage to define and articulate national and cultural identity. Heritage is thus shown to have a political and socio-cultural significance in addition to its economic value as a generator of revenue, foreign exchange and employment. These functions help to explain the higher priority allocated to it in strategic planning and its increasing use to attract visitors throughout much of Asia. Contexts may be very different, yet approaches correspond, as demonstrated by the circumstances of Hong Kong and Singapore. Copyright © 2002 John Wiley & Sons, Ltd. [source] Salinity patterns in irrigation systems, a threat to be demystified, a constraint to be managed: Field evidence from Algeria and Tunisia,IRRIGATION AND DRAINAGE, Issue S3 2009S. Bouarfa irrigation; gestion de la salinité; alcalinité résiduelle; perception des agriculteurs et stratégies; Maghreb Abstract Salinity problems induced by irrigation are often presented in the literature as a threat that can only be managed at the irrigation scheme scale by installing subsurface drainage. On the other hand, salinity is a constraint that has often been successfully managed locally by farmers adapting their practices. However, the continuing expansion of irrigation with related water scarcity problems plus the increasing use of groundwater of marginal quality has resulted in a new challenge that is difficult to handle at the farm level only. To assess the dynamics of soil salinity and water quality together with farmers' salinity management practices, we adapted a common approach to analyze two contrasted salinity patterns: a traditional salinity pattern in an oasis (Fatnassa, Tunisia), and a recent sodicity pattern in a large irrigation scheme (Lower Chelif, Algeria). This approach which combines surveys on farmers' perceptions and practices and salinity measurements and geochemical analysis paves the way for more integrated management of salinity problems related to water scarcity. Copyright © 2009 John Wiley & Sons, Ltd. Les problèmes de salinité en systèmes irrigués sont souvent présentés dans la littérature comme une menace dont la seule solution réside dans l'installation de systèmes de drainage. La salinité est cependant une contrainte qui peut également être gérée localement avec succès par les agriculteurs par une adaptation de leurs pratiques. Le développement continu de l'irrigation et les tensions sur l'eau qui en découlent contraignent à un usage accru d'eau de nappe de mauvaise qualité dont les conséquences sont difficilement maitrisables à la seule échelle de l'exploitation. Ce nouveau contexte nécessite le développement de nouvelles approches permettant d'appréhender à la fois les processus de salinisation et d'adaptation des agriculteurs. Nous avons adopté une démarche commune pour évaluer la dynamique d'évolution de la salinité et les pratiques des agriculteurs dans deux situations contrastées: un schéma de salinisation classique (oasis de Fatnassa, Tunisie) et un schéma récent d'évolution vers un processus de sodisation (plaine du Bas-Chelif, Algérie). L'utilisation de cette approche qui combine des enquêtes sur les perceptions et les pratiques des agriculteurs, des mesures de salinité et des analyzes géochimiques ouvre des perspectives pour une vision et une gestion plus intégrée des problèmes de salinité liés à la pénurie d'eau. Copyright © 2009 John Wiley & Sons, Ltd. [source] Association Between Functional Status and Use and Effectiveness of Beta-Blocker Prophylaxis in Elderly Survivors of Acute Myocardial InfarctionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2004Gail Vitagliano MD Objectives: To examine whether physical and cognitive impairments explain low use of beta-blockers in elderly patients and whether functionally impaired older adults have improved survival if a beta-blocker is prescribed at hospital discharge. Design: Cross-sectional and retrospective cohort study. Setting: Acute care hospitals in the United States. Participants: National cohort of 45,370 elderly acute myocardial infarction survivors, with no chart-documented contraindications to beta-blocker treatment. Measurements: The main outcome measures were beta-blocker prescription at hospital discharge and 1-year survival. Results: Fifty percent (n=22,683) of eligible patients were prescribed a beta-blocker at discharge. Older age and functional impairments (incontinence, mobility impairment, and cognitive impairment) were independently associated with decreased use of beta-blockers. The odds ratios for prescribing a beta-blocker at hospital discharge were 0.82 (95% confidence interval (CI)=0.77,0.86), 0.63 (95% CI=0.56,0.71), and 0.40 (95% CI=0.32,0.51) for persons with one, two, and three impairments, respectively, compared with those with no impairments. In survival analysis, patients prescribed a beta-blocker were 21% less likely than nonrecipients to die within 1 year of follow-up (relative risk=0.79, P=.0001). Similar survival benefit was observed in patients with and without functional impairments. Conclusion: This study shows a strong association between functional impairment and the use of beta-blockers after acute myocardial infarction in elderly patients. The results suggest that increasing use of beta-blockers in this group provides an opportunity to improve outcomes. [source] The Theory of Planned Behavior and Ecstasy Use: Roles for Habit and Perceived Control Over Taking Versus Obtaining SubstancesJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 1 2001Sheina Orbell Despite increasing use of the illicit substance known as ecstasy, there is a paucity of research concerning psychosocial correlates of its use. A prospective study examined the ability of variables specified by the theory of planned behavior (TPB) to predict ecstasyuse intentions and behavior. Regression analyses showed that theory of reasoned action and TPB variables provided good prediction of intentions to use the substance. Moreover, support was obtained for a distinction between perceptions of behavioral control over taking ecstasy vs. control over obtaining the substance in the prediction of intentions. Habit contributed additional variance to the prediction of intentions, and reduced the effects of perceived behavioral control over taking ecstasy to nonsignificance. Ecstasy use over 2 months was directly predicted from intentions to use the substance. [source] The Seasoned-Equity Issues of UK Firms: Market Reaction and Issuance Method ChoiceJOURNAL OF BUSINESS FINANCE & ACCOUNTING, Issue 1-2 2006Edel Barnes Abstract: This study examines the seasoned equity issues of companies traded on the London Stock Exchange. Recent regulatory changes have allowed UK firms more discretion in choice of issue approach, and this has led many firms to issue through placing in preference to a rights issue. Having first documented the trend towards increasing use of placings, we go on to identify an interesting subset of placings that are less likely to be anticipated by the market, and find a significant positive market reaction to such placings, which contrasts with the significant negative reaction we find for issues by rights. We also examine the choice of seasoned equity issuance method, focusing on the choice between placings versus rights issues. We develop a model to explain the choice of equity issue method that achieves a high level of predictive accuracy. [source] Pseudohyperaldosteronism, Liquorice, and HypertensionJOURNAL OF CLINICAL HYPERTENSION, Issue 2 2008Bruno Sontia PhD Consumption of large quantities of liquorice can cause hypokalemia and hypertension. These effects are associated with increased cortisol-mediated activation of renal mineralocorticoid receptors and hypoaldosteronism. The authors describe a patient with long-standing hypokalemia and uncontrolled hypertension related to excessive ingestion of liquorice. The case highlights the importance of obtaining a detailed dietary history, especially considering the increasing use of liquorice-containing foods, teas, and herbal products. The authors also discuss secondary causes of hypertension, focusing on pseudohyperaldosteronism. [source] Use of pharmacoeconomics in prescribing research.JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2003Part 5: modelling, beyond clinical trials Summary This paper provides an overview of modelling in the economic evaluation of pharmaceuticals, reflecting the increasing use of models in analyses prepared for reimbursement applications to national and local drug formularies. The paper seeks to demystify the most commonly encountered modelling techniques (extrapolation, decision analysis, Markov modelling and Monte Carlo simulation), and to provide guidance in assessing the quality of submitted or published modelled economic evaluations. [source] Use of pharmacoeconomics in prescribing research.JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 1 2003Part 1: costs, moving beyond the acquisition price for drugs Summary This paper addresses pharmacoeconomics in prescribing research and reflects the increasing use of techniques of economic evaluation to aid drug purchasing decisions in a variety of settings , for national drug subsidization programmes, provincial purchasing plans, insurance programmes, and for hospital and area health authority formulary decisions. First, we focus on the cost component of an economic evaluation and discuss methodological issues that are relevant to all pharmacoeconomic analyses. [source] Smoking Behavior, Information Sources, and Consumption Values of Teenagers: Implications for Public Policy and Other Intervention FailuresJOURNAL OF CONSUMER AFFAIRS, Issue 1 2002GERALD ALBAUM This paper uses a hierarchical decision process model, uses of information, and a theory of consumption values as a strategic framework for evaluating the general failure of intervention strategies for teenage smoking initiation. Extremely high smoking consideration-to-trial rates and rapid cessation by occasional smokers provide narrow but unused strategic opportunities for intervention. Use of information sources varies by stage of model with interpersonal sources dominating consideration, trial, and cessation stages and mass media showing only a slightly increasing use in cessation compared to the earlier stages. The decision process model and consumption values are necessary for planning strategic interventions. Existing intervention programs are not appropriately targeted in the decision process. Programs should be developed to reduce the smoking consideration to trial rates in younger children and to encourage rapid cessation in older teenagers. The use of either print or broadcast mass media intervention programs is not supported. [source] Effects of Microbial Transglutaminase on the Wheat Proteins of Bread and Croissant DoughJOURNAL OF FOOD SCIENCE, Issue 6 2001J.A. Gerrard ABSTRACT: Transglutaminase is a crosslinking enzyme that is finding increasing use in foods, yet the molecular changes responsible for its effects are not fully understood. Proteins were extracted from bread and croissant doughs that had been treated with transglutaminase and compared to those from control doughs by size exclusion high performance liquid chromatography and sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis. Transglutaminase increased the amount of protein extracted in the gliadin fraction in both bread and croissant doughs. In croissant doughs, a corresponding decrease in the protein extracted in the albumin to globulin fraction was seen. In each case, crosslinking of the high molecular weight glutenins was observed. The possible role of each of these changes on the functional properties of baked products is discussed. [source] Altered Mesencephalic Dopaminergic Populations in Adulthood as a Consequence of Brief Perinatal Glucocorticoid ExposureJOURNAL OF NEUROENDOCRINOLOGY, Issue 8 2005S. McArthur Abstract Early exposure to stressors is strongly associated with enduring effects on central nervous system function, but the mechanisms and neural substrates involved in this biological ,programming' are unclear. This study tested the hypothesis that inappropriate exposure to glucocorticoid stress hormones (GCs) during critical periods of development permanently alters the mesencephalic dopaminergic populations in the ventral tegmental area (VTA) and substantia nigra pars compacta (SNc). Using a rat model, the synthetic GC dexamethasone was added to the maternal drinking water during gestational days 16,19 or over the first week of postnatal life. In adulthood, the effects upon tyrosine hydroxylase immunopositive (TH+) cell numbers in the midbrain, and monoamine levels in the forebrain, of the adult offspring were assessed and compared with control offspring whose dams received normal drinking water. In the VTA, both prenatal and postnatal dexamethasone treatment increased TH+ cell numbers by approximately 50% in males and females. Although prenatal dexamethasone treatment also increased TH+ cell numbers in the SNc by 40,50% in males and females, postnatal treatment affected females only by increasing TH+ cell numbers by approximately 30%. In comparison, similar changes were not detected in the monoamine levels of the dorsolateral striatum, nucleus accumbens or infralimbic cortex of either males or females, which is a feature likely to reflect adaptive changes in these pathways. These studies demonstrate that the survival or phenotypic expression of VTA and SNc dopaminergic neurones is profoundly influenced by brief perinatal exposure to GCs at times when endogenous levels are normally low. These findings are the first to demonstrate permanent changes in the cytoarchitecture within midbrain dopamine nuclei after perinatal exposure to stress hormones and implicate altered functionality. Thus, they have significance for the increasing use of GCs in perinatal medicine and indicate potential mechanisms whereby perinatal distress may predispose to the development of a range of psychiatric conditions in later life. [source] Seventy Years of Research on Personality and Close Relationships: Substantive and Methodological Trends Over TimeJOURNAL OF PERSONALITY, Issue 6 2002M. Lynne Cooper ABSTRACT The present review is based on a quantitative analysis of the abstracts for 477 studies published since 1932 on the topic of personality and close (romantic) relationships. This approach enables a "bird's-eye" view of the content and methods that have characterized research in this area and an examination of publication trends over time. Results showed that 60% of all published studies in this area relied exclusively on cross-sectional and self-report methods; that nearly all used convenience samples, though more than half used nonstudent samples; and that more than one-third relied exclusively on data from individuals rather than couples. Few studies appeared to include elaborated networks of constructs in either the personality or relationship domain or to attempt to integrate an elaborated model of personality with an elaborated relationship model. Examination of trends over time revealed a mixed picture, with increasing use of the least informative designs balanced by evidence of increasingly complex conceptual models. [source] Sampling within households in household surveysJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2007Robert G. Clark Summary., The number of people to select within selected households has significant consequences for the conduct and output of household surveys. The operational and data quality implications of this choice are carefully considered in many surveys, but the effect on statistical efficiency is not well understood. The usual approach is to select all people in each selected household, where operational and data quality concerns make this feasible. If not, one person is usually selected from each selected household. We find that this strategy is not always justified, and we develop intermediate designs between these two extremes. Current practices were developed when household survey field procedures needed to be simple and robust; however, more complex designs are now feasible owing to the increasing use of computer-assisted interviewing. We develop more flexible designs by optimizing survey cost, based on a simple cost model, subject to a required variance for an estimator of population total. The innovation lies in the fact that household sample sizes are small integers, which creates challenges in both design and estimation. The new methods are evaluated empirically by using census and health survey data, showing considerable improvement over existing methods in some cases. [source] Investigation of the physical mechanisms in rolling bearings during the passage of electric currentLUBRICATION SCIENCE, Issue 4 2005A. Jagenbrein Abstract With the increasing use of frequency converters as control units for electric motors, bearing failures caused by the passage of electric current through the bearings are more common. This paper discusses the most relevant parasitic current loops in frequency converter-driven motors that can lead to damage of bearing raceways or deterioration of lubricants. Electrical stray capacitances, which are inevitably present in any electric motor, in combination with the high-frequency components of the drive voltages, have been identified as the source of electric discharge machining (EDM) currents. Based on an EDM equivalent electric circuit, the passage of electric current through the rolling contact of a bearing is simulated. A set-up is introduced to initiate EDM processes in bearings under well-controlled electrical and mechanical conditions. The effect of EDM currents on bearing elements in the presence of different lubricants is studied. Initial results are presented. [source] Cell-free expression and selective isotope labelling in protein NMRMAGNETIC RESONANCE IN CHEMISTRY, Issue S1 2006David Staunton Abstract Isotope labelling is a very powerful tool in NMR studies of proteins and has been employed in various ways for over 40 years. 15N and 13C incorporation, using recombinant expression systems, is now commonplace because heteronuclear experiments assist with the fundamental problems of peak resolution and assignment. The use of selective labelling for peak assignment has been restricted by the scrambling of isotope label through metabolic pathways within the expression host organism. The availability of efficient cell-free expression systems with low levels of metabolic conversion allow the increasing use of selective isotope labelling as a tool in protein NMR. We describe two examples, one where a selective labelling scheme can identify backbone amide peaks from unassigned 1H15N HSQC and HNCO spectra of a 84 residue protein, and another where a specific backbone amide in a 198 residue construct of the ninth and tenth Type III repeats from human fibronectin can be labelled and rapidly identified using a simple HSQC experiment. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||||||||||||||