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Limited Knowledge (limited + knowledge)
Selected AbstractsHuman fetal radial glia cells generate oligodendrocytes in vitroGLIA, Issue 5 2009Zhicheng Mo Abstract Limited knowledge about human oligodendrogenesis prompted us to explore the lineage relationship between cortical radial glia (RG) cells and oligodendrocytes (OLs) in the human fetal forebrain. RG cells were isolated from cortical ventricular/subventricular zone and their progeny was followed in vitro. One portion of RG cells differentiated into cells of OL lineage identified by cell-type specific antibodies, including platelet-derived growth factor receptor-alpha (PDGFR,), NG2, O4, myelin basic protein, and myelin oligodendrocyte glycoprotein. Moreover, using Cre Lox fate mapping (brain lipid binding protein-Cre/Floxed-yellow fluorescent protein) we established a direct link between RG cells and OL progenitors. In vitro generation of RG-derived O4+ OL progenitors was enhanced by addition of sonic hedgehog (SHH) and reduced by the SHH inhibitor, cyclopamine, suggesting the role of SHH signaling in this process. In summary, our in vitro experiments revealed that a portion of cortical RG cells isolated from human forebrain at the second trimester of gestation generates OL progenitors and this suggests a role of SHH in this process. © 2008 Wiley-Liss, Inc. [source] When Should Heparin Preferably Be Administered During Radiofrequency Catheter Ablation?PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2001OLE-GUNNAR ANFINSEN ANFINSEN, O.-G., et al.: When Should Heparin Preferably be Administered During Radiofrequency Catheter Ablation? RF catheter ablation is complicated by thromboembolism in about 1% of patients. Limited knowledge exists concerning when and how to use anticoagulation or antithrombotic treatment. We studied the activation of coagulation (prothrombin fragment 1 + 2 [PF1 + 2] and D-dimer), platelets (,-thromboglobulin [,-TG]) and fibrinolysis (plasmin-antiplasmin complexes [PAP]) during RF ablation of accessory pathways in 30 patients. They were randomized to receive heparin (100 IU/kg, intravenously) (1) immediately after introduction of the femoral venous sheaths (group I) or (2) after the initial electrophysiological study, prior to the delivery of RF current (groups II and III). Group II additionally received saline irrigation of all femoral sheaths. After the initial bolus, 1,000 IU of heparin was supplied hourly in all groups. Within groups II and III, median plasma values of PF1 + 2 and ,-TG more than tripled (P , 0.007) during the diagnostic study and gradually declined during heparin administration despite RF current delivery. Median D-dimer tripled (P = 0.005) and PAP doubled (NS) before heparin administration; then both remained around the upper reference values. In the early heparin group, however, PF1 + 2, Ddimer, and PAP did not rise at all, and ,-TG showed only a slight increase towards the end of the procedure. The differences between group I versus groups II and III were statistically significant prior to the first RF current delivery (PF1 + 2, D-dimer, and ,-TG) and by the end of the procedure (PF1 + 2, D-dimer, and PAP). In conclusion, "late" heparin administration allows hemostatic activation during the initial catheterization and diagnostic study. By administering intravenous heparin immediately after introduction of the venous sheaths, hemostatic activation is significantly decreased. Saline irrigation of the venous sheaths added nothing to late heparin administration. [source] Effect of gold nanoparticle on the microscopic morphology of white blood cellCYTOPATHOLOGY, Issue 2 2009V. Wiwanitkit Background:, In medicine, there is limited knowledge on the toxicity of nanoparticles. In medicine, there has been limited knowledge on the effect of nanoparticles on the white blood cell. Objective:, To evaluate the effect of gold nanoparticle on the microscopic morphology of white blood cell. Setting:, Chulalongkorn Univesity, Bangkok, Thailand. Method:, This study was performed as an experimental study. Mixture of gold nanoparticle solution and blood sample was prepared and analysed. Result:, This work revealed that after mixing the blood sample with gold nanoparticle solution, accumulation of gold nanoparticle in the white blood cell was observed. Conclusion:, The effect of gold nanoparticle on the white blood cell can be detected and this knowledge can be used in cytotoxic drug treatment. [source] Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries , a review articleDENTAL TRAUMATOLOGY, Issue 3 2002J.O. Andreasen Abstract,,,Based on an analysis of the literature concerning parameters influencing the prognosis of traumatic dental injuries, few studies were found to have examined possible relationships between treatment delay and pulpal and periodontal ligament healing complications. It has been commonly accepted that all injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. For practical and especially economic reasons, various approaches can be selected to fulfill such a demand, such as acute treatment (i.e. within a few hours), subacute (i.e. within the first 24 h), and delayed (i.e. after the first 24 h). In this survey the consequences of treatment delay on pulpal and periodontal healing have been analyzed for the various dental trauma groups. Applying such a treatment approach to the various types of injuries, the following treatment guidelines can be recommended, based on our present rather limited knowledge of the effect of treatment delay upon wound healing. Crown and crown/root fractures: Subacute or delayed approach. Root fractures: Acute or subacute approach. Alveolar fractures: Acute approach (evidence however questionable). Concussion and subluxation: Subacute approach. Extrusion and lateral luxation: Acute or subacute approach (evidence however questionable). Intrusion: Subacute approach (evidence however questionable). Avulsion: If the tooth is not replanted at the time of injury, acute approach; otherwise subacute. Primary tooth injury: Subacute approach, unless the primary tooth is displaced into the follicle of the permanent tooth or occlusal problems are present; in the latter instances, an acute approach should be chosen. These treatment guidelines are based on very limited evidence from the literature and should be revised as soon as more evidence about the effect of treatment delay becomes available. [source] Macro Models and Poverty Analysis: Theoretical Tensions and Empirical PracticeDEVELOPMENT POLICY REVIEW, Issue 3 2005Sherman Robinson This article reviews economy-wide, multisectoral models and the issues involved when using them to analyse macro-poverty linkages in developing countries. It explores the theoretical underpinnings for simple SAM multiplier models, real-economy CGE models, and real-financial CGE models. The latter represent an ,eclectic' approach, which strives to build models that integrate elements from CGE and macro-financial models, the alternative, more applied, ,ecumenical' approach being to keep these models separate but specify ways through which they can communicate. Due to limited knowledge about the data and processes, the ability of analysts to address short-run distributional issues is limited; we therefore expect most progress in the analysis of medium- and long-run issues, using both eclectic and ecumenical approaches. [source] Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatmentDRUG AND ALCOHOL REVIEW, Issue 3 2007BIANCA WATSON Abstract Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study. [source] Integrating highly diverse invertebrates into broad-scale analyses of cross-taxon congruence across the PalaearcticECOGRAPHY, Issue 6 2009Andreas Schuldt Our knowledge on broad-scale patterns of biodiversity, as a basis for biogeographical models and conservation planning, largely rests upon studies on the spatial distribution of vertebrates and plants, neglecting large parts of the world's biodiversity. To reassess the generality of these patterns and better understand spatial diversity distributions of invertebrates, we analyzed patterns of species richness and endemism of a hyperdiverse insect taxon, carabid beetles (ca 11 000 Palaearctic species known), and its cross-taxon congruence with well-studied vertebrates (amphibians, reptiles) and plants across 107,units of the Palaearctic. Based on species accumulation curves, we accounted for completeness of the carabid data by separately examining the western (well-sampled) and eastern (partly less well-sampled) Palaearctic and China (deficient data). For the western Palaearctic, we highlight overall centers of invertebrate, vertebrate and plant diversity. Species richness and endemism of carabids were highly correlated with patterns of especially plant and amphibian diversity across large parts of the Palaearctic. For the well-sampled western Palaearctic, hotspots of diversity integrating invertebrates were located in Italy, Spain and Greece. Only analysis of Chinese provinces yielded low congruence between carabids and plants/vertebrates. However, Chinese carabid diversity is only insufficiently known and China features the highest numbers of annual new descriptions of carabids in the Palaearctic. Even based on the incomplete data, China harbors at least 25% of all Palaearctic carabid species. Our study shows that richness and endemism patterns of highly diverse insects can exhibit high congruence with general large scale patterns of diversity inferred from plants/vertebrates and that hotspots derived from the latter can also include a high diversity of invertebrates. In this regard, China qualifies as an outstanding multi-taxon hotspot of diversity, requiring intense biodiversity research and conservation effort. Our findings extend the limited knowledge on broad-scale invertebrate distributions and allow for a better understanding of diversity patterns across a larger range of the world's biodiversity than usually considered. [source] Emergency Department Pelvic Examination and Pap Testing: Addressing Patient MisperceptionsACADEMIC EMERGENCY MEDICINE, Issue 4 2004Michael S. Lyons MD Objectives: Failure to obtain cervical cancer screening can be precipitated by limited knowledge. This study describes understanding of Papanicolaou (Pap) smear testing among women undergoing emergency department (ED) pelvic examination and tests the feasibility of educating patients in the ED. Methods: Patients undergoing pelvic examination in an urban, tertiary care ED were surveyed about Pap smear screening. Among the initial cohort, no education was provided prior to survey administration. Subsequently, a pilot study of scripted information provided by physicians alone or both physicians and counselors was conducted. Results: There were 81 patients in the non-intervention cohort and 32 patients in the intervention cohort. Of the 32 intervention patients, 16 received physician-administered intervention, and 16 received reinforced counseling (physician + counselor). Of 113 total patients, 90 (82%) were African American; mean age was 26 years (SD ± 7.7 years). Of the 81 non-intervention patients, six (7%; 95% CI = 3% to 15%) said they were told that a Pap test was not done, and 60 (74%; 95% CI = 64% to 82%) mistakenly believed they had a Pap test. Sixty-six (81.5%; 95% CI = 72% to 88%) patients stated they knew the purpose of a Pap test; only 17 (26%; 95% CI = 17% to 37%) of these correctly identified the Pap test as a test for cervical cancer. All 32 intervention patients were surveyed after physician counseling. Compared with the non-intervention group, fewer (56%; 95% CI = 39% to 72%) thought they had a Pap test, and more (31%; 95% CI = 18% to 49%) said they were told they did not receive a Pap test. All 16 reinforced intervention patients correctly denied receiving a Pap test after counselor education. Conclusions: Knowledge of Pap testing among women undergoing ED pelvic examination is poor; most mistakenly believe they receive a Pap test during ED evaluation. Educating patients may be feasible and effective in the ED setting. [source] The impact of a social network intervention on retention in Belgian therapeutic communities: a quasi-experimental studyADDICTION, Issue 7 2006Veerle Soyez ABSTRACT Background Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. Aims The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. Design, setting and participants Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake (n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). Findings Hierarchical regression analyses showed that client-perceived social support (F1,198 = 10.9, P = 0.001) and treatment motivation and readiness (F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable ,significant others' participation in network intervention' (network involvement) in the model, the fit clearly improved (F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased (F1,197 = 2.9; P = 0.091). Conclusions Participation in the social network intervention was associated with improved treatment retention controlling for other client characteristics. This suggests that the intervention may be of benefit in the treatment of addicted individuals. [source] Effects of routine education on people newly diagnosed with type 2 diabetesEUROPEAN DIABETES NURSING, Issue 3 2009A Clarke SRN, PhD Health Promotion & Research Manager Abstract Background: In Ireland, there is limited knowledge about the perceptions or behaviours of people newly diagnosed with diabetes and, due to the lack of a national register, poor knowledge of their demographic profile. Aim: To add to the body of knowledge about diabetes, to obtain perceptions of people newly diagnosed with type 2 diabetes who attend group diabetes education, and to examine their relationships with the adoption of diabetes self-management behaviours. Method: A correlational study was conducted among people attending routine group diabetes education at three diabetes clinics during 2006/7, from which a convenience sample of 168 (38%) participants were recruited. Results: Men newly diagnosed with diabetes were younger, waited less time to attend group diabetes education, had a more positive diabetes attitude and perceived themselves to have more social support than women. Women had better diabetes self-management dietary and medication adherence behaviours prior to attending group diabetes education than the men. Conclusion: People newly diagnosed with diabetes differ in their attitude, perceived support and self-efficacy to adopt dietary and exercise behaviours and have different behaviour change needs at diagnosis. Post-attendance at diabetes education, they adopt behaviours at variable rates and may not sustain the change. The study findings indicate that healthcare professionals should monitor continually the need for behavioural change, in particular physical exercise behaviours in women and dietary and medication adherence in men. They should also continuously assess the maintenance of diabetes self-management behaviours of all people with diabetes, while promoting confidence in achieving desired outcomes. Copyright © 2009 FEND [source] Testimony and Trauma in Herta Müller's HerztierGERMAN LIFE AND LETTERS, Issue 1 2000Beverley Driver Eddy This article attempts to distinguish between testimony (an account of one's personal, limited knowledge of a crime or an atrocity) and trauma (a reconstructed life-story intended to overcome a troubling, recurring memory by locating that memory within its larger, historical context). It is the author's contention that Herta Müller's novel Herztier is a skilful blending of testimony and trauma narrative that illuminates the terrors of the Ceaus¸escu dictatorship and their lasting impact on its survivors. The testimonial aspects of the novel reveal one's inability to achieve complete knowledge of another's trauma, while the trauma narrative, through skilful incorporation of recurring, ,transfinite' images into the text, links the personal stories of the narrator and her friends by subsuming them and making them part of the history of a larger, national trauma. As Müller's novel makes clear, neither testimony nor trauma narrative is able to heal or bring closure to the victims of the Romanian state terror. [source] Adherence to antiretroviral therapy: are we doing enough?INTERNAL MEDICINE JOURNAL, Issue 5-6 2003T. Read Abstract Adherence to antiretroviral therapy is a powerful predictor of response to therapy. For optimal antiretroviral therapy response, individuals need to take more than 95% of their prescribed medication. The most widely used method for measuring adherence is self-report of the number of missed doses and this should be done at every clinic visit. There are several well-recognized predictors of poor adherence, such as illicit drug use, depression, limited knowledge or ambivalence about starting treatment. Adherence can be improved by addressing these issues or through other means such as pill boxes or electronic reminders. (Intern Med J 2003; 33: 254,256) [source] A continuum mechanics-based framework for boundary and finite element mesh optimization in two dimensions for application in excavation analysisINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 4 2005Attila M. Zsáki Abstract The determination of the optimum excavation sequences in mining and civil engineering using numerical stress analysis procedures requires repeated solution of large models. Often such models contain much more complexity and geometric detail than required to arrive at an accurate stress analysis solution, especially considering our limited knowledge of rock mass properties. This paper develops an automated framework for estimating the effects of excavations at a region of interest, and optimizing the geometry used for stress analysis. It eliminates or simplifies the excavations in a model while maintaining the accuracy of analysis results. The framework can equally be applied to two-dimensional boundary and finite element models. The framework will have the largest impact for non-linear finite element analysis. It can significantly reduce computational times for such analysis by simplifying models. Error estimators are used in the framework to assess accuracy. The advantages of applying the framework are demonstrated on an excavation-sequencing scenario. Copyright © 2005 John Wiley & Sons, Ltd. [source] Competency-Based Education and Assessment for the Accounting Profession: A Critical Review,ACCOUNTING PERSPECTIVES, Issue 1 2003J. EFRIM BORITZ ABSTRACT In recent years many professional accounting associations have become interested in establishing competency-based professional requirements and assessment methods for certifying accounting professionals. A competency-based approach to qualification specifies expectations in terms of outcomes, or what an individual can accomplish, rather than in terms of an individual's knowledge or capabilities. This idea has an obvious appeal to many practitioners and administrators of professional qualification programs. However, there is limited knowledge about competency-based approaches in the accounting profession and among accounting academics, which is constraining discussion about the value of these approaches and about the strengths and weaknesses of the different competency models that have sprung up in various jurisdictions. In this paper we review and synthesize the literature on competency-based approaches. We identify a number of theoretical benefits of competency-based approaches. However, we also find many alternative definitions and philosophies underlying competency-based approaches, and a variety of visions of how competencies should be determined and assessed. We note that there is limited evidence supporting many competency-based approaches and we identify 14 research questions that could be used to help policy makers to more effectively address policy matters related to competency-based education and assessment. [source] Endocrine disrupters and human pubertyINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 1 2006E. DEN HOND Summary In this overview of the literature, epidemiological research studying the effect of endocrine disrupters on the onset of puberty is summarized. In girls, earlier age at menarche was reported after exposure to polychlorinated biphenyls (PCBs), polybrominated biphenyls (PBBs), persistent pesticides [dichlorodiphenyltrichloroethane (DDT)] and phthalate esters. However, several other studies found no effect of these compounds on age at menarche or pubertal Tanner stages. One study reported a delaying effect of dioxin-like compounds on breast development. In boys, exposure to PCBs, PCDFs or the pesticide endosulfan was associated with delayed puberty or decreased penile length. Much of the results found in population studies are in accordance with experimental studies in animals. However, the mixture of different components with antagonistic effects (oestrogenic, anti-oestrogenic, anti-androgenic) and the limited knowledge about the most critical window for exposure (prenatal, peri-natal and pubertal) may hamper the interpretation of results. [source] Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2005Sebastiaan Engelborghs Abstract Objective Given the rather limited knowledge on profiles of neuropsychiatric symptoms (behavioural and psychological signs and symptoms of dementia, BPSD) in several degenerative dementias, we designed a prospective study of which we here present the baseline data. Methods Diagnosed according to strictly applied clinical diagnostic criteria, patients with probable Alzheimer's disease (AD) (n,=,205), frontotemporal dementia (FTD) (n,=,29), mixed dementia (MXD) (n,=,39) and dementia with Lewy bodies (DLB) (n,=,23) were included. All patients underwent a neuropsychological examination and behavioural assessment by means of a battery of scales (Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia). Results In AD and MXD, activity disturbances and aggressiveness occurred in more than 80% of the patients. With a prevalence of 70%, apathy was very common whereas delusions and hallucinations were rare in FTD patients. Frequently used behavioural assessment scales like the Behave-AD systematically underestimated BPSD in FTD whereas the MFS displayed high sensitivity for frontal lobe symptoms. Hallucinations discriminated DLB patients from other dementias. A high prevalence of disinhibition (65%) in DLB pointed to frontal lobe involvement. Conclusions Behavioural assessment may help differentiating between different forms of dementia, further stressing the need for the development of new and more sensitive behavioural assessment scales. By means of the MFS, frontal lobe involvement was frequently observed in DLB. As 70% of FTD patients displayed apathy, prevalence was about two times higher compared to the other disease groups, meanwhile indicating that apathy is frequently observed in dementia, irrespective of its etiology. Copyright © 2005 John Wiley & Sons, Ltd. [source] Nurses' experiences of caring encounters with older people living in Swedish nursing homesINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 1 2006Lars Westin MNSc Aim., The aim of the study was to describe and interpret the meaning of nurses' experiences of caring encounters with residents in nursing homes. Background., Life for residents in nursing homes can be characterized as a process of decreased physical and psychological resources. Therefore, encounters with nurses are important activities for providing meaning and security for the residents. Research in this field has previously focused on communication, attitudes and job satisfaction, but gives limited knowledge about what the human encounters in this context mean for the nurses. Method., A hermeneutic method was used in this study. Interviews were conducted with 14 nurses from two nursing homes about their experiences of caring encounters. The transcribed interview texts were interpreted as a whole. Results., In the interpretation of the text concerning the meaning of nurses' experiences of encounters with resident's four themes and 11 subthemes emerged. The comprehensive interpretation mainly showed possible ways available being present, being significant and being aware of opportunities for the nurse to find meaning in the encounter with the resident, but impossible ways as being inadequately were also revealed. Conclusion., This study shows the importance of caring encounters between nurses and residents in nursing homes. The good encounters provide various possible ways for nurses to find meaning and a sense of communion with residents. However, bad encounters, described as being inadequate, were found to inhibit nurses from finding meaning in their encounters with residents. Relevance to clinical practice., Meeting the needs of older people in nursing homes requires special knowledge about the importance of the caring encounter. Therefore, nurses in this care context need supervision and continuous education in order to gain relevant knowledge about the meaning of caring encounters for themselves and residents. [source] Supply of over-the-counter weight-loss products from community pharmaciesINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 6 2009Anna-Maria Andronicou Abstract Objectives The aim was to ascertain the availability of over-the-counter (OTC) weight-loss products from community pharmacies and other retail outlets in a large conurbation, and to determine the knowledge and practices of pharmacy staff in the supply of OTC weight-loss products. Method The setting was one primary care trust in England. We used a cross-sectional survey of 123 community pharmacies, 12 health stores and 64 supermarkets, plus telephone interview of the pharmacists. Key findings Over two-thirds of community pharmacies (69%) and health stores (67%) but few supermarkets (8%) stocked one or more OTC weight-loss products. In total, 73 different products were available from pharmacies, most of which (50) were claimed by manufacturers to be appetite suppressants. Seventy-eight pharmacists were interviewed, of whom 57 stocked OTC weight-loss products. Of these 57, only two claimed to undertake any measurements before supplying the products and 33 had no supporting materials/information about the products, although 38 claimed to provide advice. None of the 57 pharmacists had undertaken any specific training in relation to weight loss. Only 44% of all those interviewed considered OTC weight-loss products to be useful, with even fewer (35%) considering them to be safe. Conclusions Community pharmacies are a major distributor of OTC weight-loss products, despite the lack of evidence of their efficacy and concerns about their safety. Many pharmacists had limited knowledge of the products, placed few restrictions on their supply and viewed training in weight loss as unnecessary. Pharmacists should consider the appropriateness of supplying these products and utilize the opportunities presented to support weight reduction by more effective means. [source] Older Women and HIV: How Much Do They Know and Where Are They Getting Their Information?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2004Susan J. Henderson MD Objectives: To assess older urban women's knowledge about sexual transmission of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and to evaluate the relationship between their HIV/AIDS knowledge level and sources of information. Design: Cross-sectional survey conducted between June 2001 and July 2002. Trained research assistants administered a questionnaire in a face-to-face interview. Setting: General medicine clinic in a large public hospital in a high HIV/AIDS incidence area. Participants: Five hundred fourteen women aged 50 and older. Measurements: Nine questions assessing knowledge of risk of HIV sexual transmission with potential scores ranging from 0 to 9 correct answers. Participants identified all sources of HIV information. Results: The mean knowledge score was 3.7 out of a possible 9 correct responses (range 0 (3%) to 8 (1%)). Younger age, employment, and higher educational level were associated with higher knowledge scores, whereas marital status was unrelated. No respondent correctly answered all of the nine questions. The most commonly identified sources of HIV/AIDS information were television (85%), friends (54%), and newspapers (51%). Only 38% of respondents identified health professionals as a source of information about HIV/AIDS. Health professionals, newspapers, and family members were each independently associated with higher knowledge scores (P<.05). Conclusion: Older women in a general medicine clinic had limited knowledge of sexual transmission of HIV. HIV/AIDS education specifically targeted to this subpopulation is warranted, and health professionals may have an important role in disseminating such messages. [source] The essentials of Advance Care Planning for end-of-life care for older peopleJOURNAL OF CLINICAL NURSING, Issue 3-4 2010Sarah Yeun-Sim Jeong Aims and objectives., The aim of the study was to investigate the phenomenon of Advance Care Planning and the use of Advance Care Directives in residential aged care facilities in Australia. The objectives were to: ,,investigate the implementation process of Advance Care Planning and the use of Advance Care Directives; ,,investigate the outcomes of Advance Care Planning and experiences of people involved in Advance Care Planning and Advance Care Directives, including residents, families and nursing staff. Background., Benefits of Advance Care Planning for older residents are considerable given their degenerative health-breakdown and minimal chance of recovery. To date, the use of Advance Care Planning and Advance Care Directives is limited and models of service delivery and processes are needed to enhance best practice with Advance Care Planning and positive outcomes for older Australians. Design., Case study. Methods., The study conducted using multiple sources of evidence to enrich understanding of the phenomenon of Advance Care Planning. The researcher engaged in data collection over six months involving participant observation, field notes, semi-structured interviews and document analysis. The findings contribute to the limited knowledge of options currently available to older adults and their families in their decision-making about end-of-life care options. Permission to conduct the study., Prior to commencement of the data collection, ethics clearances from the University of Newcastle and the regional Area Health Service were achieved. Permission to access the residential aged care facilities to undertake the study was obtained from the relevant residential aged care facility ethics committees or designated authorities. The researcher undertook several strategies to ensure all the ethical principles were considered and adhered to while conducting the project. Results., The research identified the components and factors involved in the Advance Care Planning process and in attaining desired outcomes. The conceptual framework developed elaborates how Advance Care Planning should be implemented and what may constitute successful implementation of Advance Care Planning in residential aged care facilities. The four main elements (input, throughput, output, feedback), and 20 sub-elements were requisites for nurses to initiate and implement the Advance Care Planning. Conclusion., The essential components for end-of-life care are identified in the implementation processes of Advance Care Planning in residential aged care facilities. The study contributes to greater awareness of the processes needed for ,dying well' and highlights the need to explore experiences of ,successful dying' and the way nurses contribute to these events. Relevance to clinical practice., The case study identified four determinative requisites for successful implementation of Advance Care Planning in aged care facilities: the expert nurse, discussion, education and involvement of a multidisciplinary team. Nurses should take these factors into account and use person-centred approach in formalised processes to encourage participation in plans for end-of-life care. [source] Population dynamics in Digitalis purpurea: the interaction of disturbance and seed bank dynamicsJOURNAL OF ECOLOGY, Issue 6 2007NINA SLETVOLD Summary 1Plant ecologists have long since realized that the persistence of many facultative biennial plants depends upon disturbance. However, we still have a limited knowledge of the population-level effects of disturbance, and the connection between adult and seed bank dynamics. 2Using data from a 3-year demographic study combined with experimental gap-opening in a large population of Digitalis purpurea, we parameterized stochastic transition matrix models in ,disturbed' vs. ,undisturbed' areas. We simulated different gap sizes (fraction of population that was disturbed) and temporal disturbance patterns (constant, random, regular and irregular return intervals) and evaluated the effects on population growth rate and seed bank dynamics. To explore seed bank importance we used two alternatives for seed bank survival rate (0.75/0.35) and three alternatives for seed bank recruitment fraction (0.9/0.5/0.1). 3Observed background recruitment levels were insufficient to ensure a positive population growth rate. Increased amounts of gap-opening led to higher growth rates, and population persistence was predicted at moderate disturbance levels if seed bank survival was high (0.75). 4Temporal disturbance pattern affected model results; random and interval scenarios resulted in lower population growth rates and higher extinction risks than constant scenarios of the same average disturbance level. Small and frequent disturbances led to considerably higher growth rates than large and rare disturbances. 5Stochastic elasticity analyses identified the seed bank as the most important life cycle stage with respect to population growth and persistence in most scenarios, and its relative impact was positively related to seed bank survival rate and negatively related to disturbance level. Variation in the recruitment fraction from seed bank vs. seed rain affected both population growth rate and elasticity patterns, indicating the large impact of spatial variation in seed bank density. 6Synthesis: Despite the existence of a large seed bank, our data suggest that recruitment may be locally seed-limited due to a patchy seed bank structure. Local population development may consequently differ widely from gap to gap. These results illustrate how spatial structures in both seed bank, adult population and gap formation interact to shape plant population dynamics, as well as the occurrence of microsite- vs. seed-limitation. [source] ,-Carotene-Loaded Nanostructured Lipid CarriersJOURNAL OF FOOD SCIENCE, Issue 2 2008A. Hentschel ABSTRACT:, Nanostructured lipid carriers (NLC) technology was used to disperse hydrophobic ,-carotene in an aqueous phase. NLC are lipid nanoparticles with a particle matrix consisting of a blend of a liquid and solid lipid. They were produced by melting the lipid blend at 80 °C and dispersing it into a hot emulsifier solution. The aim of this study was to extend the limited knowledge of melt-emulsified lipidic colloids in food systems and to evaluate the feasibility for further applications as functional ingredient in beverages. Physical stability of the NLC suspension was examined at 2 different storage temperatures by measuring the particle size with photon correlation spectroscopy (PCS) and laser diffractometry (LD). All particles containing sufficient amounts of emulsifier were smaller than 1 ,m (LD diameter 100%) at a mean particle size of around 0.3 ,m (LD) for 9 wk at 20 °C and at least 30 wk at 4 to 8 ° C. Differential scanning calorimetry (DSC) was used to study the solid state of the lipids both in the ,-carotene loaded PGMS and in the NLC particles. Propylene glycol monostearate (PGMS) when dispersed as NLC recrystallized up to 98% during storage time. Within the regarded period of 7 mo no polymorph transitions were observed. Furthermore, stability of the ,-carotene in water dependent on NLC concentration and tocopherol content was measured photospectrometrically to get an estimation of the behavior of NLC in beverages. [source] Estimating the Timing of Long Bone Fractures: Correlation Between the Postmortem Interval, Bone Moisture Content, and Blunt Force Trauma Fracture Characteristics,JOURNAL OF FORENSIC SCIENCES, Issue 5 2008Danielle A.M. Wieberg M.A. Abstract:, There is very limited knowledge about how long perimortem fracture characteristics persist into the postmortem interval (PMI). Therefore, in this study, 60 porcine long bones were exposed to natural taphonomic conditions and fractured with a steel bone breaking apparatus every 28 days throughout a 141-day period. Differences between macroscopic blunt force trauma fracture characteristics (fracture angle, surface morphology, and outline) were examined to determine if they varied over time or in relationship to bone moisture content (ash weight) and overall assessment. There are significant relationships between (1) PMI and percent ash weight (%AW), fracture surface, and fracture angle and (2) %AW and fracture surface and fracture angle. Bone moisture content correlates significantly with fracture morphology and other characteristics commonly used by forensic anthropologists to determine the timing of traumatic injuries. However, fracture characteristics normally associated with perimortem trauma can persist long into the PMI. [source] The musculotendinous system of an anguilliform swimmer: Muscles, myosepta, dermis, and their interconnections in Anguilla rostrataJOURNAL OF MORPHOLOGY, Issue 1 2008Nicole Danos Abstract Eel locomotion is considered typical of the anguilliform swimming mode of elongate fishes and has received substantial attention from various perspectives such as swimming kinematics, hydrodynamics, muscle physiology, and computational modeling. In contrast to the extensive knowledge of swimming mechanics, there is limited knowledge of the internal body morphology, including the body components that contribute to this function. In this study, we conduct a morphological analysis of the collagenous connective tissue system, i.e., the myosepta and skin, and of the red muscle fibers that sustain steady swimming, focusing on the interconnections between these systems, such as the muscle-tendon and myosepta-skin connections. Our aim is twofold: (1) to identify the morphological features that distinguish this anguilliform swimmer from subcarangiform and carangiform swimmers, and (2) to reveal possible pathways of muscular force transmission by the connective tissue in eels. To detect gradual morphological changes along the trunk we investigated anterior (0.4L), midbody (0.6L), and posterior body positions (0.75L) using microdissections, histology, and three-dimensional reconstructions. We find that eel myosepta have a mediolaterally oriented tendon in each the epaxial and hypaxial regions (epineural or epipleural tendon) and two longitudinally oriented tendons (myorhabdoid and lateral). The latter two are relatively short (4.5,5% of body length) and remain uniform along a rostrocaudal gradient. The skin and its connections were additionally analyzed using scanning electron microscopy (SEM). The stratum compactum of the dermis consists of ,30 layers of highly ordered collagen fibers of alternating caudodorsal and caudoventral direction, with fiber angles of 60.51 ± 7.05° (n = 30) and 57.58 ± 6.92° (n = 30), respectively. Myosepta insert into the collagenous dermis via fiber bundles that pass through the loose connective tissue of the stratum spongiosum of the dermis and either weave into the layers of the stratum compactum (weaving fiber bundles) or traverse the stratum compactum (transverse fiber bundles). These fiber bundles are evenly distributed along the insertion line of the myoseptum. Red muscles insert into lateral and myorhabdoid myoseptal tendons but not into the horizontal septum or dermis. Thus, red muscle forces might be distributed along these tendons but will only be delivered indirectly into the dermis and horizontal septum. The myosepta-dermis connections, however, appear to be too slack for efficient force transmission and collagenous connections between the myosepta and the horizontal septum are at obtuse angles, a morphology that appears inadequate for efficient force transmission. Though the main modes of undulatory locomotion (anguilliform, subcarangiform, and carangiform) have recently been shown to be very similar with respect to their midline kinematics, we are able to distinguish two morphological classes with respect to the shape and tendon architecture of myosepta. Eels are similar to subcarangiform swimmers (e.g., trout) but are substantially different from carangiform swimmers (e.g., mackerel). This information, in addition to data from kinematic and hydrodynamic studies of swimming, shows that features other than midline kinematics (e.g., wake patterns, muscle activation patterns, and morphology) might be better for describing the different swimming modes of fishes. J. Morphol., 2008. © 2007 Wiley-Liss, Inc. [source] Prediction of human pharmacokinetics , renal metabolic and excretion clearanceJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 11 2007Urban Fagerholm The kidneys have the capability to both excrete and metabolise drugs. An understanding of mechanisms that determine these processes is required for the prediction of pharmacokinetics, exposures, doses and interactions of candidate drugs. This is particularly important for compounds predicted to have low or negligible non-renal clearance (CL). Clinically significant interactions in drug transport occur mostly in the kidneys. The main objective was to evaluate methods for prediction of excretion and metabolic renal CL (CLR) in humans. CLR is difficult to predict because of the involvement of bi-directional passive and active tubular transport, differences in uptake capacity, pH and residence time on luminal and blood sides of tubular cells, and limited knowledge about regional tubular residence time, permeability (Pe) and metabolic capacity. Allometry provides poor predictions of excretion CLR because of species differences in unbound fraction, urine pH and active transport. The correlation between fraction excreted unchanged in urine (fe) in humans and animals is also poor, except for compounds with high passive Pe (extensive/complete tubular reabsorption; zero/negligible fe) and/or high non-renal CL. Physiologically based in-vitro/in-vivo methods could potentially be useful for predicting CLR. Filtration could easily be predicted. Prediction of tubular secretion CL requires an in-vitro transport model and establishment of an in-vitro/in-vivo relationship, and does not appear to have been attempted. The relationship between passive Pe and tubular fraction reabsorbed (freabs) for compounds with and without apparent secretion has recently been established and useful equations and limits for prediction were developed. The suggestion that reabsorption has a lipophilicity cut-off does not seem to hold. Instead, compounds with passive Pe that is less than or equal to that of atenolol are expected to have negligible passive freabs. Compounds with passive Pe that is equal to or higher than that of carbamazepine are expected to have complete freabs. For compounds with intermediate Pe the relationship is irregular and freabs is difficult to predict. Tubular cells are comparably impermeable (for passive diffusion), and show regional differences in enzymatic and transporter activities. This limits the usefulness of microsome data and makes microsome-based predictions of metabolic CLR questionable. Renal concentrations and activities of CYP450s are comparably low, suggesting that CYP450 substrates have negligible metabolic CLR. The metabolic CLR of high-Pe UDP-glucuronyltransferase substrates could contribute to the total CL. [source] The Impact of Regulations on Firms: A Case Study of the Biotech Industry,LAW & POLICY, Issue 3 2005FILIPPA CORNELIUSSEN Drawing on semi-structured interviews carried out with founders, managers, and senior scientists in start-up biotech firms, this paper illustrates that the socio-legal literature's characterization of small firms as less compliance oriented is too neat. Small firms do not necessarily have a limited knowledge and comprehension of the law. Nor do they necessarily have low levels of motivation to improve and maintain health and safety standards. In fact, the opposite may be true. Small firms may approach the regulatory ideal where the routines, procedures, and precautionary measures prescribed by regulations permeate the organizations. [source] Toward the discovery of new biomarkers of hepatocellular carcinoma by proteomicsLIVER INTERNATIONAL, Issue 2 2007Enrique Santamaría Abstract Primary liver cancer is the fifth most frequent neoplasm and the third most common cause of cancer-related death, with more than 500 000 new cases diagnosed yearly. The outcome for hepatocellular carcinoma (HCC) patients still remains dismal, partly because of our limited knowledge of its molecular pathogenesis and the difficulty in detecting the disease at its early stages. Therefore, studies aimed at the definition of the mechanisms associated with HCC progression and the identification of new biomarkers leading to early diagnosis and more effective therapeutic interventions are urgently needed. Proteomics is a rapidly expanding discipline that is expected to change the way in which diseases will be diagnosed, treated, and monitored in the near future. In the last few years, HCC has been extensively investigated using different proteomic approaches on HCC cell lines, animal models, and human tumor tissues. In this review, state-of-the-art technology on proteomics is overviewed, and recent advances in liver cancer proteomics and their clinical projections are discussed. [source] Molecular and functional characterization of kshA and kshB, encoding two components of 3-ketosteroid 9, -hydroxylase, a class IA monooxygenase, in Rhodococcus erythropolis strain SQ1MOLECULAR MICROBIOLOGY, Issue 4 2002R. van der Geize Summary 9, -Hydroxylation of 4-androstene-3,17-dione (AD) and 1,4-androstadiene-3,17-dione (ADD) is catalysed by 3-ketosteroid 9, -hydroxylase (KSH), a key enzyme in microbial steroid catabolism. Very limited knowledge is presently available on the KSH enzyme. Here, we report for the first time the identification and molecular characterization of genes encoding KSH activity. The kshA and kshB genes, encoding KSH in Rhodococcus erythropolis strain SQ1, were cloned by functional complementation of mutant strains blocked in AD(D) 9, -hydroxylation. Analysis of the deduced amino acid sequences of kshA and kshB showed that they contain domains typically conserved in class IA terminal oxygenases and class IA oxygenase reductases respectively. By definition, class IA oxygenases are made up of two components, thus classifying the KSH enzyme system in R. erythropolis strain SQ1 as a two-component class IA monooxygenase composed of KshA and KshB. Unmarked in frame gene deletion mutants of parent strain R. erythropolis SQ1, designated strains RG2 (kshA mutant) and RG4 (kshB mutant), were unable to grow on steroid substrates AD(D), whereas growth on 9, -hydroxy-4-androstene-3,17-dione (9OHAD) was not affected. Incubation of these mutant strains with AD resulted in the accumulation of ADD (30,50% conversion), confirming the involvement of KshA and KshB in AD(D) 9, -hydroxylation. Strain RG4 was also impaired in sterol degradation, suggesting a dual role for KshB in both sterol and steroid degradation. [source] Size of environmental grain and resource matchingOIKOS, Issue 3 2000Esa Ranta For most animals their foraging environment consists of a patch network. In random environments there are no spatial autocorrelation at all, while in fine-grained systems positive autocorrelations flip to negative ones and back again against distance. With increasing grain size the turnover rate of spatial autocorrelation slows down. Using a cellular automaton with foragers having limited information about their feeding environment we examined how well consumer numbers matched resource availability, also known as the ideal free distribution. The match is the better the smaller the size of the environmental grain. This is somewhat contrary to the observation that in large-grained environments the spatial autocorrelation is high and positive over long distances. In such an environment foragers, by knowing a limited surrounding, should in fact know a much larger area because of the spatially autocorrelated resource pattern. Yet, when foragers have limited knowledge, we observed that the degree of undermatching (i.e., more individuals in less productive patches than expected) increases with increasing grain size. [source] Estimation of the day-specific probabilities of conception: current state of the knowledge and the relevance for epidemiological researchPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2006Courtney D. Lynch Summary Conception, as defined by the fertilisation of an ovum by a sperm, marks the beginning of human development. Currently, a biomarker of conception is not available; as conception occurs shortly after ovulation, the latter can be used as a proxy for the time of conception. In the absence of serial ultrasound examinations, ovulation cannot be readily visualised leaving researchers to rely on proxy measures of ovulation that are subject to error. The most commonly used proxy measures include: charting basal body temperature, monitoring cervical mucus, and measuring urinary metabolites of oestradiol and luteinising hormone. Establishing the timing of the ovulation and the fertile window has practical utility in that it will assist couples in appropriately timing intercourse to achieve or avoid pregnancy. Identifying the likely day of conception is clinically relevant because it has the potential to facilitate more accurate pregnancy dating, thereby reducing the iatrogenic risks associated with uncertain gestation. Using data from prospective studies of couples attempting to conceive, several researchers have developed models for estimating the day-specific probabilities of conception. Elucidating these will allow researchers to more accurately estimate the day of conception, thus spawning research initiatives that will expand our current limited knowledge about the effect of exposures at critical periconceptional windows. While basal body temperature charting and cervical mucus monitoring have been used with success in field-based studies for many years, recent advances in science and technology have made it possible for women to get instant feedback regarding their daily fertility status by monitoring urinary metabolites of reproductive hormones in the privacy of their own homes. Not only are innovations such as luteinising hormone test kits and digital fertility monitors likely to increase study compliance and participation rates, they provide valuable prospective data that can be used in epidemiological research. Although we have made great strides in estimating the timing and length of the fertile window, more work is needed to elucidate the day-specific probabilities of conception using proxy measures of ovulation that are inherently subject to error. Modelling approaches that incorporate the use of multiple markers of ovulation offer great promise to fill these important data gaps. [source] | |||||||||||||||||||||||||||||||||||||