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Intent
Kinds of Intent Selected AbstractsCONSUMER ACCEPTANCE AND PURCHASE INTENT OF A NOVEL LOW-FAT SUGAR-FREE SHERBET CONTAINING SOY PROTEINJOURNAL OF FOOD QUALITY, Issue 2010J. WALKER ABSTRACT This research was designed to develop low-fat sugar-free frozen sherbet products containing an acceptable level of soy protein (SP) recommended by the Food and Drug Administration and to determine consumer sensory profile driving consumer acceptance and purchase intent. Four orange-flavored sherbets were manufactured using four levels of SP isolate (6.0, 6.5, 7.5 and 7.9 g/serving) and evaluated by 140 consumers. Consumers evaluated each sample for acceptability of appearance/color, flavor, sweetness, sourness, texture/mouthfeel and overall liking. Consumers also evaluated overall acceptance and purchase intent of these products. All four formulations were overall different (multivariate analysis of variance, Pr > F = 0.0003). Appearance and sweetness were not used by the consumers to differentiate among the four sherbet formulations. Formulations with 7.9 g and 6.0 g SP were equally liked with the mean overall liking score of 5.60,5.66. Formulation with 6.0 g SP had the highest acceptance (65.0%) and purchase intent (55.7%) after consumers had been informed of soy health benefits. Specifically, overall liking and texture were identified as the two most critical attributes affecting overall acceptance and purchase intent of these products. PRACTICAL APPLICATIONS Consumer interest in healthy eating is increasing. Soy-based products have moved into the marketplace and are becoming increasingly popular. Consumers tend to associate consuming soy with healthy eating habits. In this study, consumer acceptability of low-fat sugar-free sherbets containing soy protein (SP) was evaluated. Development of a frozen dessert with SP would give consumers another venue to satisfy consumer's eating desire and provide them with the health benefits of soy. [source] Distinct Population Segments and Congressional Intent: Reply to WaplesCONSERVATION BIOLOGY, Issue 2 2000David S. Pennock No abstract is available for this article. [source] Toward a New Critical Theory with a Cosmopolitan IntentCONSTELLATIONS: AN INTERNATIONAL JOURNAL OF CRITICAL AND DEMOCRATIC THEORY, Issue 4 2003Ulrich Beck In this article I want to outline an argument for a New Critical Theory with a cosmopolitan intent. Its main purpose is to undermine one of the most powerful beliefs of our time concerning society and politics. This belief is the notion that "modern society" and "modern politics" are to be understood as society and politics organized around the nation-state, equating society with the national imagination of society. There are two aspects to this body of beliefs: what I call the "national perspective" (or "national gaze") of social actors, and the "methodological nationalism" of scientific observers. The distinction between these two perspectives is important because there is no logical co-implication between them, only an interconnected genesis and history. [source] Effects of nucleoside reverse transcriptase inhibitor backbone on the efficacy of first-line boosted highly active antiretroviral therapy based on protease inhibitors: meta-regression analysis of 12 clinical trials in 5168 patientsHIV MEDICINE, Issue 9 2009A Hill Objectives Tenofovir/emtricitabine (TDF/FTC) and abacavir/lamivudine (ABC/3TC) are widely used with ritonavir (RTV)-boosted protease inhibitors (PIs) as first-line highly active antiretroviral therapy (HAART), but there is conflicting evidence on their relative efficacy. The ACTG 5202 and BICOMBO trials suggested higher efficacy for TDF/FTC, whereas the HEAT trial showed no efficacy difference between the nucleoside reverse transcriptase inhibitor (NRTI) backbones. Methods A systematic MEDLINE search identified 21 treatment arms in 12 clinical trials of 5168 antiretroviral-naïve patients, where TDF/FTC (n=3399) or ABC/3TC (n=1769) was used with RTV-boosted PI. For each NRTI backbone and RTV-boosted PI, the percentage of patients with viral load <50 HIV-1 RNA copies/mL at week 48 by standardized Intent to Treat, Time to Loss of Virological Failure (ITT TLOVR) analysis were combined using inverse-variance weighting. The effect of baseline HIV RNA, CD4 cell count and choice of NRTI backbone were examined using a weighted analysis of covariance. Results Across all the trials, HIV RNA suppression rates were significantly higher for those with baseline viral load below 100 000 copies/mL (77.2%) vs. above 100 000 copies/mL (70.9%) (P=0.0005). For the trials of lopinavir/ritonavir (LPV/r), atazanavir/ritonavir (ATV/r) and fosamprenavir/ritonavir (FAPV/r) using either TDF/FTC or ABC/3TC, the HIV RNA responses were significantly lower when ABC/3TC was used, relative to TDF/FTC, for all patients (P=0.0015) and for patients with baseline viral load <100 000 copies/mL (70.1%vs. 80.6%, P=0.0161), and was borderline for those with viral load >100 000 copies/mL (67.5%vs. 71.5%, P=0.0523). Conclusions This systematic meta-regression analysis suggests higher efficacy for first-line use of a TDF/FTC NRTI backbone with boosted PIs, relative to use of ABC/3TC. However, this effect may be confounded by differences between the trials in terms of baseline characteristics, patient management or adherence. [source] The Influence of Anger-arousal Level on Attribution of Hostile Intent and Problem Solving Capability in an Individual with a Mild Intellectual Disability and a History of Difficulties with AggressionJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2006Kenneth M. A. MacMahon Background, Recent studies have suggested that cognitive biases may play an important mediating role in aggressive outbursts from people with mild intellectual disabilities (IDs). Essentially, some individuals may frequently perceive other people as acting towards them in a hostile fashion. This biased perception may develop through repeated adverse experiences, and may make them more likely to respond, likewise, in an aggressive manner. These studies have led to the development of a cognitive behavioural model of aggression, incorporating factors both intrinsic and extrinsic to the individual. This study aimed to explore one facet of this model: a putative relationship between anger-arousal level, problem-solving ability and perception of hostile intent in others. Method, Single-case methodology was utilized, and a 44-year-old man with a mild ID and a history of difficulties with aggression participated. A series of vignettes, containing potentially provocative social interactions, were read to the participant. His perception of hostile intent, and suggestions of possible behavioural responses were recorded as dependent variables. Anger-arousal was manipulated, through autobiographical recall, as a dependent variable. Results, Although not conclusive, results indicate that anger-arousal may act in an interactive fashion to increase perception of hostile intent. No effect of anger-arousal was observed on problem-solving ability; however, floor-effects in the task used may provide an explanation for this. Conclusions, A high level of anger-arousal may exacerbate the probability of a frequently aggressive individual perceiving others as acting in a hostile manner. However, future research should take the limitations of this study into account, and continue development of a cognitive model of frequent aggression in those with a mild ID. [source] Identifying Drivers for Consumer Acceptance and Purchase Intent of Corn TortillaJOURNAL OF FOOD SCIENCE, Issue 9 2007J.A. Herrera-Corredor ABSTRACT:, The traditional production of corn tortilla has been modified by new processing technologies to make possible a commercial-scale production; this practice has resulted in products having sensory properties different from those produced by the traditional method. There is no published information on sensory attributes driving acceptance and purchase intent of corn tortillas. Identifying sensory drivers for acceptance and purchase intent of corn tortillas will help commercially produce products that satisfy consumers' expectations. A consumer study was conducted to evaluate acceptance and purchase intent of corn tortillas and determine drivers of acceptance and purchase intent of the products. Ten samples of corn tortillas were selected to represent a variety of corn tortillas available in the Mexican market. Three hundred Mexican consumers evaluated acceptability of appearance, color, thickness, rollability, resistance to tearing, aroma, chewiness, taste and aftertaste, and overall liking using a 9-point hedonic scale. Overall acceptance and purchase intent were determined with a yes/no scale. Analysis of variance and multivariate analysis of variance revealed that consumers were able to differentiate differences in sensory acceptability among 10 samples. For example, 2 homemade and 1 small commercial-scale samples, with an overall liking score of 6.6 to 6.7, were more acceptable than others. Rollability, resistance to tearing, and chewiness were attributes underlying overall differences among 10 samples. Attributes determining overall acceptance of corn tortillas were chewiness and overall liking. Purchase intent was influenced by overall appearance, rollability, chewiness, taste, and overall liking. This study revealed critical sensory attributes and their weights given by Mexican consumers when making decisions for acceptance and purchase intent of corn tortilla. [source] Intention to 'leave' or 'stay' in nursingJOURNAL OF NURSING MANAGEMENT, Issue 3 2007GERALDINE McCARTHY PhD Background, Turnover in nursing and midwifery has recently become a problem in the Republic of Ireland and Irish health-care managers are constantly challenged to retain qualified nurses. The literature suggests that intention to stay or leave employment is the final step in the decision-making process. It is, therefore, reasonable to suggest that understanding ,intent to stay or leave' might facilitate nurse managers in introducing of appropriate retention strategies. Aim, The aim of this study was to investigate registered nurses ,intent to stay or leave' employment. Methods, A cross-sectional quantitative design was utilized. A questionnaire was designed and these were randomly distributed to 352 registered nurses at 10 hospital sites throughout the Republic of Ireland. Results, Almost 60% of the sample, comprising of young, female, college educated nurses, expressed an intent to leave their current post. The most statistically significant predictors of intent to leave were ,kinship responsibilities' (P < 0.05) and ,job satisfaction' (P < 0.0001). Conclusion, ,Intent to leave' has serious implications for workforce planning. Investigating the impact of focussed interventions in relation to job satisfaction and kinship responsibilities may be key retention strategies for nurse managers. [source] Integration Factors Related to the Academic Success and Intent to Persist of College Students with Learning DisabilitiesLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 3 2009Lisa M. W. DaDeppoArticle first published online: 3 AUG 200 Despite increased enrollment, outcomes such as grade point average (GPA), persistence, and graduation rates for college students with learning disabilities (LD) continue to lag behind those of their nondisabled peers. Reasons for the differences vary but may include academic and social integration, factors identified as important to the success of college students in general. This research investigated the relative influence of background characteristics, precollege achievement, and college integration variables on the academic success and intent to persist of college freshmen and sophomores with LD. While academic and social integration were not unique predictors of college GPA, both integration variables were unique predictors of intent to persist. The findings suggest that beyond high school achievement and background characteristics, college experiences as captured by academic and social integration are promising constructs to help explain the persistence of college students with LD. Implications for future research and practices for high school and college personnel are discussed. [source] Predictors of Homicidal Ideation and Intent in Schizophrenia: An Empirical StudyAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2001Robert C. Schwartz Ph.D. Correlations of age, gender, and psychosocial variables with ratings of current homicidal ideation and intent were investigated among psychiatric facility clients with schizophrenia. Multiple regression analyses revealed, irrespective of age or gender, significantly positive correlations of three psychosocial variables , manic symptoms, psychotic symptoms, and impaired global functioning , with homicidal ideation and intent. Implications for research are discussed. [source] Hostile Intent: U.S. Covert Operations in Chile, 1964,1974 , By Kristian GustafsonTHE HISTORIAN, Issue 1 2010Joyce S. Goldberg No abstract is available for this article. [source] Hostile Attribution of Intent and Aggressive Behavior: A Meta-AnalysisCHILD DEVELOPMENT, Issue 3 2002Bram Orobio De Castro A meta-analytic review was conducted to explain divergent findings on the relation between children's aggressive behavior and hostile attribution of intent to peers. Forty-one studies with 6,017 participants were included in the analysis. Ten studies concerned representative samples from the general population, 24 studies compared nonaggressive to extremely aggressive nonreferred samples, and 7 studies compared nonreferred samples with children referred for aggressive behavior problems. A robust significant association between hostile attribution of intent and aggressive behavior was found. Effect sizes differed considerably between studies. Larger effects were associated with more severe aggressive behavior, rejection by peers as one of the selection criteria, inclusion of 8- to-12-year-old participants, and absence of control for intelligence. Video and picture presentation of stimuli were associated with smaller effect sizes than was audio presentation. Staging of actual social interactions was associated with the largest effects. The importance of understanding moderators of effect size for theory development is stressed. [source] The Assessment of Emergency Physicians by a Regulatory AuthorityACADEMIC EMERGENCY MEDICINE, Issue 12 2006Jocelyn M. Lockyer PhD Abstract Objectives To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program (360° evaluation) for emergency physicians. Methods Surveys with 16, 20, 30, and 31 items were developed to assess emergency physicians by 25 patients, eight coworkers, eight medical colleagues, and self, respectively, using five-point scales along with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management. Results Data from 187 physicians who identified themselves as emergency physicians were available. The mean number of respondents per physician was 21.6 (SD ± 3.87) (93%) for patients, 7.6 (SD ± 0.89) (96%) for coworkers, and 7.7 (SD ± 0.61) (95%) for medical colleagues, suggesting it was a feasible tool. Only the patient survey had four items with "unable to assess" percentages ,15%. The factor analysis indicated there were two factors on the patient questionnaire (communication/professionalism and patient education), two on the coworker survey (communication/collegiality and professionalism), and four on the medical colleague questionnaire (clinical performance, professionalism, self-management, and record management) that accounted for 80.0%, 62.5%, and 71.9% of the variance on the surveys, respectively. The factors were consistent with the intent of the instruments, providing empirical evidence of validity for the instruments. Reliability was established for the instruments (Cronbach's , > 0.94) and for each physician (generalizability coefficients were 0.68 for patients, 0.85 for coworkers, and 0.84 for medical colleagues). Conclusions The psychometric examination of the data suggests that the instruments developed to assess emergency physicians were feasible and provide evidence for validity and reliability. [source] A Review of Feral Cat Eradication on IslandsCONSERVATION BIOLOGY, Issue 2 2004MANUEL NOGALES efecto de depredación; erradicación; Felis catus; gato asilvestrado; islas Abstract:,Feral cats are directly responsible for a large percentage of global extinctions, particularly on islands. We reviewed feral cat eradication programs with the intent of providing information for future island conservation actions. Most insular cat introductions date from the nineteenth and twentieth centuries, whereas successful eradication programs have been carried out in the last 30 years, most in the last decade. Globally, feral cats have been removed from at least 48 islands: 16 in Baja California (Mexico), 10 in New Zealand, 5 in Australia, 4 in the Pacific Ocean, 4 in Seychelles, 3 in the sub-Antarctic, 3 in Macaronesia (Atlantic Ocean), 2 in Mauritius, and 1 in the Caribbean. The majority of these islands (75%; n= 36) are small (,5 km2). The largest successful eradication campaign took place on Marion Island (290 km2), but cats have been successfully removed from only 10 islands (21%) of ,10 km2. On Cousine Island (Seychelles) cat density reached 243 cats/km2, but on most islands densities did not exceed 79.2 cats/km2 (n= 22; 81%). The most common methods in successful eradication programs were trapping and hunting (often with dogs; 91% from a total of 43 islands). Frequently, these methods were used together. Other methods included poisoning (1080; monofluoracetate in fish baits; n= 13; 31%), secondary poisoning from poisoned rats (n= 4; 10%), and introduction of viral disease (feline panleucopaenia; n= 2; 5%). Impacts from cat predation and, more recently, the benefits of cat eradications have been increasingly documented. These impacts and benefits, combined with the continued success of eradication campaigns on larger islands, show the value and role of feral cat eradications in biodiversity conservation. However, new and more efficient techniques used in combination with current techniques will likely be needed for success on larger islands. Resumen:,Los gatos asilvestrados han sido responsables directos de un gran número de extinciones, particularmente en islas. En este estudio, se revisan los programas de erradicación de este felino con el fin de ofrecer información de utilidad en futuras acciones de conservación en islas. La mayor parte de las introducciones datan de los siglos diecinueve y veinte, mientras que las erradicaciones han sido realizadas básicamente durante los últimos 30 años, y sobre todo en la última década. Los gatos asilvestrados han sido erradicados de al menos 48 islas: 16 de ellas en Baja California (México), 10 en Nueva Zelanda, 5 en Australia, 4 en el Océano Pacífico, 4 en Seychelles, 3 en la Región Subantártica, 3 en Macaronesia (Océano Atlántico), 2 en Mauricio, y una en el Caribe. La mayoría de éstas (75%; n= 36) son de reducidas dimensiones (,5 km2), mientras que la más extensa es Marion Island (290 km2). En tan sólo 10 islas (21%) , 10 km2 se ha podido erradicar este depredador. En Cousine Island (Seychelles) la densidad de gatos alcanzó 243 individuos/km2; sin embargo, en la mayoría de las islas, las densidades no excedieron los 79,2 individuos/km2 (n= 22; 81%). Los métodos más comúnmente empleados fueron el trampeo y la caza, a menudo con perros (91% de un total de 43 islas). Con frecuencia dichas prácticas fueron empleadas conjuntamente. Otros métodos incluyeron venenos (1080, monofluoracetato de sodio en cebos de pescado: n= 13; 31%), envenenamiento secundario con ratas envenenadas (n= 4; 10%) y el virus de la leucemia felina (n= 2; 5%). La información sobre el efecto negativo de los gatos en islas y, más recientemente, el beneficio de su erradicación, se ha ido dando a conocer paulatinamente, poniendo de manifiesto su importancia en la conservación de la biodiversidad insular. No obstante, la combinación de técnicas nuevas y más eficientes junto con las habituales, será necesaria para el éxito de la erradicación de los gatos en islas de grandes dimensiones. [source] Toward a New Critical Theory with a Cosmopolitan IntentCONSTELLATIONS: AN INTERNATIONAL JOURNAL OF CRITICAL AND DEMOCRATIC THEORY, Issue 4 2003Ulrich Beck In this article I want to outline an argument for a New Critical Theory with a cosmopolitan intent. Its main purpose is to undermine one of the most powerful beliefs of our time concerning society and politics. This belief is the notion that "modern society" and "modern politics" are to be understood as society and politics organized around the nation-state, equating society with the national imagination of society. There are two aspects to this body of beliefs: what I call the "national perspective" (or "national gaze") of social actors, and the "methodological nationalism" of scientific observers. The distinction between these two perspectives is important because there is no logical co-implication between them, only an interconnected genesis and history. [source] Geriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health SystemACADEMIC EMERGENCY MEDICINE, Issue 12 2006Scott T. Wilber MD Abstract Three recently published Institute of Medicine reports, Hospital-Based Emergency Care: At the Breaking Point, Emergency Medical Services: At the Crossroads, and Emergency Care for Children: Growing Pains, examined the current state of emergency care in the United States. They concluded that the emergency medicine system as a whole is overburdened, underfunded, and highly fragmented. These reports did not specifically discuss the effect the aging population has on emergency care now and in the future and did not discuss special needs of older patients. This report focuses on the emergency care of older patients, with the intent to provide information that will help shape discussions on this issue. [source] Homicide, psychopathology, prosecutorial and jury discretion and the death penaltyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2000Chief, Division of Forensic Psychiatry, Richard M. Yarvis MD MPH Professor of Clinical Psychiatry Introduction The American preoccupation with the death penalty persists and, in fact, shows no sign of abatement. This is demonstrated not only by attitudinal measures but also by the quickening pace of executions. In California, homicide convictions can result in either 25-year-to-life, life-with-no-possibility-of-parole, or death sentences. The ultimate outcome in any given case is determined by a complex interaction of prosecutorial and jury decisions. Three vignettes illustrate how heinous crimes have been handled quite variably. Method A data set comprising 115 homicide cases was examined. To determine how murderers who qualify for the death penalty differed, if at all, from those who did not so qualify, 52 defendants who met the criteria for a death sentence were compared with 63 who did not. Criteria utilized and ignored by prosecutors in seeking the death penalty were analysed by comparing 39 cases in which death sentences could have been and were sought with 13 cases in which prosecutors chose to seek a lesser penalty instead. Finally, criteria utilized and ignored by juries to reach sentencing decisions were analysed by comparing 25 cases in which juries chose not to hand down death sentences with 14 cases in which they did render death verdicts. Results Special circumstance murderers did not differ significantly on personal variables from ordinary murderers. (1) Special circumstances were invariably charged when more than one criterion for this was present. Robbery and sexual assault usually provoked a special circumstances charge. Mitigating factors did not deter prosecutors from charging a special circumstance. (2) There was no excess of aggravating factors in individuals sentenced to death by juries, indeed there was a trend for the opposite to be the case, but there was a trend for mitigating factors to be commoner in those excused the death penalty. Conclusion It is not clear that the death penalty process in California carries out the legislature's intent but the US Supreme Court's 1976 mandate that mitigating and aggravating factors should provide discretion may be having a modest impact. Copyright © 2000 Whurr Publishers Ltd. [source] Curricular Theorizing From the PeripheryCURRICULUM INQUIRY, Issue 5 2008ANGELINA WEENIE ABSTRACT The purpose of this article is to propose theory and knowledge from the peripheral space. Through an analysis of historical and contemporary perspectives of curriculum, the intent of this article is to make explicit the story of curriculum, and the influence of poststructuralist, postmodern, and postcolonial paradigms on the development of Aboriginal curriculum. This article will explore the philosophical and ontological basis of Aboriginal knowledge and its implications for curricular theory. [source] Frequency of Use of Suturing and Repair Techniques Preferred by Dermatologic SurgeonsDERMATOLOGIC SURGERY, Issue 5 2006BETH ADAMS MD BACKGROUND There are many closure techniques and suture types available to cutaneous surgeons. Evidence-based data are not available regarding the frequency of use of these techniques by experienced practitioners. OBJECTIVE To quantify, by anatomic site, the frequency of use of common closure techniques and suture types by cutaneous surgeons. METHOD A prospective survey of the members of the Association of Academic Dermatologic Surgeons that used length-calibrated visual-analog scales to elicit the frequency of use of specific suture techniques. RESULTS A response rate of 60% (61/101) indicated reliability of the received data. Epidermal layers were closed most often, in descending order, by simple interrupted sutures (38,50%), simple running sutures (37,42%), and vertical mattress sutures (3,8%), with subcuticular sutures used more often on the trunk and extremities (28%). The most commonly used superficial sutures were nylon (51%) and polypropylene (44%), and the most common absorbable suture was polyglactin 910 (73%). Bilayered closures, undermining, and electrocoagulation were used, on average, in 90% or more sutured repairs. The median diameters (defined as longest extent along any axis) of most final wound defects were 1.1 to 2.0 cm (56%) or 2.1 to 3.0 cm (37%). Fifty-four percent of wounds were repaired by primary closure, 20% with local flaps, and 10% with skin grafting, with the remaining 15% left to heal by second intent (10%) or referred for repair (5%). Experience-related differences were detected in defect size and closure technique: defects less than 2 cm in diameter were seen by less experienced surgeons, and defects greater than 2 cm by more experienced surgeons (Wilcoxon's rank-sum test: p=.02). But more experienced surgeons were less likely to use bilayered closures (r=,0.28, p=.036) and undermining (r=,0.28, p=.035). CONCLUSIONS There is widespread consensus among cutaneous surgeons regarding optimal suture selection and closure technique by anatomic location. More experienced surgeons tend to repair larger defects but, possibly because of their increased confidence and skill, rely on less complicated repairs. [source] Clinical trials and statistical analyses: what should dermatologists look for in a report?DERMATOLOGIC THERAPY, Issue 3 2009Mohamed Alosh ABSTRACT Clinicians need to evaluate the quality of individual clinical studies and synthesize the information from multiple clinical studies to provide insights in selecting appropriate therapies for patients. Understanding the key statistical principles that underlie a clinical trial and how they may be implemented can help clinicians properly interpret the efficacy and safety findings of clinical trials. Several factors should be considered when evaluating clinical studies reported in the literature, as important differences might exist among reported studies, thereby impacting the reliability of their findings. Studies vary in terms of study design, conduct, analysis, and presentation of findings. The key features to consider when evaluating clinical trials are inferential intent (exploratory versus confirmatory), choice of control group, randomization, extent of blinding, prespecification of analyses, appropriate handling of missing data, and multiple end points. Making comparisons across studies is extremely difficult and rarely statistically justified. However, this article will point out issues to keep in mind when evaluating multiple studies, such as variations in design and study populations. [source] The Future of Search: A Different PerspectiveDESIGN MANAGEMENT REVIEW, Issue 1 2009Stephen P. Anderson Vice President The mission at Viewzi is to dramatically improve the search experience. But, as Stephen Anderson explains, that doesn't mean developing a better search engine; rather, it means developing a better way to view search results. The results are a series of custom-tailored scenes whose look and feel change depending on the intent of the search. It's an impressive innovation that promises to reshape the Internet landscape. [source] Endocervical curetting vs. endocervical brushing as case finding methods,DIAGNOSTIC CYTOPATHOLOGY, Issue 5 2006John A. Maksem M.D. Abstract This paper focuses on the performance of endocervical curettage (ECC) and intensive endocervical brushing (ECB) (comprising two or more brushings of the endocervix with liquid-based cytology and cell-block examination) in the course of colposcopic examination for abnormal gynecological cytology. To assess their relative effectiveness in disease detection, we reviewed the outcomes of 1,824 colposcopic biopsy collections from women who had an index cytology diagnosis of LSIL or higher. Our intent was to gauge the relative success of ECC and ECB as case-finding procedures in relation to (1) the original cytological diagnosis and (2) the highest (most abnormal) histological diagnosis of the colposcopy study. Our purpose was to determine whether ECB could effectively replace ECC. One thousand five hundred and seven cases of LSILs or higher cases included an ECC along with two or more colposcopic biopsies and 317 cases included an ECB. ECBs were collected into a liquid fixative and processed as both cytology and cell-block specimens; whereas, ECCs were processed according to standard histological techniques. We found that intensive ECB recapitulates the highest diagnosis of the colposcopy study about 5,8 times as often as that of ECC. Moreover, when calculating the proportion of positive outcomes, we found that cases examined with biopsy and ECC discovered fewer women with CIN 2 or higher among both LSIL and HSIL index cytologies as compared with those of cases examined with biopsy and ECB (9.2% vs. 16.8% for LSIL and 63.7% vs. 72.2% for HSIL cases); and, more negative outcomes were seen among women evaluated with biopsy plus ECC than those with biopsy plus ECB (11.3% vs. 8.1% for LSIL and 4.7% vs. 1.4% for HSIL cases). Our findings suggest that the colposcopic study is optimized when it is performed in conjunction with ECB as opposed to ECC, and that intensive ECB may be superior to ECC. Diagn. Cytopathol. 2006; 34:313,316. © 2006 Wiley-Liss, Inc. [source] Success in Kashmir: a positive trend in civil,military integration during humanitarian assistance operationsDISASTERS, Issue 1 2010Wiley C. Thompson The modern cast of disaster relief actors includes host nations, non-governmental organisations, private volunteer organisations, military organisations and others. Each group, civilian or military, has valuable skills and experiences critical to disaster relief work. The goal of this paper is to supplement the study of civil,military relief efforts with contemporary anecdotal experience. The paper examines the interaction between US military forces and other disaster relief actors during the 2005 Kashmir earthquake relief effort. The author uses direct observations made while working in Pakistan to contrast the relationships and activities from that effort with other accounts in prevailing scholarly disaster literature and military doctrine. Finally, this paper suggests that the Kashmir model of integration, coordination and transparency of intent creates a framework in which future humanitarian assistance operations could be successfully executed. Recommendations to improve civil,military interaction in future relief efforts will also be addressed. [source] Concurrent chemoradiation alone with curative intent for limited-disease small-cell esophageal cancer in nine Japanese patientsDISEASES OF THE ESOPHAGUS, Issue 2 2009H. Yamashita SUMMARY Small-cell carcinoma of the esophagus is a rare and aggressive tumor with early widespread dissemination. In this retrospective study, we report clinical outcomes of limited-disease small-cell carcinoma of the esophagus from the analysis of nine patients. Between 2003 and 2006, nine consecutive patients with small-cell carcinoma of the esophagus were treated in our single institution, representing 2.8% of all esophageal malignancies treated with curative concurrent chemoradiation during this period. All the patients received four cycles of etoposide (100 mg/m2, days 1,3), combined with cisplatin (80 mg/m2, day 1), plus radiation therapy (50 Gy in daily doses of 2 Gy, 5 days/week). At the time of analysis, the median follow-up time was 10.8 months (range: 4.2,42.8 months) and 21.8 months in five living patients (56%). Of all the nine patients, five patients (56%) had a complete response, and the actuarial 3-year overall survival rate was 55.6%. This regimen resulted in a favorable 3-year survival rate. We conclude that the optimum treatment seems to be the same as for small-cell carcinomas of the lung, that is, a multidrug combination chemotherapy regimen used with concurrent radiation. [source] Psychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluationDISEASES OF THE ESOPHAGUS, Issue 6 2007H. Bergquist SUMMARY., Cancer of the esophagus is often diagnosed at a late stage and is related to severe morbidity and a low 5-year survival rate. Previous studies have reported low health-related quality of life and high suicide rates for these patients. The occurrence of psychiatric morbidity and thus the potential need for psychological support may vary over time after diagnosis. This has not been adequately studied in patients with newly diagnosed cancer of the esophagus or gastro-esophageal junction. The present study therefore aimed to prospectively evaluate the prevalence of psychiatric morbidity in 94 consecutive patients (median age 66, range 45,88 years) with all stages of disease. Psychiatric morbidity was evaluated with the Hospital Anxiety and Depression Scale (HADS) questionnaire at inclusion and 1, 2, 3, 6 and 12 months later. At inclusion, 42% of the patients had HADS scores indicating possible or probable anxiety disorder and/or depression. At all follow-ups except at 3 months, proportions of patients with possible/probable anxiety disorder were significantly lower than at inclusion. Among patients with a duration of tumor-specific symptoms exceeding 6 months pre-diagnosis, larger proportions of patients with a possible/probable anxiety disorder were found at the 1- and 6-month follow ups. The prevalence of possible/probable depression was greater among patients treated with a palliative intent than among those with a curative intent at inclusion. Patients who died during the study period scored worse for depression compared to the survivors. Apart from this, the proportion of patients with possible/probable psychiatric morbidity (anxiety and/or depression) was relatively stable over time and was unrelated to patient characteristics or clinical background, including the treatment regime. In conclusion, psychiatric morbidity is common among esophageal cancer patients, both at inclusion and over time, regardless of the cancer therapy given. The findings stress the importance of monitoring the patients' mental health and of offering adequate psychological care when needed. [source] Chemoradiation therapy is effective for the palliative treatment of malignant dysphagiaDISEASES OF THE ESOPHAGUS, Issue 3 2004J. A. Harvey SUMMARY., Between 1993 and 2001, 106 patients with esophageal cancer were reviewed at a multidisciplinary clinic and treated with palliative intent by chemoradiation therapy. This study assesses the palliative benefit on dysphagia and documents the toxicity of this treatment. The study population comprised 72 men and 34 women with a median age of 69 years. Patients were treated with a median radiation dose of 35 Gy in 15 fractions with a concurrent single course of 5 FU-based chemotherapy. Dysphagia was measured at the beginning and completion of treatment and at monthly intervals until death, using a modified DeMeester (4-point) score. Treatment was well tolerated, with only 5% of patients failing to complete therapy. The treatment-related mortality was 6%. The median survival for the study population was 7 months. The median baseline score at presentation was 2 (difficulty with soft food). Following treatment, 49% of patients were assessed as having a dysphagia score of 0 (no dysphagia). Seventy-eight per cent had an improvement of at least one grade in their dysphagia score after treatment. Only 14% of patients showed no improvement with treatment. Fifty-one per cent maintained improved swallowing until the time of last follow-up or death. This single-institution study shows that chemoradiation therapy administered for the palliation of malignant dysphagia is well tolerated and produces a sustainable normalization in swallowing for almost half of all patients. [source] Electronic Medical Record Review as a Surrogate to Telephone Follow-up to Establish Outcome for Diagnostic Research Studies in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2005Jeffrey A. Kline MD Abstract Background: Follow-up for diagnostic research studies might be facilitated if medical record review (MRR) could be used instead of telephone calls. Objectives: The authors hypothesized that MRR would yield similar accuracy to telephone follow-up. Methods: This was a secondary analysis of 2,178 initially disease-free patients who were followed after enrollment in a diagnostic study of either acute coronary syndrome (45 days) or pulmonary embolism (90 days) conducted in an urban teaching emergency department (ED). Disease status (positive or negative) was defined explicitly. Using structured data forms, trained researchers performed MRR using a comprehensive electronic database, and formulated an opinion about disease status. Trained researchers, blinded to the MRR, then dialed telephone numbers, asked questions from a script, and categorized disease status. The criterion standard was adjudication by consensus of two of three physicians who independently determined disease status based on explicit criteria and access to all follow-up data. Results: Adjudicators found that 13 of 2,178 patients developed disease during follow-up; all 13 true positives occurred among the 2,054 (94.3%) of patients who acknowledged intent to return to the study hospital. Telephone follow-up was successful in 81% of patients, and found all 13 true positives (sensitivity 100%) but with three additional false-positive cases. MRR disclosed 12 of 13 cases of disease (sensitivity 92%) with no false-positive cases. Further review of the one false-negative case from MRR revealed that it occurred after the prescribed time limit for follow-up. Conclusions: Under limited circumstances, accurate clinical follow-up for diagnostic studies conducted in the ED can be obtained by medical record review. [source] Cell microarray platform for anticancer drug development,DRUG DEVELOPMENT RESEARCH, Issue 5 2007Min-Jung Lee Abstract Pharmacodynamic assessment of whether a drug has interacted with and modified its target is an essential component of molecularly targeted clinical trials. Although many trials are written with the intent to assess tumor biopsies, if available, thus far the great majority of early drug trials have used peripheral blood mononuclear cells (PBMC) as a tumor surrogate. Typically, PBMC are studied by low-throughput techniques such as Western blot. We present the use of a cell-based tissue microarray for assessment of anticancer drug activity in vivo. We demonstrate the utility of this technique for analysis of protein hyperacetylation in response to treatment with the histone deacetylase inhibitor, SNDX-275 in PBMC treated in vitro and in PBMC and bone marrow aspirates from patients in Phase I clinical trials with SNDX-275. We demonstrate that the cell microarray can be used to measure drug response in a high-throughput manner, allowing analysis of an entire trial on one or two glass slides. The cell microarray technique brings the advantages of the tissue microarray platform to the pharmacodynamic assessment of single cells, such as those isolated from bone marrow aspirates, fine needle aspirates, or malignant effusions, and to analysis of PBMC, the most commonly studied surrogate in oncology trials. Drug Dev Res 68:226,234, 2007. Published 2007 Wiley-Liss, Inc. [source] The Knot of Contracts: The Corporate Geography of Legacy CostsECONOMIC GEOGRAPHY, Issue 2 2008Ashby H. B. Monk Abstract Burdensome past commitments are threatening a concentrated group of industries and communities, predominantly in the U.S. Midwest. Beginning with the bankruptcy of Delphi Corporation, this article documents the crisis for "old-economy firms" with significant legacy costs. To understand the root causes of this legacy crisis, the analysis builds on previous research in economic geography and the results of a widely subscribed and unique "expert opinion" survey highlighting the corporate impacts of defined benefit pensions in the private sector. The result is a conceptual framework that describes the corporate geography of legacy costs: the "knot of contracts." Specifically, the knot of contracts conceptualizes the role of intergenerational commitments in restricting corporate evolution and innovation, while underscoring time as a central component of the nature of the firm. Developing this framework requires linking microeconomic theories of the firm with the institutional aspects of firms' geographies. While referring to specific cases and proprietary data throughout, the article is principally concerned with understanding legacy costs. In addition, the intent is to uncover managerial and governmental behavior that tightened this knot of contracts and to expose the current managers' attempts to manage their firms through the adverse affects of the knot of contracts. The explanations in this article serve as a useful bridge between the realities faced by firms and their surrounding communities and the more abstract notions of the firm and competitiveness in the context of globalization. [source] English county populations in the later eighteenth century1ECONOMIC HISTORY REVIEW, Issue 1 2007E. A. WRIGLEY SUMMARY When directing the first English census John Rickman was intent not only on discovering the size of the population in 1801 but also on tracing past trends both nationally and for individual counties. He returned to the latter investigation on several later occasions, notably in the 1830s. There have been many subsequent attempts to improve upon his national estimates, but his estimates of county totals have continued to be used extensively, either unchanged or slightly modified. Rickman was aware that his estimates were subject to wide margins of error. For the later eighteenth century it is possible to produce new estimates which are probably substantially more accurate, taking advantage of the fact that after Hardwicke's Act (1753) the registration of marriages in Anglican parish registers, unlike that of baptisms and burials, was virtually complete. They show that the contrast between population growth rates in ,industrial' counties and those in which agriculture continued to predominate were significantly more marked than suggested by Rickman's estimates. The same exercise that produces county estimates also yields hundredal totals, which will in future allow a more refined account of relative growth and stagnation to be made. [source] Advanced Opportunities for Student Education in Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 10 2004Charissa B. Pacella MD Abstract Many medical students are excited about emergency medicine (EM) following a standard clerkship and seek out additional learning opportunities. An advanced EM elective may accomplish several educational goals, including development of clinical skills in evaluating the undifferentiated patient, broader exploration of the field of EM, and more focused study of one particular aspect of EM. Previously cited examples include pediatric EM, medical toxicology, occupational medicine, sports medicine, and EM research. Numerous other EM specialty courses for senior medical students are emerging, as reflected in the "Undergraduate Rotations" listings on the Society for Academic Emergency Medicine. A few examples drawn from the list include emergency ultrasound, international EM, wilderness medicine, disaster medicine, geriatric EM, and hyperbaric medicine. Educators aspiring to develop, or in the process of developing, an advanced EM elective may benefit from a brief overview of necessary course considerations, including didactic format, the clinical role of the medical student in the emergency department, and involvement with patient procedures. Suggestions are made regarding additional educational opportunities, including follow-up of patients seen in the emergency department and development of an emergency department radiology case file. This article also addresses several related concerns, including suggested prerequisites, administration and cost considerations, appropriate didactic topics, and methods for evaluating students. Several EM subspecialty areas, namely pediatric EM, medical toxicology, and out-of-hospital care, are specifically discussed. Formal advanced cardiac life support training is also often included in an advanced EM elective and is briefly discussed. The overall intent of this article is to provide medical student educators with resources and ideas to assist them in developing a unique advanced EM elective. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||