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Selected AbstractsRisk markers associated with challenging behaviours in people with intellectual disabilities: a meta-analytic studyJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2003K. McClintock A meta-analysis of prevalence and cohort studies conducted over the last 30 years was carried out to identify risk markers for challenging behaviour shown by individuals with intellectual disabilities (IDs). A total of 86 potential studies was identified from the review, with 22 (25.6%) containing sufficient data to enable a statistical analysis to be conducted. Results indicated that males were significantly more likely to show aggression than females, and that individuals with a severe/profound degree of ID were significantly more likely to show self-injury and stereotypy than individuals with a mild/moderate degree of ID. Individuals with a diagnosis of autism were significantly more likely to show self-injury, aggression and disruption to the environment whilst individuals with deficits in receptive and expressive communication were significantly more likely to show self-injury. In most cases, tests for heterogeneity were statistically significant, as expected. The meta-analysis highlighted the paucity of methodologically robust studies of risk markers for challenging behaviours and the lack of data on incidence, prevalence and chronicity of challenging behaviour in this population. [source] Evaluation of emergency medicine trainees' ability to use transport equipmentEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2009Manoj Samuel Abstract Objective: To assess the skills of advanced emergency medicine trainees in the use of commonly used transport equipment and to determine what teaching has been undertaken and what level of confidence trainees have in their ability to use the equipment tested. Methods: This is a prospective multicentre observational study examining equipment use. Three pieces of equipment were examined: the infusion pump, defibrillator-monitor and transport ventilator. A questionnaire and a series of practical tasks were used. Advanced trainees from Victorian ED were enrolled as participants. Outcomes included proportion of participants able to perform all tasks successfully, subjective registrar confidence with use of equipment and departmental training practices. Eleven ED were represented, covering metropolitan tertiary, metropolitan peripheral and regional hospitals. Results: There were 47 participants enrolled in the study. The range of advanced training years of participants was 1,5+. Of the 47 participants, 39 (83%; 95% CI 72.2,93.7%) had been involved as medical escorts. Eighteen participants (38.3%; 95% CI 24.4,52.2%) described some form of teaching for equipment use. The median level of confidence of participants (on a 5-point scale) was 4 (25,75% interquartile range 3,4), which correlates with a moderate degree of confidence. Of 47 participants, 7 (14.9%; 95% CI 4.7,25.1%) rated themselves as not confident or somewhat under-confident (i.e. 1 or 2 on the scale). Of 47, 12 passed overall (25.5%; 95% CI 13.1,38%) and 8 completely failed (17.0%; 95% CI 6.3,27.8%) the skill testing. Conclusion: When tested in isolation, there appears to be deficits in the equipment skills of advanced ED trainees who are expected to be proficient in transport medicine. [source] The ameliorative effect of cysteine prodrug l -2-oxothiazolidine-4-carboxylic acid on cisplatin-induced nephrotoxicity in ratsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2007B.H. Ali Abstract Pathogenesis of nephrotoxicity of the synthetic anticancer drug cisplatin (CP) involves generation of reactive oxygen species and free radicals in the kidney cortex, and cysteine prodrug l -2-oxothiazolidine-4-carboxylic acid (OTC) has been confirmed to have a strong antioxidant action. Therefore, in the present work, we aimed at testing the possible protective or palliative effect of OTC on CP nephrotoxicity in rats. OTC was given at an oral dose of 150 mg/kg/day for 7 days. On day 7, some of these rats were given a single intraperitoneal injection of CP (or vehicle) at a dose of 6 mg/kg. Rats were killed, blood and urine samples were collected, and the kidneys were removed 6 days after CP treatment. Nephrotoxicity was evaluated histopathologically by light microscopy, and biochemically by measuring the concentrations of creatinine and urea in serum, reduced glutathione (GSH) concentration and superoxide dismutase (SOD) activity in renal cortex, and by urinalyses. CP significantly increased the concentrations of urea and creatinine (P < 0.05) by about 128% and 170% respectively. CP treatment reduced cortical GSH concentration by about 34% (P < 0.05), and the activity of SOD by about 28% (P < 0.05). CP treatment significantly increased urine volume and N -acetyl- , - d -glucosaminidase (NAG) activity, and significantly decreased osmolality and protein concentrations. OTC significantly mitigated all these effects. Sections from saline- and OTC-treated rats showed apparently normal proximal tubules. However, kidneys of CP-treated rats had a moderate degree of necrosis. This appeared to be lessened when CP was given simultaneously with OTC. The concentration of CP in the cortical tissues was not significantly altered by OTC treatment. The results suggested that OTC had ameliorated the histopathological and biochemical indices of nephrotoxicity in rats. Pending further pharmacological and toxicological studies, OTC may potentially be useful as a nephroprotective agent. [source] Validity and Reliability of the Turkish Migraine Disability Assessment (MIDAS) QuestionnaireHEADACHE, Issue 8 2004Mustafa Erta Objectives.,The aim of this study is to assess the comprehensibility, internal consistency, patient-physician reliability, test-retest reliability, and validity of Turkish version of Migraine Disability Assessment (MIDAS) questionnaire in patients with headache. Background.,MIDAS questionnaire has been developed by Stewart et al and shown to be reliable and valid to determine the degree of disability caused by migraine. Design and Methods.,This study was designed as a national multicenter study to demonstrate the reliability and validity of Turkish version of MIDAS questionnaire. Patients applying to 17 Neurology Clinics in Turkey were evaluated at the baseline (visit 1), week 4 (visit 2), and week 12 (visit 3) visits in terms of disease severity and comprehensibility, internal consistency, test-retest reliability, and validity of MIDAS. Since the severity of the disease has been found to change significantly at visit 2 compared to visit 1, test-retest reliability was assessed using the MIDAS scores of a subgroup of patients whose disease severity remained unchanged (up to ±3 days difference in the number of days with headache between visits 1 and 2). Results.,A total of 306 patients (86.2% female, mean age: 35.0 ± 9.8 years) were enrolled into the study. A total of 65.7%, 77.5%, 82.0% of patients reported that "they had fully understood the MIDAS questionnaire" in visits 1, 2, and 3, respectively. A highly positive correlation was found between physician and patient and the applied total MIDAS scores in all three visits (Spearman correlation coefficients were R= 0.87, 0.83, and 0.90, respectively, P < .001). Internal consistency of MIDAS was assessed using Cronbach's , and was found at acceptable (>0.7) or excellent (>0.8) levels in both patient and physician applied MIDAS scores, respectively. Total MIDAS score showed good test-retest reliability (R= 0.68). Both the number of days with headache and the total MIDAS scores were positively correlated at all visits with correlation coefficients between 0.47 and 0.63. There was also a moderate degree of correlation (R= 0.54) between the total MIDAS score at week 12 and the number of days with headache at visit 2 + visit 3, which quantify headache-related disability over a 3-month period similar to MIDAS questionnaire. Conclusion.,These findings demonstrated that the Turkish translation is equivalent to the English version of MIDAS in terms of internal consistency, test-retest reliability, and validity. Physicians can reliably use the Turkish translation of the MIDAS questionnaire in defining the severity of illness and its treatment strategy when applied as a self-administered report by migraine patients themselves. [source] Dose- and time-dependent oval cell reaction in acetaminophen-induced murine liver injury,HEPATOLOGY, Issue 6 2005Alexander V. Kofman We examined the response of murine oval cells, that is, the putative liver progenitor cells, to acetaminophen. Female C57BL/6J mice were injected intraperitoneally with varying doses of N -acetyl-paraaminophen (APAP) (250, 500, 750, and 1,000 mg/kg of weight) and sacrificed at 3, 6, 9, 24, and 48 hours. In preliminary studies, we showed that anticytokeratin antibodies detected A6-positive cells with a sensitivity and specificity of greater than 99%. The oval cell reaction was quantified, on immunostaining for biliary-type cytokeratins, as both number and density of oval cells per portal tract, analyzed by size of portal tract. Acetaminophen injury was followed by periportal oval cell accumulation displaying a moderate degree of morphological homogeneity. Oval cell response was biphasic, not temporally correlating with the single wave of injury seen histologically. Increases in oval cells were largely confined to the smallest portal tracts, in keeping with their primary derivation from the canals of Hering, and increased in a dose-dependent fashion. The timing of the two peaks of the oval cell reaction also changed with increasing dose, the first becoming earlier and the second later. In conclusion, our studies indicate a marked oval cell activation during the height of hepatic injury. Oval cells appear to be resistant to acetaminophen injury. The close fidelity of mechanism and histology of acetaminophen injury between mouse and human livers makes it a useful model for investigating liver regeneration and the participation of stem/progenitor cells in that process. (HEPATOLOGY 2005.) [source] The non-linear viscoelastic behaviour of human hair at moderate extensionsINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 4 2000Barnes Synopsis We report the results of experiments carried out on the stress relaxation of slightly stretched human hair. The results show that human hair is viscoelastic, and that when quickly extended to a moderate degree (0.5,6.5%) and held, the force generated will fall to half its original value in about 15 h. However, the relaxation process is also dependent on extension, so that iso-chronous (constant time) data is non-Hookean. We show that the iso-chronous stress/strain behaviour departs from linearity at about 1% extension and the modulus progressively decreases thereafter according to a power-law relationship with strain. Résumé Nous présentons ici les résultats d'expériences réalisées afin d'étudier la relaxation de la contrainte appliquée sur un cheveu humain légèrement étiré. Les résultats obtenus montrent que le cheveu humain est viscoélastique, et que lorsque'il est étiré rapidement, et de façon modérée (0,5,6,5%), la force nécessaire pour le maintenir étiré diminue de moitié en 15 heures. La relaxation dépend également du degré d'extension, de sorte que les données isochrones (à temps constant) ne suivent pas la loi de Hooke. Nous avons démontré que le comportement isochrone contrainte/cisaillement dévie du comportement linéaire lorsque le cheveu est étiré de 1% environ et que le module décroît ensuite progressivement en suivant une loi de puissance avec le cisaillement. [source] cDNA cloning of the polymeric immunoglobulin receptor of the marsupial Macropus eugenii (tammar wallaby)INTERNATIONAL JOURNAL OF IMMUNOGENETICS, Issue 2 2002C. L. Taylor Summary cDNA encoding a marsupial polymeric immunoglobulin receptor (pIgR) was isolated from Macropus eugenii (tammar wallaby) mammary lymph node primarily by reverse transcriptase coupled polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) PCR. This resulted in a 5, truncated clone and, in order to obtain the full-length sequence, genomic walking PCR was utilized. The complete sequence consists of 2696 bp of cDNA and encodes a predicted polypeptide of 732 amino acids. The wallaby sequence is highly conserved in relation to the only other reported marsupial pIgR sequence, that of Trichosurus vulpecula (brushtail possum), having a nucleotide identity of 86.7% and a deduced amino acid identity of 79.9%. The wallaby nucleotide sequence also has a moderate degree of similarity with the pIgR sequences of eutherian mammals, being most similar to that of the rat, with an identity of 63.1%. At the amino acid level, in comparison to eutherian sequences, the wallaby pIgR is most similar to that of humans with an identity of 52.6%. pIgR phylogenetic trees were constructed for tammar wallaby, brushtail possum and several eutherian mammal cDNA and deduced amino acid sequences. In both DNA and protein analyses, the eutherian sequences formed a sister clade to the exclusion of the marsupial sequences, in agreement with the current view of mammalian evolution. [source] Stable isotope evidence for impala Aepyceros melampus diets at Akagera National Park, RwandaAFRICAN JOURNAL OF ECOLOGY, Issue 4 2009Sandi R. Copeland Abstract Stable isotope analysis of tooth enamel was used to investigate the relative proportions of grass and browse in seasonal and overall diets of impala Aepyceros melampus at Akagera National Park, Rwanda. Bulk enamel samples suggest that on average, impala ate c. 86% C4 grass year-round, far more than in most previously studied impala populations across Africa. Intra-tooth samples show that seasonal changes in the proportion of C4 grass versus C3 browse are minimal (c. 10%), the diet being dominated by C4 grass year-round in contrast to other impala populations that consume ,50% browse during the dry season. Intra-tooth oxygen isotope values track carbon isotope changes to a moderate degree, but are not patterned clearly enough to permit identification of wet versus dry seasons. As other studies have shown that impala select high-protein diets, the foraging behaviour at Akagera is probably because of the availability of palatable grass for much of the year in the edaphic grasslands around the lacustrine environments of the eastern portions of Akagera National Park. Résumé L'analyse des isotopes stables de l'émail des dents a servi pour étudier les proportions relatives d'herbes et d'autres matières végétales dans le régime alimentaire saisonnier et général de l'impala Aepyceros melampus au Parc National de l'Akagera, au Rwanda. Des échantillons d'émail suggèrent qu'en moyenne, les impalas mangent c. 86% d'herbes de type C4 tout au long de l'année, beaucoup plus que la plupart des populations d'impalas étudiées ailleurs en Afrique. Les échantillons du centre des dents montrent que les changements saisonniers de la proportion d'herbes de type C4 par rapport au type C3 sont minimaux (c. 10%) et que le régime alimentaire est dominé par des herbes de type C4 toute l'année, contrairement aux autres populations d'impalas qui consomment ,50% d'autre végétation pendant la saison sèche. Les valeurs de l'isotope d'oxygène dans les dents permettent, dans une faible mesure, de détecter des changements de l'isotope de carbone, mais ils ne sont pas suffisamment définis pour permettre l'identification des saisons sèches ou humides. Comme d'autres études ont montré que les impalas sélectionnent une alimentation riche en protéines, le comportement alimentaire des impalas à l'Akagera est probablement dûà la disponibilité d'herbes goûteuses pendant une grande partie de l'année dans les prairies édaphiques qui entourent les environnements lacustres de l'est du Parc National de l'Akagera. [source] Measurement of Fractional Flow Reserve to Assess Moderately Severe Coronary Lesions: Correlation with Dobutamine Stress EchocardiographyJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2001MANUEL JIMÉNEZ-NAVARRO PH.D. Background: New techniques to evaluate coronary artery disease, such as calculation of myocardial fractional flow reserve (FFR) with a guidewire and pressure transducer, provide a functional assessment of coronary lesions. The present study was designed to determine the correlation between FFR and dobutamine stress echocardiography in patients with moderately severe coronary stenosis in order to judge the usefulness of FFR for commonly encountered clinical problems. Methods and Results: We studied 21 patients with 23 moderately severe coronary artery stenoses on angiography. The FFR was calculated and dobutamine stress echocardiography was performed to detect ischemia. Of the 16 stenoses with a negative FFR (, 0.75), dobutamine echocardiography also was negative. In the seven stenoses with a positive FFR (< 0.75), dobutamine echocardiography was positive in three. The efficacy of FFR in detecting ischemia that was confirmed with stress echocardiography was sensitivity 100%, specificity 80%, positive and negative predictive value 42.8%, and 100%. respectively, with a global predictive value 82.6%. A moderate degree of correlation was found between the two diagnostic tests (kappa [k] = 0.51). Conclusions: FFR correlates moderately well with dobutamine stress echocardiography in the assessment of moderately severe lesions in patients for whom coronary arteriography is usually indicated. However, its high negative predictive value makes FFR a useful aid in reaching clinical decisions promptly in the hemodynamics laboratory. [source] Synthesis of N -alkoxybenzimidoyl azides and their reactions in electrophilic mediaJOURNAL OF PHYSICAL ORGANIC CHEMISTRY, Issue 3 2010Debra D. Dolliver Abstract A new general route to N -alkoxybenzimidoyl azides [ArC(N3)=NOR] from a reaction of N -alkoxybenzimidoyl bromide [ArC(Br)=NOR] with sodium azide in DMSO is described. These reactions result in the Z -geometric configuration. These compounds show a moderate degree of thermal stability as assessed by differential scanning calorimetry, and lack reactivity in traditional 1,3-dipolar cycloaddition ,click' reactions. Upon exposure to electrophilic compounds (trifluoroacetic acid or acetyl chloride), these azide compounds can react by two pathways: a Schmidt-type rearrangement to form an N -alkoxyurea or an isomerization,cyclization reaction pathway to form an N -alkoxytetrazole. The route of the reaction has no dependence on solvent polarity and appears to depend upon the electrophile (H+vs. CH3CO+): reaction of the azide with trifluoroacetic acid results predominantly in the urea; reaction with acetyl chloride results solely in the tetrazole. Calculations indicate that the urea product is thermodynamically favored over the tetrazole product. They also indicate that both reaction conditions result in an equilibration between the starting azide and the tetrazole with the tetrazole being the major component in this equilibrium mixture. The fact that the azide also undergoes a Schmidt-type rearrangement to form an N -alkoxyurea when treated with trifluoroacetic acid appears to indicate that the barrier for aromatic ring migration is lower in the protonated azide produced on reaction with trifluoroacetic acid than in the acetylated azide produced on reaction with acetyl chloride. Copyright © 2009 John Wiley & Sons, Ltd. [source] Genetic variation in eastern North American and putatively introduced populations of Ceratocystis fimbriata f. plataniMOLECULAR ECOLOGY, Issue 10 2004C. J. B. ENGELBRECHT Abstract The plant pathogenic fungus Ceratocystis fimbriata f. platani attacks Platanus species (London plane, oriental plane and American sycamore) and has killed tens of thousands of plantation trees and street trees in the eastern United States, southern Europe and Modesto, California. Nuclear and mitochondrial DNA fingerprints and alleles of eight polymorphic microsatellite markers of isolates of C. fimbriata from these regions delineated major differences in gene diversities. The 33 isolates from the eastern United States had a moderate degree of gene diversity, and unique genotypes were found at each of seven collection sites. Fingerprints of 27 isolates from 21 collection sites in southern Europe were identical with each other; microsatellite markers were monomorphic within the European population, except that three isolates differed at one locus each, due perhaps to recent mutations. The genetic variability of C. fimbriata f. platani in the eastern United States suggests that the fungus is indigenous to this region. The genetic homogeneity of the fungus in Europe suggests that this population has gone through a recent genetic bottleneck, perhaps from the introduction of a single genotype. This supports the hypothesis that the pathogen was introduced to Europe through Naples, Italy during World War II on infected crating material from the eastern United States. The Californian population may also have resulted from introduction of one or a few related genotypes because it, too, had a single nuclear and mitochondrial genotype and limited variation in microsatellite alleles. [source] Immunohistochemical detection of carcinoma in radical prostatectomy specimens following hormone therapyPATHOLOGY INTERNATIONAL, Issue 11 2008Tomomi Kusumi Following hormone therapy, residual carcinoma is frequently difficult to identify on HE-stained prostatectomy specimens. The aim of the present study was therefore to investigate whole-mounted specimens obtained by radical prostatectomy from patients who had undergone hormone therapy. Formalin-fixed and paraffin-embedded specimens were immunostained with prostate secretory cell markers including prostate-specific antigen (PSA), P504S (,-methylacyl-coenzyme A racemase, AMACR), P501S (prostein), and prostate-specific membrane antigen (PSMA). Residual carcinoma was detected in 250 histological slides of 42 patients in a total of 497 slides from 45 patients. In five of 250 slides (2%), carcinoma was not able to be recognized on HE-stained slides, but was found on the immunohistochemistry slides. PSMA had reacted positively beyond a moderate degree in carcinoma from all patients. PSA was positive for carcinoma in most of the patients, while negative or minimal staining was observed in a small number of patients. Carcinoma was positively reactive with P504S and P501S in most of the patients, but was negatively reactive in a few. The Gleason score for a pretreatment needle biopsy correlated with P504S staining of the prostatectomy specimens. P504S and P501S had limited ability to identify degenerated carcinoma. PSMA was the most useful marker to identify carcinoma after hormone therapy. [source] The comparative pressure-flow plot properties of radiological bladder neck and prostatic obstructionBJU INTERNATIONAL, Issue 11 2009Sanjin Idriz OBJECTIVES To test the hypotheses that: (i) significant differences should exist in pressure/flow data between radiologically determined bladder neck and prostatic obstruction; (ii) these differences should inform understanding of the pathophysiology of male outflow obstruction. The biomechanics of the voiding/pressure/flow plot imply that a urodynamic assessment trace should identify outflow obstruction and characterise the urethral viscoelastic properties. Micturating cystourethrograms (MCUG) images might provide a useful diagnostic dichotomy for testing these assumptions. MATERIALS AND METHODS The pressure/flow data from 71 men who also provided video-urodynamic imaging data that a radiologist could classify unequivocally as showing bladder neck obstruction (42) or prostatic obstruction (29) were analysed. The following variables were recorded: the detrusor pressure at initiation of voiding (Pdet.open); the detrusor pressure at the end of voiding (Pdet.close); the detrusor pressure at maximum flow rate (Qmax), (Pdet.Qmax), and Qmax. The urethral resistance relation (URR) was drawn onto the pressure-flow plot and the gradient of the URR, ,Pdet/,Q, was calculated. RESULTS There were significant between group differences in Pdet.open (95% confidence interval of the difference 5.2,28.6, U = 352, P = 0.003); Pdet.close (0.2,15.0, U = 428, P = 0.034); Pdet.Qmax (0.0,18.9, U = 439, P = 0.05); Qmax and ,Pdet/,Q did not distinguish between the MCUG groups (95% confidence interval of the difference 2.3,18, U = 111; P = 0.004). The best-fit model from linear combinations of the data achieved an area under the receiver operator curve of 0.72 for discriminating between the MCUG groups. CONCLUSIONS The urodynamic assessment identified interesting and coherent biomechanical differences, and could distinguish between the obstructions with a moderate degree of accuracy. [source] Hydrolysis of Toxic Natural Glucosides Catalyzed by Cyclodextrin DicyanohydrinsEUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 4 2008Jeannette Bjerre Abstract The hydrolysis of toxic 7-hydroxycoumarin glucosides and other aryl and alkyl glucosides, catalyzed by modified ,- and ,-cyclodextrin dicyanohydrins, was investigated using different UV, redox, or HPAEC detection assays. The catalyzed reactions all followed Michaelis,Menten kinetics, and an impressive rate increase of up to 7569 (kcat/kuncat) was found for the hydroxycoumarin glucoside substrate 4-MUGP. Good and moderate degrees of catalysis (kcat/kuncat) of up to 1259 were found for the natural glucosides phloridzin and skimmin. By using a newly developed catechol detection UV-assay, a weak degree of catalysis was also found for the toxic hydroxycoumarin esculin. A novel synthesized diaminomethyl ,-cyclodextrin showed a weak catalysis of p -nitrophenyl ,- D -glucopyranoside hydrolysis. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2008) [source] Staff Morale in Day Care Centres for Adults with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2007Katerina Mascha Background, Levels of burnout, job satisfaction and intended turnover of staff working in day care centres for adults with intellectual disabilities are investigated in relation to role clarity, staff support and supervision, and coping strategies used by staff. Materials and methods, Thirty six direct-care staff of four day care centres in the UK were administered the Maslach Burnout Inventory, The Staff Support Questionnaire (SSQ), and The Shortened Ways of Coping (Revised) Questionnaire (SWC-R). Results, Although staff reported high levels of job satisfaction, they experienced moderate degrees of emotional exhaustion and personal accomplishment and reported a high propensity to leave the service. Factors identified as relating to staff morale were staff support and supervision, role clarity, wishful thinking, staff cooperation, and other practical issues regarding the day-to-day running of the service. Conclusions, Staff in day care services for people with intellectual disabilities experience similar stressors to those experienced by staff in residential facilities with the informal culture of the service being of most importance to staff morale. Suggestions for the enhancement of staff morale are provided. [source] Microdermabrasion followed by a 5% retinoid acid chemical peel vs. a 5% retinoid acid chemical peel for the treatment of photoaging , a pilot studyJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2005Doris Hexsel Summary Background, Both retinoid acid (RA) chemical peeling and microdermabrasion are minimally invasive procedures recently developed for the treatment of photoaging. The efficacy of each procedure has been proved, but the results of the combination of these two methods have not been studied until now. Objectives, To assess and compare the efficacy of microdermabrasion followed by a 5% RA chemical peel with that of a 5% RA chemical peel alone. Methods, Six female patients with moderate degrees of photodamage were evaluated. Three submitted to microdermabrasion followed by the application of a 5% RA chemical peel and three submitted to a 5% RA chemical peel alone. Each patient underwent three treatment sessions, with intervals of 7,10 days. Photographs were taken, and both biopsies and histological assessments were carried out, before treatment and 7 days after the final treatment session. Results, In the opinion of the patients, in both groups there was improvement in the texture, pigmentation, and appearance of the treated skin, and this was confirmed with the assessment of the pre- and post-treatment photographs. The combination of microdermabrasion followed by a 5% RA peel showed slightly greater improvement in the histological alterations resulting from photoaging. Conclusion, Both methods, microdermabrasion followed by a 5% RA chemical peel and a 5% RA chemical peel alone are effective in the treatment of photoaging. [source] On conflict, containment and the relationship between themNURSING INQUIRY, Issue 3 2006Len Bowers A programme of research into conflict (e.g. violence, absconding, medication refusal) and containment (e.g. seclusion, special observation, physical restraint) in inpatient psychiatry has been under way at City University, London, UK, for the past 10 years. Recent research findings, plus the challenges posed by ongoing projects, have made apparent the need for greater clarity about the overarching concepts of ,conflict' and ,containment'. This paper pulls together research findings pertaining to this issue, and conducts a reasoned analysis of what common characteristics might underlie ,conflict' and ,containment'. It is concluded that these are patient threats to safety, and the staff maintenance of safety. Details are presented on the inclusions and exclusions that follow from taking such a position, and potential definitions offered. On the grounds of this conceptual analysis, plus evidence for moderate degrees of statistical association between behaviours and events in each domain, it is concluded that it is legitimate to conduct analyses at the level of total conflict and containment rates, as well as at the level of individual types of behaviours and events (e.g. verbal abuse, sedation). Some of the mathematical difficulties in the analysis of total conflict and containment are addressed, and results of a weighting exercise presented. This exercise challenges our perception of the severity of some containment measures that are becoming more commonly used in acute psychiatry. [source] | |||||||||||||||||||||||||