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Appropriate Decisions (appropriate + decision)

Distribution by Scientific Domains
Medical Sciences40%
Engineering40%

Selected Abstracts

Evaluation of cytomegalovirus-specific T-cell reconstitution in patients after various allogeneic haematopoietic stem cell transplantation using interferon- , -enzyme-linked immunospot and human leucocyte antigen tetramer assays with an immunodominant T-cell epitope

BRITISH JOURNAL OF HAEMATOLOGY, Issue 4 2005
Mutsuko Ohnishi
Summary Cytomegalovirus (CMV) infection is a major complication for patients who received allogeneic haematopoietic stem cell transplantation (HSCT). Accurate monitoring of CMV-specific T-cell reconstitution is required for appropriate decision on treatment, such as anti-viral drugs, which have adverse effects. Although human leucocyte antigen (HLA) tetramer and interferon- , -enzyme-linked immunospot (IFN- , -ELISPOT) assays have been used to measure CMV-specific T cells, detailed comparison of these assays and kinetics of anti-CMV T-cell reconstitution between reduced-intensity transplantation (RIST) and conventional HSCT has not yet been performed. In this study, we performed prospective comparative monitoring of CMV-specific T cells using HLA tetramer and IFN- , -ELISPOT assays with a single immunodominant CMV495 peptide in 28 HLA-A*0201 and 9 HLA-A*0206 patients after various allogeneic HSCTs. The IFN- , -ELISPOT assay was more sensitive for evaluation of functional T cells than the HLA tetramer assay, and CMV-specific T cells were reconstituted earlier in patients who received RIST without anti-thymocyte globulin (ATG) than those receiving RIST with ATG or conventional HSCT. The threshold level for protection from CMV reactivation was estimated as over 1 × 106 cells/l peripheral blood with the IFN- , -ELISPOT assay. These results demonstrate that the IFN- , -ELISPOT assay with CMV495 provides more accurate evaluation on CMV immunity in HLA-A*0201 and -A*0206 patients, and may be useful for determining timing of various treatments. [source]

Management Strategies and Improvement of Performance of Sewer Networks

COMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 7 2007
Denys Breysse
Even when they are conscious about the needs of maintenance to keep the system in a good condition, they lack efficient methods and tools that may help them in taking appropriate decisions. One can say that no really satisfactory and efficient tool exists, enabling the optimization of Inspection, Maintenance, or Rehabilitation (IMR) strategies on such systems. Sewer managers and researchers have been involved for many years in the French National Research Project for Renewal of Non Man Entry Sewer System (RERAU,Réhabilitation des Réseaux d'Assainissement Urbains, in French) to improve their knowledge of these systems and the management policies. During the RERAU project, a specific action has been dedicated to the modeling of asset ageing and maintenance. A special attention has been dedicated to the description of defects and dysfunctions, to the evaluation of performances and its modeling, accounting for its various dimensions (from the point of view of the manager, of the user, of the environment,). After having defined an Index of Technical Performance (ITp), we will introduce the Index of Technical and Economic Performance (ITEp) that is a combined measure of performance (including social costs) and technical costs. This index provides an objective standard tool for managers to compare different alternatives. It is used in the article to compare some simple IMR strategies. It sets the basis of a new method for no-man entry sewer system management, enabling us to analyze the profitableness of investment in terms of both technical and economic performance. [source]

Isotope Methods for Management of Shared Aquifers in Northern Africa

GROUND WATER, Issue 5 2005
Bill Wallin
Access to fresh water is one of the major issues of northern and sub-Saharan Africa. The majority of the fresh water used for drinking and irrigation is obtained from large ground water basins where there is minor contemporary recharge and the aquifers cross national borders. These aquifers include the Nubian Aquifer System shared by Chad, Egypt, Libya, and Sudan; the Iullemeden Aquifer System, extending over Niger, Nigeria, Mali, Benin, and Algeria; and the Northwest Sahara Aquifer System shared by Algeria, Libya, and Tunisia. These resources are subject to increased exploitation and may be severely stressed if not managed properly as witnessed already by declining water levels. In order to make appropriate decisions for the sustainable management of these shared water resources, planners and managers in different countries need an improved knowledge base of hydrological information. Three technical cooperation projects related to aquifer systems will be implemented by the International Atomic Energy Agency, in collaboration with the United Nations Educational, Scientific and Cultural Organization and United Nations Development Programme/Global Environmental Facility. These projects focus on isotope hydrology studies to better quantify ground water recharge and dynamics. The multiple isotope approach combining commonly used isotopes 18O and 2H together with more recently developed techniques (chlorofluorocarbons, 36Cl, noble gases) will be applied to improve the conceptual model to study stratification and ground water flows. Moreover, the isotopes will be an important indicator of changes in the aquifer due to water abstraction, and therefore they will assist in the effort to establish a sustainable ground water management. [source]

Medicines information and adherence in HIV/AIDS patients

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 1 2006
L. E. Mansoor BPharm
Summary Background:, Providing written medicines information is being legislated in an increasing number of countries worldwide, with the patient information leaflet (PIL) being the most widely used method for conveying health information. The impact of providing such information on adherence to therapy is reportedly unpredictable. Therapy for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and related opportunistic infections usually involves polytherapy and complex regimens, both of which are risk factors for non-adherence. The objective of this study was to assess the impact of medicines information on adherence to chronic co-trimoxazole therapy in low-literate HIV/AIDS patients. Methods:, Two different PILs were designed for co-trimoxazole tablets and were available in both English and isiXhosa. Participants were randomly allocated to a control group (receiving no PIL), group A (receiving a ,complex PIL') and group B (receiving a ,simple PIL' incorporating pictograms). At the first interview, demographic data were collected and the time, date and day that the participant would take his/her first tablet of the month's course was also documented. In a follow-up interview adherence to therapy was assessed using two methods; self-report and tablet count. Results:, The medicines information materials incorporating simple text and pictograms resulted in significantly improved adherence to therapy in the short term, whereas a non-significant increase in adherence was associated with the availability of the more complex information. This was shown by both the self-reported assessment as well as the tablet count. Conclusion:, This research suggests that appropriately designed written material can have a positive impact in improving adherence and, together with verbal consultation, are essential for enabling patients to make appropriate decisions about their medicine taking. [source]

Institutional decision making for increasing academic preparedness in community colleges

NEW DIRECTIONS FOR COMMUNITY COLLEGES, Issue 129 2005
Dolores Perin
This chapter identifies current organizational and instructional approaches to developmental education in community colleges and recommends a process by which colleges can make institutionally appropriate decisions to improve developmental education outcomes. [source]