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Other Considerations (other + consideration)
Selected AbstractsWhy Current Breast Pathology Practices Must Be Evaluated.THE BREAST JOURNAL, Issue 5 2007A Susan G. Komen for the Cure White Paper: June 200 To this end, the organization has a strong interest and proven track record in ensuring public investment in quality breast health and breast cancer care. Recently, Susan G. Komen for the Cure identified major issues in the practice of pathology that have a negative impact on the lives of thousands of breast cancer patients in the United States. These issues were identified through a comprehensive literature review and interviews conducted in 2005,2006 with experts in oncology, breast pathology, surgery, and radiology. The interviewees practiced in community, academic, and cooperative group settings. Komen for the Cure has identified four areas that have a direct impact on the quality of care breast cancer patients receive in the United States, the accuracy of breast pathology diagnostics, the effects of current health insurance, and reimbursement policies on patients who are evaluated for a possible breast cancer diagnosis, the substantial decrease in tissue banking participation, particularly during a time of rapid advances in biologically correlated clinical science and the role for the Susan G. Komen for the Cure, pathology professional societies and the Federal government in ensuring that breast pathology practices meet the highest possible standards in the United States Concerns surrounding the quality and practice of breast pathology are not limited to diagnostic accuracy. Other considerations include, training and proficiency of pathologists who are evaluating breast specimens, the lack of integration of pathologists in the clinical care team, inadequate compensation for the amount of work required to thoroughly analyze specimens, potential loss in translational research as a result of medical privacy regulations, and the lack of mandatory uniform pathology practice standards without any way to measure the degree of variation or to remedy it. [source] Evaluating high-performance computers,CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 10 2005Jeffrey S. Vetter Abstract Comparisons of high-performance computers based on their peak floating point performance are common but seldom useful when comparing performance on real workloads. Factors that influence sustained performance extend beyond a system's floating-point units, and real applications exercise machines in complex and diverse ways. Even when it is possible to compare systems based on their performance, other considerations affect which machine is best for a given organization. These include the cost, the facilities requirements (power, floorspace, etc.), the programming model, the existing code base, and so on. This paper describes some of the important measures for evaluating high-performance computers. We present data for many of these metrics based on our experience at Lawrence Livermore National Laboratory (LLNL), and we compare them with published information on the Earth Simulator. We argue that evaluating systems involves far more than comparing benchmarks and acquisition costs. We show that evaluating systems often involves complex choices among a variety of factors that influence the value of a supercomputer to an organization, and that the high-end computing community should view cost/performance comparisons of different architectures with skepticism. Published in 2005 by John Wiley & Sons, Ltd. [source] A simulation study comparing different experimental designs for estimating uptake and elimination ratesENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 1 2006Bryan R. Bell Abstract The design of ecotoxicological studies requires decisions about the number and spacing of exposure groups tested, the number of replications, the spacing of sampling times, the duration of the study, and other considerations. For example, geometric spacing of sampling times or toxicant concentrations is often used as a default design. Optimal design methods in statistics can suggest alternative spacing of sampling times that yield more precise estimates of regression coefficients. In this study, we use a computer simulation to explore the impact of the spacing of sampling times and other factors on the estimation of uptake and elimination rate constants in an experiment addressing the bioaccumulation of a contaminant. Careful selection of sampling times can result in smaller standard errors for the parameter estimates, thereby allowing the construction of smaller, more precise confidence intervals. Thus, the effort invested in constructing an optimal experimental design may result in more precise inference or in a reduction of replications in an experimental design. [source] The efficiency frontier approach to economic evaluation of health-care interventionsHEALTH ECONOMICS, Issue 10 2010J. Jaime Caro Abstract Background: IQWiG commissioned an international panel of experts to develop methods for the assessment of the relation of benefits to costs in the German statutory health-care system. Proposed methods: The panel recommended that IQWiG inform German decision makers of the net costs and value of additional benefits of an intervention in the context of relevant other interventions in that indication. To facilitate guidance regarding maximum reimbursement, this information is presented in an efficiency plot with costs on the horizontal axis and value of benefits on the vertical. The efficiency frontier links the interventions that are not dominated and provides guidance. A technology that places on the frontier or to the left is reasonably efficient, while one falling to the right requires further justification for reimbursement at that price. This information does not automatically give the maximum reimbursement, as other considerations may be relevant. Given that the estimates are for a specific indication, they do not address priority setting across the health-care system. Conclusion: This approach informs decision makers about efficiency of interventions, conforms to the mandate and is consistent with basic economic principles. Empirical testing of its feasibility and usefulness is required. Copyright © 2010 John Wiley & Sons, Ltd. [source] Cultural Property, Restitution and ValueJOURNAL OF APPLIED PHILOSOPHY, Issue 3 2003Janna Thompson abstract,Demands for restitution of cultural artefacts and relics raise four main issues: 1) how claims to cultural property can be justified; 2) whether and under what conditions demands for restitution of cultural property are valid , especially when they are made long after the artefacts were taken away; 3) whether there are values, aesthetic, scholarly and educational, which can override restitution claims, even when these claims are legitimate; and 4) how these values bear on the question of whether artefacts should be returned to their place of origin. I argue that a proper conception of cultural property emphasises the role that artefacts play in the practices and traditions of a collectivity. On the basis of this conception, some restitution claims can be defended as legitimate. However, many demands for restitution are not justified (including the Greek claim to the Parthenon Marbles). Moreover, a case for restitution can be more or less strong, and other considerations sometimes prevail over rights of cultural property. [source] An Empirically Based Method of Q-Matrix Validation for the DINA Model: Development and ApplicationsJOURNAL OF EDUCATIONAL MEASUREMENT, Issue 4 2008Jimmy De La Torre Most model fit analyses in cognitive diagnosis assume that a Q matrix is correct after it has been constructed, without verifying its appropriateness. Consequently, any model misfit attributable to the Q matrix cannot be addressed and remedied. To address this concern, this paper proposes an empirically based method of validating a Q matrix used in conjunction with the DINA model. The proposed method can be implemented with other considerations such as substantive information about the items, or expert knowledge about the domain, to produce a more integrative framework of Q-matrix validation. The paper presents the theoretical foundation for the proposed method, develops an algorithm for its practical implementation, and provides real and simulated data applications to examine its viability. Relevant issues regarding the implementation of the method are discussed. [source] Cardioversion for Atrial Fibrillation: Treatment Options and AdvancesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2009JAMES A. REIFFEL M.D. Atrial fibrillation (AF) is associated with significant morbidity and mortality. There are two basic approaches to managing AF: slowing the ventricular rate, while allowing the arrhythmia to continue (the rate-control approach), and restoring and maintaining sinus rhythm (the rhythm-control approach) with antiarrhythmic drugs (AADs) and/or ablation, electrical cardioversion (CV), if needed, or both. Strategy trials comparing rate and rhythm control have found no survival advantage of one approach over the other, but other considerations, such as symptom reduction, often necessitate pursuit of rhythm control. Electrical, or direct current, CV is a widely used and effective method for termination of nonparoxysmal AF, although its success can be affected by patient- and technique-related variables. Pharmacological CV options also exist and are preferable in specific circumstances. Both pharmacological and electrical CV are associated with the risk of proarrhythmia. Many AADs are under development for both CV and maintenance of sinus rhythm. Some are atrioselective, such as vernakalant, and target ion channels in the atria, with little or no effects in the ventricle. Vernakalant, currently under Food and Drug Administration review, appears to offer a safer profile than current CV agents and is likely to expand the role of pharmacological CV. Other new AADs that provide increased efficacy or safety while maintaining normal sinus rhythm may also be better than current drugs; if so, rate-rhythm comparisons will differ from those of previous studies. In conclusion, further trials should clarify the long-term safety profiles of new atrioselective agents and other investigational drugs and define their role in the treatment of AF. [source] Development of tRNA synthetases and connection to genetic code and diseasePROTEIN SCIENCE, Issue 10 2008Paul Schimmel Abstract The genetic code is established by the aminoacylation reactions of aminoacyl tRNA synthetases, where amino acids are matched with triplet anticodons imbedded in the cognate tRNAs. The code established in this way is so robust that it gave birth to the entire tree of life. The tRNA synthetases are organized into two classes, based on their active site architectures. The details of this organization, and other considerations, suggest how the synthetases evolved by gene duplications, and how early proteins may have been statistical in nature, that is, products of a primitive code where one of several similar amino acids was used at a specific position in a polypeptide. The emergence of polypeptides with unique, defined sequences,true chemical entities,required extraordinary specificity of the aminoacylation reaction. This high specificity was achieved by editing activities that clear errors of aminoacylation and thereby prevent mistranslation. Defects in editing activities can be lethal and lead to pathologies in mammalian cells in culture. Even a mild defect in editing is casually associated with neurological disease in the mouse. Defects in editing are also mutagenic in an aging organism and suggest how mistranslation can lead to mutations that are fixed in the genome. Thus, clearance of mischarged tRNAs by the editing activities of tRNA synthetases was essential for development of the tree of life and has a role in the etiology of diseases that is just now being understood. [source] Case for mandatory fortification of food with folate in Australia, for the prevention of neural tube defectsBIRTH DEFECTS RESEARCH, Issue 11 2004Carol Bower BACKGROUND Since the publication of randomized controlled trials demonstrating the prevention of neural tube defects (NTDs) with periconceptional folate, several Australian states have promoted an increase in periconceptional use of folic acid supplements. Since 1996, voluntary fortification of food with folate has been allowed in Australia and New Zealand for the purpose of preventing NTDs. METHODS For this report, we synthesized published and unpublished data on folic acid supplement use, voluntary fortification, and trends in NTDs. RESULTS There has been an increase in the proportion of women (up to 30,40%) taking periconceptional folic acid supplements in Australia, and many foods (mainly breakfast cereals) are fortified. Supplement use is strongly correlated with educational and socioeconomic status; consumption of voluntarily fortified foods is not. There has been a fall in NTDs of about 30% in the non-Aboriginal population, but no change has been seen in the Aboriginal population. CONCLUSIONS These data support mandatory fortification of food as a more equitable approach to achieving sufficient folate intake in the periconceptional period for all women in Australia and New Zealand to prevent the majority of NTDs in their offspring. In May 2004, based on these and other considerations, the Australia and New Zealand Food Regulation Ministerial Council agreed that mandatory fortification of food with folate should be considered as a priority. Birth Defects Research (Part A), 2004. © 2004 Wiley-Liss, Inc. [source] Randomised controlled trial comparing the efficacy of same-day administration of mifepristone and misoprostol for termination of pregnancy with the standard 36 to 48 hour protocolBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2007J Guest Objective, To determine the efficacy of oral mifepristone followed by vaginal misoprostol 6 hours later compared with the standard 36- to 48-hour regimen for medical termination of pregnancy. Design, Single centre, two arm, parallel, open randomised controlled trial. Setting, Medical termination service at a teaching hospital. Sample, Four hundred and fifty women undergoing medical termination of pregnancy at up to 63 days of gestation. Methods, Eligible women were randomised to receive mifepristone 200 mg orally followed by vaginal misoprostol 800 micrograms either 6 hours (n= 225) or 36,48 hours (n= 225) later. All participants were invited to attend for a follow-up pelvic ultrasound scan within 7 days following the misoprostol administration. For those women in whom products of conception remained at the follow-up ultrasound scan, expectant management ensued with weekly follow-up ultrasound scans until the termination was complete. They could elect to undergo an evacuation of uterus at any stage following the scan. Those women with a nonviable gestation sac at the follow-up scan were offered a further dose of vaginal misoprostol 800 micrograms or suction termination of pregnancy. Women with a continuing pregnancy were managed with surgical termination. Main outcome measure, Successful medical abortion defined as no requirement for medical or surgical intervention beyond the initial dose of misoprostol. Results, One hundred and sixty-five women (79%) in the 6-hour group and 197 women (92%) in the 36- to 48-hour group had a successful termination at first follow-up ultrasound or presumed on the basis of other considerations (those not seen for ultrasound but deemed successful by negative pregnancy test, products passed on ward or long-term assessment of notes). Twenty-two women (10%) in the 6-hour regimen required up to three further ultrasound scans after 7 days following the mifepristone administration in order to ensure that the termination process was complete. None of these women required a suction evacuation of uterus. In the 36- to 48-hour regimen, ten (5%) women had up to two further ultrasound scans to confirm a complete termination without the need for a surgical evacuation of uterus. Therefore, the overall successful termination rate in the 6-hour regimen was 89% (187/210) compared with 96% (207/215) in the 36- to 48-hour regimen (relative risk = 0.92, 95% CI 0.84,0.98). Repeat administration of misoprostol or surgical treatment was required in 23 women (11%) in the 6-hour group and 8 women (4%) in the 36- to 48-hour group. A viable pregnancy was found in five women (2%) in the 6-hour group and in three women (1%) in the 36- to 48-hour group. Conclusions, Oral mifepristone 200 mg followed by vaginal misoprostol 800 micrograms after 6 hours is not as effective at achieving a complete abortion compared with the 36- to 48-hour protocol. [source] Administrative discretion and the Access to Information Act: An "internal law" on open government?CANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 2 2002Alasdair Roberts However, critics complain that some politically sensitive requests - often filed by journalists or political parties - are given differential treatment, with longer delays and tougher decisions on disclosure. An econometric analysis of 2,120 requests handled by Human Resources Development Canada in 1999,2001 suggests that the complaints have some merit. Requests that were identified as sensitive, or that came from the media or political parties, were found to have longer processing time, even after other considerations were accounted for. The probability that such requests would exceed statutory response times was also significantly higher. The analysis illustrates a broader point: that internal bureaucratic procedures play an important role in defining what the right to information means in practice. The analysis also highlights the need to give the federal information commissioner better tools to deal with problems of delay. Sommaire: La Loi sur l'accès à l'information du Canada assure le droit à l'information gouvernementale pour tous les Canadiens. Cependant, les critiques se plaignent du fait que certaines demandes épineuses sur le plan politique - requêtes souvent déposées par des journalistes ou des partis politiques - font l'objet d'un traitement différentiel, avec des délais plus longs et des décisions plus strictes au moment de la divulgation. Une analyse économétrique de 2 120 requêtes traitées par Développement des Ressources humaines Canada de 1999 à 2001 laisse entendre que les plaintes sont en partie justifiées. On a constaté que les requêtes dites «sensibles», ou qui viennent des média ou des partis politiques, prenaient plus de temps à traiter, même compte tenu d'autres considérations. En outre, ces requêtes risquaient souvent de dé passer le temps de réponse légal. L'analyse illustre un point plus général, à savoir que les procédures bureaucratiques internes jouent un rôle important en définissant ce que le droit à l'information signifie dam la pratique. L'analyse souligne également qu'il est néessaire de dormer au Commissaire fédéral à l'information de meilleurs outils pour faire face aux problèmes de délai. [source] Growth in weight and lengthACTA PAEDIATRICA, Issue 4 2003RG Whitehead Some of the complex factors that can affect growth in weight but especially in height are discussed. It is emphasized that although due attention needs to be paid to diet and the regular provision of the extra macro- and micro-nutrients needed during catch-up growth, other considerations are just as important. Conclusion: As well as dealing with the problem of poor sanitation and consequent frequent infection in developing countries, social stimulation and the restoration of a feeling of well-being and general happiness can be just as important. [source] | |||||||||||||