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Objective Criteria (objective + criterion)
Selected AbstractsObjective Criteria: Guiding and Evaluating Dental Implant EstheticsJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 3 2008LYNDON F. COOPER DDS [source] Review: A systematic review of prospective studies on attention problems and academic achievementACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010T. J. C. Polderman Polderman TJC, Boomsma DI, Bartels M, Verhulst FC, Huizink AC. A systematic review of prospective studies on attention problems and academic achievement. Objective:, Our aim was to provide an overview of prospective studies that have addressed the association between attention problems (AP, i.e. symptoms of hyperactivity and inattentiveness) and academic achievement (AA). Method:, We conducted a systematic search in the literature. Normal population studies and clinical studies were included. The methodological quality of each study was evaluated by objective criteria. A best evidence synthesis was used to determine the strengths of the association. Results:, Sixteen studies were included. We found convincing evidence for a negative association between AP and AA. After controlling for intelligence, comorbidity, and socioeconomic status (SES), the association between the hyperactive symptoms of AP and AA was non-significant in two studies. Conclusion:, Children with AP are at risk for lower AA and subsequent adverse outcomes later in life. Interventions in affected children should focus on their behavioural and educational development. [source] Medium-term outcome of fundoplication after lung transplantationDISEASES OF THE ESOPHAGUS, Issue 8 2009P. R. Burton SUMMARY Gastroesophageal reflux disease (GERD) in lung transplant recipients has gained increasing attention as a factor in allograft failure. There are few data on the impact of fundoplication on survival or lung function, and less on its effect on symptoms or quality of life. Patients undergoing fundoplication following lung transplantation from 1999 to 2005 were included in the study. Patient satisfaction, changes in GERD symptoms, and the presence of known side effects were assessed. The effect on lung function, body mass index, and rate of progression to the bronchiolitis obliterans syndrome (BOS) were recorded. Twenty-one patients (13 males), in whom reflux was confirmed on objective criteria, were included, with a mean age of 43 years (range 20,68). Time between transplantation and fundoplication was 768 days (range 145,1524). The indication for fundoplication was suspected microaspiration in 13 and symptoms of GERD in 8. There was one perioperative death, at day 17. There were three other late deaths. Fundoplication did not appear to affect progression to BOS stage 1, although it may have slowed progression to stage 2 and 3. Forced expiratory volume-1% predicted was 72.9 (20.9), 6 months prior to fundoplication and 70.4 (26.8), six months post-fundoplication, P= 0.33. Body mass index decreased significantly in the 6 months following fundoplication (23 kg/m2 vs. 21 kg/m2, P= 0.05). Patients were satisfied with the outcome of the fundoplication (mean satisfaction score 8.8 out of 10). Prevalence of GERD symptoms decreased significantly following surgery (11 of 14 vs. 4 of 17, P= 0.002). Fundoplication does not reverse any decline in lung function when performed at a late stage post-lung transplantation in patients with objectively confirmed GERD. It may, however, slow progression to the more advanced stages of BOS. Reflux symptoms are well controlled and patients are highly satisfied. Whether performing fundoplication early post-lung transplant in selected patients can prevent BOS and improve long-term outcomes requires formal evaluation. [source] On the reliability of long-period response spectral ordinates from digital accelerogramsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 5 2008Roberto Paolucci Abstract Using records from co-located broadband and digital strong motion (SM) instruments, it is first shown that the displacement waveforms obtained by double integration of the accelerogram need not be free of unrealistic baseline drift to yield reliable spectral ordinates up to at least 10,s. Secondly, to provide objective criteria for selecting reliable digital SM records for ground motion predictions at long periods, a set of synthetic accelerograms contaminated by random long-period noise has been used, and the difference between the original accelerograms and the spurious ones in terms of response spectra has been quantified, by introducing a noise index that can be easily calculated based on the velocity waveform of the record. The results of this study suggest that high-pass filtering the digital acceleration record from a cutoff period selected to suppress baseline drifts on the displacement waveform appears to be in most cases too conservative and unduly depletes reliable information on long-period spectral ordinates. Copyright © 2007 John Wiley & Sons, Ltd. [source] The Demands of 24/7 Coverage: Using Faculty Perceptions to Measure Fairness of the ScheduleACADEMIC EMERGENCY MEDICINE, Issue 1 2004Frank L. Zwemer Jr. MD Objectives: Ensuring fair, equitable scheduling of faculty who work 24-hour, 7-day-per-week (24/7) clinical coverage is a challenge for academic emergency medicine (EM). Because most emergency department care is at personally valuable times (evenings, weekends, nights), optimizing clinical work is essential for the academic mission. To evaluate schedule fairness, the authors developed objective criteria for stress of the schedule, modified the schedule to improve equality, and evaluated faculty perceptions. They hypothesized that improved equality would increase faculty satisfaction. Methods: Perceived stress was measured for types of clinical shifts. The seven daily shifts were classified as weekday, weekend, or holiday (plus one unique teaching-conference coverage shift). Faculty assigned perceived stress to shifts (ShiftStress) utilizing visual analog scales (VAS). Faculty schedules were measured (ShiftScores) for two years (1998,1999), and ShiftScore distribution of faculty was determined quarterly. Schedules were modified (1999) to reduce interindividual ShiftScore standard deviation (SD). The survey was performed pre- and postintervention. Results: Preintervention, 26 faculty (100% of eligible) assigned VAS to 22 shifts. Increased stress was perceived in progression (weekday data, 0,10 scale) from day to evening to night (2.07, 5.00, 6.67, respectively) and from weekday to weekend to holiday (day-shift data, 2.07, 4.93, 5.87). The intervention reduced interindividual ShiftScore SD by 21%. Postintervention survey revealed no change in perceived equality or satisfaction. Conclusions: Faculty perceived no improvement despite scheduling modifications that improved equality of the schedule and provided objective measures. Other predictors of stress, fairness, and satisfaction with the demanding clinical schedule must be identified to ensure the success of EM faculty. [source] The concept of the epilepsy syndrome: How useful is it in clinical practice?EPILEPSIA, Issue 2009Ettore Beghi Summary An epilepsy syndrome is a disorder characterized by a cluster of symptoms and signs customarily occurring in combination. A syndromic approach to the epilepsies would be of practical value for diagnostic, prognostic, and therapeutic purposes. However, despite considerable efforts by leaders in the field of epileptology and the improved knowledge of the clinical, genetic, imaging, and biologic aspects of epilepsy, there are no measurable objective criteria for recognizing seizure types and epilepsy syndromes as separate diagnostic entities with well-defined prognostic and therapeutic aspects. The lack of pragmatic, evidence-based instruments to devise a syndromic classification useful for clinical practice can be explained by the evolving concept of epilepsy syndrome, its dynamic characteristics, the poor prognostic predictivity, and the extremely complex genetic and pathophysiologic mechanisms underlying the epileptic phenomena. In addition, the results of the published reports on epilepsy syndromes are mostly biased by flaws in the study population, design, and statistical analysis. The Classification Core Group of the International League Against Epilepsy (ILAE), which is working on a new classification of the epilepsies, stated that the process of syndrome identification requires that an evidence-based approach be applied to the published literature and future studies. [source] Correlation between routine radiographic findings and early racing career in French TrottersEQUINE VETERINARY JOURNAL, Issue S36 2006C. ROBERT Summary Reasons for performing study: The relationship between the presence of radiological abnormalities and subsequent racing performance is controversial. However, as training is expensive and time consuming, it would save time and money to identify subjects with osteo-articular lesions not compatible with a normal racing career on the basis of routine radiographic screenings at yearling age. Objectives: To evaluate the impact of osteo-articular lesions on racing ability in French Trotters and identify radiographic changes associated with failure in ,qualification', in order to provide objective criteria for selection of horses based on their osteo-articular status. Hypothesis: The influence of radiographic findings (RF) on racing ability depends on their nature, location, clinical relevance and number. Methods: The limbs of 202 French Trotters were radiographed just before they started training. All the RF were graded according to a standardised protocol depending on their severity. The success in ,qualification' (first race in career of French Trotters) was the criteria used to assess racing ability. Breeders and trainers were questioned about the causes for horses not racing. Results: Overall 113 (55.9%) horses qualified. Osteoarticular lesions were directly responsible for nonqualification in 31% of the horses. Subjects with more than one abnormal RF, with abnormal RF on the fore-, hind-fetlock or proximal tarsus were less likely to qualify. Dorsal modelling in the front fetlock and osteochondrosis of the lateral trochlear ridge of the femur also significantly reduced the qualification rate. Conclusions: Most RF are compatible with beginning a racing career, but severe RF or multiple abnormal RF significantly compromise future racing career. Potential relevance: This study supports the use of routine radiographic programmes for detection of osteoarticular lesions in yearlings. A synthetic radiographic score, based on both the severity and the number of lesions, could be useful for breeders and trainers as complementary information to select their horses. [source] Human survivability in motor vehicle firesFIRE AND MATERIALS, Issue 4 2008K. H. Digges Abstract Automobile fires are consistently among the largest causes of fire death in the United States (about 500 annually) and the U.S. motor vehicle industry and others have spent a significant amount of money in recent years studying this problem. The authors of this review have analyzed the auto industry reports, the scientific literature, and statistical data, and conclude that measures should be taken to improve survivability in automobile fires. The U.S. Federal Motor Vehicle Safety Standard 302 (FMVSS 302) was introduced almost 40 years ago to measure the flammability of interior materials, but improvements in the crashworthiness of automobiles and their fuel tanks and the increased use of combustible materials have changed the motor vehicle fire scenario significantly. In particular, the primary threat has changed from ignition of a small quantity of combustible interior materials by a lit cigarette, in 1960, to ignition of a large quantity of combustible interior and exterior materials by an impact-induced fire, at present. The authors therefore suggest that FMVSS 302 is no longer relevant to automobile fire safety and recommend improved standards based on objective criteria for fire safety performance (fireworthiness) at the system/vehicle level as is routinely done for crashworthiness. Copyright © 2008 John Wiley & Sons, Ltd. [source] Classification of upper lateral body shapes for the apparel industryHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 5 2010Young Lim Choi Abstract The lateral body shape is a critical determiner of the fit of garments. Either visual assessment or statistical analysis methods have been used to classify the lateral body types. These methods are limited to some extent since various anthropometric features inherently coexist and interact in a human body shape. This study aims to develop objective criteria for the classification of upper lateral body shapes integrating visual assessment and statistical analysis. The three-dimensional scan data of 246 women between 18 and 49 years old were visually classified into four lateral body shapes by an expert panel. In addition, the back space and lateral angles extracted from the scan data were employed for further statistical analyses. Multinomial logistic regressions were used to develop logit models for lateral body types. It was concluded that the resulting logit models could classify lateral body types and calculate the probability of a set of body scan data being classified as a certain lateral body type. It is expected that this probability might be a guideline to quantify the characteristics of the lateral body shape in the apparel industry. © 2010 Wiley Periodicals, Inc. [source] The Concept of Ecological Validity: What Are Its Limitations and Is It Bad to Be Invalid?INFANCY, Issue 4 2001David J. Lewkowicz The concept of ecological validity has played an important role in research on perceptual development. The limitations of this concept are discussed and illustrated with examples from research on the development of intersensory perception. By itself the concept of ecological validity fails to provide objective criteria for experimental design, but together with more traditional bottom-up methodological approaches it can be used in a convergent operations manner to enrich our understanding of perceptual development. [source] Methodological approaches in the assessment of interferon-alfa-induced depression in patients with chronic hepatitis C , a critical reviewINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2007Arne Schäfer Abstract In recent years, research on interferon (IFN)-induced depressive symptoms in antivirally treated patients suffering from chronic hepatitis C (CHC) has considerably intensified. Profound scientific knowledge of this complication is of great relevance with regard to adherence, compliance, and premature therapy discontinuation. Presently, there is considerable variability of both, the frequency and extent of IFN-induced depression reported in different cohorts of patients. The aim of the presented study was to systematically review recent literature of research within this field; and particularly (1) to identify to what extent methodological bias contributed to inconsistent results in different studies, (2) to critically appraise methods and results of studies published so far, and (3) to suggest directions for future work, especially with respect to alternative and improved methodological approaches. The results of this critical review suggest that the variability of findings seem to be largely due to different study populations, treatment regimens, methodological approaches, and sometimes arbitrary or at least poorly defined choice of screening instruments for depression, particularly criteria for clinically relevant depression (cut-off criteria). Study designs and methodological approaches to investigate IFN-alfa-induced depression in patients with CHC have been incoherent. Future research in this field needs agreement on the use of standardized assessment of IFN-induced depression in CHC. Furthermore, objective criteria and guidelines for the treatment of IFN-induced depression in these patients are needed in clinical practice. Copyright © 2008 John Wiley & Sons, Ltd. [source] Search strategies in decision making: the success of "success"JOURNAL OF BEHAVIORAL DECISION MAKING, Issue 2 2004Ben R. Newell Abstract Examination of search strategies has tended to focus on choices determined by decision makers' personal preferences among relevant cues, and not on learning cue-criterion relationships. We present an empirical and rational analysis of cue search for environments with objective criteria. In such environments, cues can be evaluated on the basis of three properties: validity (the probability that a cue identifies the correct choice if cue values differ between alternatives); discrimination rate (the proportion of occasions on which a cue has differing values); and success (the expected proportion of correct choices when only that cue can be used). Our experiments show that though there is a high degree of individual variability, success is a key determinant of search. Furthermore, a rational analysis demonstrates why success-directed search is the most adaptive strategy in many circumstances. Copyright © 2004 John Wiley & Sons, Ltd. [source] The Use of Intraoperative Doppler Assessment to Guide the Surgical Treatment of Anomalous Right Coronary ArteriesJOURNAL OF CARDIAC SURGERY, Issue 5 2008Louis H. Stein M.H.S. Because of this risk, many patients elect surgical correction of this anomaly. Surgical strategies for correction of this include ostioplasty, coronary artery reimplantation, and, more commonly, coronary artery bypass grafting. After coronary artery bypass grafting, some advocate ligation of the proximal RCA, speculating that competitive flow will cause graft failure. As no objective criteria for this have been established, we propose a method using of intraoperative Doppler flow measurements to guide the decision to preserve the proximal anomalous native vessel. We present three cases in which an RCA with an anomalous origin from the left sinus was corrected with coronary artery bypass grafting with the assistance of intraoperative Doppler flow measurements to guide the decision to preserve the proximal anomalous native vessel. In each case, the RCA was bypassed using a saphenous vein graft (SVG) that was used to bypass origin of the RCA. Flow through the graft was compared with and without ligation of the proximal RCA, before creation of the proximal anastomosis. In each case, flow through the SVG was not significantly reduced with the proximal RCA patent and ligation was not performed. [source] Assessment of Walkway Tribometer Readings in Evaluating Slip Resistance: A Gait-Based ApproachJOURNAL OF FORENSIC SCIENCES, Issue 2 2007Christopher M. Powers Ph.D. ABSTRACT: The purpose of this study was to assess the viability of using slip risk (as quantified during human subject walking trials) to create a reference standard against which tribometer readings could be compared. First, human subjects (N=84) were used to rank objectively the slipperiness of three different surfaces with and without a contaminant (six conditions). Second, nine tribometers were used to independently measure and rank surface slipperiness for all six conditions. The slipperiness ranking determined from the walking trials was considered the reference against which the tribometer measurements were compared. Our results revealed that only two of the nine tribometers tested (Tortus II and Mark III) met our compliance criteria by both correctly ranking all six conditions and differentiating between surfaces of differing degrees of slipperiness. These findings reinforce the need for objective criteria to ascertain which tribometers effectively evaluate floor slipperiness and a pedestrian's risk of slipping. [source] Comparison of non-coplanar and coplanar irradiation techniques to treat cancer of the pancreasJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2006C Osborne Summary We compared two different techniques of pancreatic irradiation using measures associated with normal tissue complications. Seven consecutive patients with pancreatic cancer were planned for both coplanar and non-coplanar (NCP) external beam radiation treatments, using the same defined anatomical volumes for each patient, in each case. Each pair of plans was then compared using a range of objective criteria. Individual normal tissues were assessed against traditional tolerance limits. Selected dose-points, normal tissue complication probability (NTCP) and equivalent uniform doses (EUD) were also compared, as were indices combining information from individual tissues , total NTCP and total weighted EUD. All individual normal tissues doses were within established tolerance limits. For NCP relative to coplanar planning, NTCP and EUD were lower for all individual tissues in four cases and one case, respectively, i.e. in most cases a benefit to one tissue was offset by detriment to others. Summary measures demonstrated overall benefits for NCP techniques, with the total NTCP in six patients, and with the total weighted EUD in all patients. NCP techniques show potentially useful benefits. We present a new objective measure, the total weighted EUD, which may be particularly useful comparing plans where there are multiple critical tissues. [source] A comprehensive framework for the evaluation of metacommunity structureOIKOS, Issue 6 2010Steven J. Presley The metacommunity framework is a powerful platform for evaluating patterns of species distribution in geographic or environmental space. Idealized patterns (checkerboard, Clementsian, evenly spaced, Gleasonian and nested distributions) give the framework shape. Each pattern represents an area in a multidimensional continuum of metacommunity structures; however, the current approach to analysis of spatial structure of metacommunities is incomplete. To address this, we describe additional non-random structures and illustrate how they may be discerned via objective criteria. First, we distinguish three distinct forms of species loss in nested structures, which should improve identification of structuring mechanisms for nested patterns. Second, we define six quasi-structures that are consistent with the conceptual underpinnings of Clementsian, Gleasonian, evenly spaced and nested distributions. Finally, we demonstrate how combinations of structures at smaller spatial extents may aggregate to form Clementsian structure at larger extents. These refinements should facilitate the identification of best-fit patterns, associated structuring mechanisms, and informative scales of analysis and interpretation. This conceptual and analytical framework may be applied to network properties within communities (i.e. structure of interspecific interactions) and has broad application in ecology and biogeography. [source] Actual asthma control in a paediatric outpatient clinic population: Do patients perceive their actual level of control?PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 7 2008Sanne C Hammer Several epidemiological studies described poor asthma control in children. However, the diagnosis of childhood asthma in these studies is uncertain, and asthma control in children of an outpatient clinic population during treatment by a paediatrician is unknown. (1) to investigate the hypothesis that asthma control in a paediatric outpatient clinic population is better than epidemiological surveys suggest; (2) to find possible explanations for suboptimal asthma control. Asthmatic children aged 6,16 years, known for at least 6 months by a paediatrician at the outpatient clinic, were selected. During a normal visit, both the responsible physicians and parent/children completed a standardised questionnaire about asthma symptoms, limitation of daily activities, treatment, asthma attacks and emergency visits. Overall, excellent asthma control of 8.0% in this study was not significantly better than of 5.8% in the European AIR study (Chi-square, p = 0.24). Separate GINA goals like minimal chronic symptoms and no limitation of activities were better met in our study. Good to excellent controlled asthma was perceived by most children/parents (83%), but was less frequently indicated by the paediatrician (73%), or by objective criteria of control (45%) (chi-square, p = 0.0001). The agreement between patient-perceived and doctor assessed control was low, but improved in poorly controlled children. Patients were not able to perceive the difference between ,excellent asthma control' and ,good control' (p = 0.881). Too little children with uncontrolled disease got step-up of their asthma treatment. Although separate GINA goals like ,minimal chronic symptoms' and ,no limitation of activities' were significantly better in our study, overall, asthma control in this outpatient clinic population, treated by a paediatrician, was not significantly better than in the European AIR study. Poorly controlled disease was related to several aspects of asthma management, which are potentially accessible for improvements. [source] Habitat diversity relative to wave action on rocky shores: implications for the selection of marine protected areasAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 6 2009Laura K. Blamey Abstract 1.Current selection of marine protected areas in South Africa is based on objective criteria including biogeographic representation and habitat heterogeneity. This paper specifically examines rocky shores on the west coast of South Africa to determine whether they are divisible into discrete ,habitats' that need independent conservation. 2.Seventeen rocky shores spanning the full spectrum of wave exposure were compared in terms of maximum wave forces, biomass, species richness and diversity among zones and sites. Three biotic assemblages were identified, characterizing sheltered, semi-exposed to exposed, and very exposed habitats. Differences among these were clear-cut low on the shore but disappeared at the top of the shore where wave action was attenuated and desiccation uniformly intense. 3.The recognition of three discrete biologically-defined habitats means that rocky shores cannot be regarded as a uniform habitat for conservation purposes. All three components need protection if the full spectrum of rocky-shore communities is to be conserved. 4.It is argued that this approach allows habitats to be defined in an objective manner, and that once this has been done, habitat heterogeneity constitutes a better measure of conservation value of an area than a ,hotspot' approach based on species richness and endemism. Copyright © 2008 John Wiley & Sons, Ltd. [source] Protein flexibility: coordinate uncertainties and interpretation of structural differencesACTA CRYSTALLOGRAPHICA SECTION D, Issue 11 2009Alexander A. Rashin Valid interpretations of conformational movements in protein structures determined by X-ray crystallography require that the movement magnitudes exceed their uncertainty threshold. Here, it is shown that such thresholds can be obtained from the distance difference matrices (DDMs) of 1014 pairs of independently determined structures of bovine ribonuclease A and sperm whale myoglobin, with no explanations provided for reportedly minor coordinate differences. The smallest magnitudes of reportedly functional motions are just above these thresholds. Uncertainty thresholds can provide objective criteria that distinguish between true conformational changes and apparent `noise', showing that some previous interpretations of protein coordinate changes attributed to external conditions or mutations may be doubtful or erroneous. The use of uncertainty thresholds, DDMs, the newly introduced CDDMs (contact distance difference matrices) and a novel simple rotation algorithm allows a more meaningful classification and description of protein motions, distinguishing between various rigid-fragment motions and nonrigid conformational deformations. It is also shown that half of 75 pairs of identical molecules, each from the same asymmetric crystallographic cell, exhibit coordinate differences that range from just outside the coordinate uncertainty threshold to the full magnitude of large functional movements. Thus, crystallization might often induce protein conformational changes that are comparable to those related to or induced by the protein function. [source] Objective vs. subjective factors in the psychological impact of vitiligo: the experience from a French referral centreBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2009P. Kostopoulou Summary Background, Vitiligo affects around 0·5% of the population. The burden of disease perceived by patients seems to be underestimated by the medical community. Objectives, To analyse the impact of objective and psychological factors on the quality of life (QoL) and self-body image of patients with vitiligo. Methods, Demographic data, medical information and psychological factors (perceived severity, trait anxiety, trait depression, trait self-esteem, body image and QoL) were prospectively collected for all patients. Results, Forty-eight patients with a mean age of 43·9 years were included in the study. Vitiligo caused overall a moderate effect on patients' QoL with a 7·17 Dermatology Life Quality Index (DLQI) mean score (out of 30) without correlation with gender. According to distribution, no or minimal (DLQI 0,1), mild (2,5), moderate (6,11) and severe (12,20) impairment of QoL was found in five (10%), 14 (29%), 18 (38%) and 11 (23%) patients, respectively. The mean perceived severity evaluated by the patients was 4·91 based on visual analogue scale from 0 to 10. The self-body image was influenced by gender, perceived severity and disease characteristics. Perceived severity and patient personality were predictors of QoL impairment. Perceived severity of vitiligo was explained mainly by the patients' personality and less significantly by objective criteria. Conclusions, Subjective as well as objective factors should be included in the assessment of disease severity and follow-up of patients with vitiligo. A simple perceived severity scale is useful in clinical practice. [source] 3446: Management and therapy of MGDACTA OPHTHALMOLOGICA, Issue 2010JM BENITEZ-DEL-CASTILLO Purpose Treatment of Meibomian gland dysfunction varies greatly among eye care providers.Practitioners have noted widespread deficiencies in the patient education. As a result, suboptimal and ineffective therapy is commonly practiced and abandoned prematurely as ineffective. The aim of the subcommittee was to review the current practice and published evidence of medical and surgical treatment options for Meibomian gland dysfunction and to identify areas with conflicting or lack of evidence, observations, concepts or even mechanisms were further research is required. Methods To achieve this a comprehensive review of clinical textbooks and scientific literature was performed and the quality of published evidence graded according to an agreed standard, using objective criteria for clinical and basic research studies. Results Lid warming and cleansing, artificial lubricants, systemic tetracyclines, topical antibiotic and or antibiotic-steroid combinations are commonly prescibed. Future developments are described. Conclusion The subcommittee have prsented current and future treatment options for Meibomian gland dysfunction. [source] 3222: New developments in dry eye treatmentACTA OPHTHALMOLOGICA, Issue 2010JM BENITEZ-DEL-CASTILLO Purpose This study summarizes the management and therapeutic options for treating dry eye disease. Goals of this review is to identify appropriate therapeutic methods for the management of dry eye disease and recommend a sequence or strategy for their application, based on evidence-based review of the literature. Methods To achieve this a comprehensive review of clinical textbooks and scientific literature was performed and the quality of published evidence graded according to an agreed standard, using objective criteria for clinical and basic research studies. Results There have been tremendous advances in the treatment of dry eye and ocular surface disease in the last decades related to the increase in knowledge regarding the pathophysiology of dry eye. This has led to a paradigm shift in dry eye management from simply lubricating and hydrating the ocular surface with arti,cial tears to strategies that stimulate natural production of tear constituents, maintain ocular surface epithelial barrier function, and inhibit the in,ammatory factors that adversely impact the ability of ocular surface and glandular epithelia to produce tears. Conclusion The authors will present current and future treatment options for dry eye disease. [source] Pharmacodynamics of H1-antihistamines: from concept to realityCLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 3 2003N. Frossard Summary Pharmacodynamics are designed to give objective criteria to the understanding and assessment of the potency and consistency of activity of antihistamines. They allow a determination of the onset of action in the skin, and of their duration of action, which is particularly important for defining a once- or twice-a-day dosing, for instance. They also predict the antihistaminic potency in the skin, studying the cutaneous reactivity to histamine at specific time-points, or over a 24-h period. These pre-clinical studies assess drug characteristics, which is helpful in understanding their clinical efficacy. Pharmacodynamics are thus a necessary step in clinical studies, and important in the assessment of the clinical efficacy of a drug in the allergic patient. [source] What Allows Cognitive Behavioral Therapy to Be Brief: Overview, Efficacy, and Crucial Factors Facilitating Brief TreatmentCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2001Lata K. McGinn Cognitive behavior therapy (CBT) has been traditionally used as a short-term treatment for a wide range of emotional disorders and problems. In the present paper, we review aspects of CBT that allow it to be time efficient. Specifically, CBT maximizes efficiency because it uses manual-based, empirically supported treatment strategies and defines specific, measurable, and achievable target goals. A focused assessment process and a relatively structured session format facilitate the implementation of treatment strategies without delay and allow the therapist to make efficient use of session time. Once treatment is implemented, a periodic review of treatment progress using objective criteria enables the therapist and client to make informed decisions about the direction of treatment. CBT uses strategies to enhance generalization and prevent relapse and empowers patients by providing them with skills they can use outside therapy sessions. Finally, the therapist's active, directive stance plays a critical role in making CBT time-efficient. [source] Sense of coherence and social support predict living liver donors' emotional stress prior to living-donor liver transplantationCLINICAL TRANSPLANTATION, Issue 3 2008Yesim Erim Abstract:, The protection of the donors from physical or emotional harm has been a fundamental principle in living-donor liver donation from the beginning. Psychosomatic donor evaluation aims at the selection of eligible donors and the screening and exclusion of psychiatrically vulnerable donors. As clinical interviews may include subjective biases, efforts should be made to establish objective criteria for donor assessment. In recent research, protective factors have been reported to be a significant force behind healthy adjustment to life stresses and can be investigated as possible predictors of donors' eligibility. Being the central construct of Antonovsky's theory of salutogenesis, the sense of coherence is one of the most surveyed protective factors and a good predictor of individuals' stability when experiencing stress. Furthermore, family support has been shown to be a valuable protective resource in coping with stress. This study surveyed whether sense of coherence and social support predict donors' emotional strain prior to transplantation. Seventy-one donor candidates were included in the study during the donor evaluation prior to living-donor liver transplantation. Sense of coherence proved to be a significant predictor for all criterion variables, namely anxiety, depression and mental quality of life. In addition to this, donor candidates who were classified as eligible for donation in the psychosomatic interview had significantly higher values on sense of coherence total scores compared with rejected donors. In a multiple regression analysis, sense of coherence and social support together yielded a prediction of depression with an explained variance of 22% (R2 = 0.22). Sense of coherence and social support can be implemented as self-rating instruments in the psychosomatic selection of donors and would help to further objectify donors' eligibility. [source] Famine Intensity and Magnitude Scales: A Proposal for an Instrumental Definition of FamineDISASTERS, Issue 4 2004Paul Howe Ambiguities in current usage of the term ,famine' have had tragic implications for response and accountability in a number of recent food crises. This paper proposes a new approach to defining famine based on the use of intensity and magnitude scales, where ,intensity' refers to the severity of the crisis at a given location and point in time, while ,magnitude' describes the aggregate impact of a crisis. The scales perform three operations on ,famine': first, moving from a binary conception of ,famine/no famine' to a graduated, multi-level definition; second, disaggregating the dimensions of intensity and magnitude; and third, assigning harmonised ,objective' criteria in place of subjective, case-by-case judgements. If adopted, the famine scales should contribute to more effective and proportionate responses, as well as greater accountability in future food crises. [source] | |||||||||||||||||||||||||||||||