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Local Experience (local + experience)
Selected AbstractsHuman immunodeficiency virus-associated progressive multifocal leucoencephalopathy: epidemiology and predictive factors for prolonged survivalEUROPEAN JOURNAL OF NEUROLOGY, Issue 4 2007A. K. Drake We performed a retrospective review of cases of human immunodeficiency virus-associated progressive multifocal leucoencephalopathy in four hospitals (three in Australia and one in Hong Kong) between 1987 and 2003 in order to describe the local experience with this disease and to evaluate parameters impacting upon survival. Eighty-seven cases were identified and demographic details, baseline parameters and treatment methods and response were described. Survival was substantially increased in the post-highly active antiretroviral therapy (HAART) era with a median survival increase from 14 to 64 weeks. On multivariate analysis, variables associated with prolonged survival included a CD4 count of >100 cells/,l at diagnosis and the use of HAART post-diagnosis, with no significant additional advantage from the use of neuroactive antiretrovirals. [source] Treatment of New World cutaneous leishmaniasis , a systematic review with a meta-analysisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2008Felipe Francisco Tuon MD Background, New World leishmaniasis is an important endemic disease and public health problem in developing countries. The increase in ecologic tourism has extended this problem to developed countries. Few drugs have emerged over the past 50 years, and drug resistance has increased, such that the cure rate is no better than 80% in large studies. Despite these data, there has been no systematic review with a meta-analysis of the therapy used in this important tropical disease. The aim of this study was to determine the best drug management in the treatment of cutaneous leishmaniasis (CL) in Latin America based on the best studies published in the medical literature. Methods, MEDLINE, LILACS, EMBASE, Web of Science, and Cochrane Library databases were searched to identify articles related to CL and therapy. Articles with adequate data on cure and treatment failure, internal and external validity information, and more than four patients in each treatment arm were included. Results, Fifty-four articles met our inclusion criteria and 12 were included in the meta-analysis. Pentavalent antimonials were the most studied drugs, with a total of 1150 patients, achieving a cure rate of 76.5%. The cure rate of pentamidine was similar to that of pentavalent antimonials. Other drugs showed variable results, and all demonstrated an inferior response. Conclusion, Although pentavalent antimonials are the drugs of choice in the treatment of CL, pentamidine showed similar results. Nevertheless, several aspects, such as cost, adverse effects, local experience, and availability of drugs to treat CL, must be considered when determining the best management of this disease, especially in developing countries where resources are scarce. [source] Re-reading Castells: Indifference or Irrelevance Twenty Years On?INTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 1 2006LYNN A. STAEHELI This essay considers the relevance of The City and the Grassroots to contemporary debates within critical urban analysis. It argues that the book addresses many of the same empirical topics as more recent scholarship, but that shifts in the kinds of questions asked about those topics may make the book seem less relevant to contemporary debates. In particular, Castells' attempt to abstract from local experience to understand the process of political and social change in something specifically ,urban' may be at odds with the goals of contemporary research and of researchers outside Europe, many of whom attempt to provide a differentiated analysis attuned to context and the positionality of agents within social movements. So, while the book makes important contributions to theoretical and empirical arguments because of its deep and rich comparative analysis, intellectual debates and approaches over the past 20 years may have shifted focus. [source] The relative roles of domestication, rearing environment, prior residence and body size in deciding territorial contests between hatchery and wild juvenile salmonJOURNAL OF APPLIED ECOLOGY, Issue 3 2003Neil B. Metcalfe Summary 1Interactions between captive-reared and wild salmonids are frequent because hatcheries annually rear millions of fish for release in conservation programmes while many thousands of domesticated fish escape from fish farms. However, the outcome of competition between captive-reared and wild fish is not clear: wild fish may be smaller and less aggressive than hatchery fish, but they have more local experience and a prior residence advantage. Moreover, it is important to know whether any competitive differences are genetic (due to the process of domestication) or due to the rearing environment. 2We therefore examined the factors influencing competition for feeding territories in juvenile Atlantic salmon. We studied the effect of domestication by using three independent stocks of both domesticated and wild-origin fish, all of which were reared in a common hatchery environment. We also used fish from the same wild stocks that had been living in the wild. Territorial contests were staged in stream tank compartments between pairs of fish differing in origin or rearing environment; the relative importance of body size and prior residence was also assessed. 3All three stocks of domesticated fish were generally dominant over wild-origin fish when both had been raised in a common hatchery environment. If the wild-origin fish were given a 2-day period of prior residence on the territory this asymmetry in dominance was reversed. However, domesticated fish did not gain any additional advantage from being prior residents. The relative body size of the two contestants had a negligible effect on contest outcomes. 4Truly wild fish (i.e. those of wild origin that had also grown up in the wild) were generally dominant over domesticated or wild-origin fish that had been hatchery-reared. Differences in body size between contestants had no effect on the outcome. 5Synthesis and applications. These results show that, while juvenile farmed Atlantic salmon are inherently more aggressive than wild-origin fish, the hatchery environment reduces their ability to compete for territories with wild resident fish. Rearing salmon in conventional hatcheries for later release into the wild where natural populations already exist may not be a prudent conservation measure; it is preferable to plant eggs or first-feeding fry rather than attempt to ,help' the fish by rearing them through the early life stages. [source] Endocarditis due to Tropheryma whipplei: rapid detection, limited genetic diversity, and long-term clinical outcome in a local experienceCLINICAL MICROBIOLOGY AND INFECTION, Issue 8 2010R. Escher Clin Microbiol Infect 2010; 16: 1213,1222 Abstract The characteristic features of Whipple's disease include abdominal pain, diarrhoea, wasting, and arthralgias, with the causative agent, Tropheryma whipplei, being detected mainly in intestinal biopsies. PCR technology has led to the identification of T. whipplei in specimens from various other locations, including the central nervous system and the heart. T. whipplei is now recognized as one of the causes of culture-negative endocarditis, and endocarditis can be the only manifestation of the infection with T. whipplei. Although it is considered a rare disease, the true incidence of endocarditis due to T. whipplei is not clearly established. With the increasing use of molecular methods, it is likely that T. whipplei will be more frequently identified. Questions also remain about the genetic variability of T. whipplei strains, optimal diagnostic procedures and therapeutic options. In the present study, we provide clinical data on four new patients with documented endocarditis due to T. whipplei in the context of the available published literature. There was no clinical involvement of the gastrointestinal tract. Genetic analysis of the T. whipplei strains with DNA isolated from the excised heart valves revealed little to no genetic variability. In a selected case, we describe acridine orange staining for early detection of the disease, prompting early adaptation of the antibiotic therapy. We provide long-term follow-up data on the patients. In our hands, an initial 2-week course of intravenous antibiotics followed by cotrimoxazole for at least 1 year was a suitable treatment option for T. whipplei endocarditis. [source] Visitors' and locals' experiences of Rotorua, New Zealand: an interpretative study using photographs of landscapes and Q methodINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 4 2002John R. Fairweather Abstract This paper reports on an interpretative study of locals' and visitors' experiences in Rotorua, New Zealand and shows how experiences vary among different groups. Photographs were Q sorted by a non-random sample of locals and both overseas and New Zealand visitors, and the data were factor analysed to identify four factors or types of experience. These include experiences of Sublime Nature, Iconic Tourism, New Zealand Family and the Picturesque Landscape. These findings show that Q sort with photographs is a useful research approach which advances our understanding of destination image and provides results that have implications for the contemporary theoretical debate on the nature of tourist experience in New Zealand. Copyright © 2002 John Wiley & Sons, Ltd. [source] | ||||||||||