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Pressing Need (pressing + need)
Selected AbstractsProfessional Development of Nursing in Saudi ArabiaJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2001Gail Tumulty Purpose: To describe the development of nursing in Saudi Arabia and to recommend further directions for development of professional nursing in that country. Organizing Construct: A comprehensive needs assessment was performed in 1996 by an onsite consultant to: (a) evaluate the existing nursing system at the ministry, regional, and hospital levels, (b) describe the functional interrelationships of a nursing division within the Ministry of Health, and (c) prepare a work plan outlining the program elements that a nursing division could address to foster high-quality health care in the public sector. Methods: The needs assessment was conducted through direct observation, interviews, and review of existing documents in the Ministry of Health and representative hospitals, health centers, and health institutes. Data were collected about six factors as they pertained to the Ministry of Health Nursing Services: (a) key organizational and managerial activities, (b) the external environment, (c) the social system, (d) employees, (e) nursing services and research, and (f) formal organizational arrangements. Findings and Conclusions: The data showed a young country and an equally young nursing profession struggling to meet the needs of a growing population. The highest priority for the advancement of nursing in Saudi Arabia is the creation of a kingdom-wide system of nurse regulation. Pressing needs include regulation of professional standards, licensure of all nurses practicing in the Kingdom, accreditation of educational programs, and formation of a national nurses association. [source] Practical Assessment of Maternal Cardiovascular Risk in PregnancyCONGENITAL HEART DISEASE, Issue 5 2008Nazanin Moghbeli MD ABSTRACT Cardiovascular disease in pregnancy is the most common cause of maternal mortality in the developed world and an important cause of heart failure, stroke, and arrhythmia. As more children with congenital heart disease survive into adulthood, there is a more pressing need to understand the risks that pregnancy poses for these women. Pregnancy, labor, and delivery increase the hemodynamic stress on the cardiovascular system and place women with heart disease at increased risk of cardiovascular complications, which include heart failure and death. Systematic assessment of pregnancy risk in these women, ideally before conception, is essential in optimizing maternal and fetal outcomes. This article describes the process of assessing risk of pregnancy-associated cardiovascular complications in women with structural heart disease. We review the current literature on pregnancy risk in women with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy, and suggest an approach to risk stratification. Based on a review of the literature, we report features that pose an increased risk of adverse maternal and fetal outcomes, which include poor maternal functional status; prior history of heart failure, arrhythmia, or cerebral vascular events; cyanosis; poor systemic ventricular function; and severe aortic or mitral stenosis. Pulmonary hypertension and Eisenmenger syndrome place women at exceedingly high risk for cardiovascular complications in pregnancy, including maternal and fetal death. [source] Health-promoting physical activity of adults with mental retardationDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 1 2006Heidi I. Stanish Abstract This literature review describes the physical activity behavior of adults with mental retardation consistent with the U.S. Surgeon General's recommendation of 30 minutes of moderate intensity physical activity on 5 or more days per week. The proportion of participants achieving this criterion ranges from 17.5 to 33%. These data are likely to be generous estimates of activity as individuals included in physical activity studies to date have been relatively young and healthy volunteers with mild to moderate limitations. Major sources of physical activity were walking and cycling for transport, chores and work, dancing, and Special Olympics. There is a pressing need to conduct studies using appropriately powered representative samples and to validate measures that assess physical activity less directly; including methodologies in which proxy respondents are used. Accurate information about existing patterns of behavior will enhance the development of effective strategies to promote physical activity among persons with mental retardation. MRDD Research Reviews 2006;12:13,21. © 2006 Wiley-Liss, Inc. [source] Elusive '68: The Challenge to PedagogyDIE UNTERRICHTSPRAXIS/TEACHING GERMAN, Issue 2 2008William Collins Donahue Teaching ,68 presents pedagogical challenges far greater than assembling a set of workable classroom materials. Divisive controversies that were the hallmark of the time,e.g., the debate over the nature and appropriate use of violence,are with us still, though in a somewhat different form. Further, the instructor,s own politics and positionality can hardly be ignored,as they will certainly not be overlooked by our students. Additionally, this essay argues that fundamental terms (such as who qualifies as a ,68er) remain problematic; that the instrumentalization of the Holocaust by the German New Left continues to affect political decisions down to the present; that our investment as teachers in poststructuralist literary theory may,perhaps inadvertently,affect the way we view and therefore teach ,68; and, finally, that there is a pressing need, despite a recent explosion in Germany of publications celebrating the fortieth anniversary of ,68, for a didacticized reader designed for the North American German Studies classroom. [source] The Emergency Medical Treatment and Labor Act as a Federal Health Care Safety Net ProgramACADEMIC EMERGENCY MEDICINE, Issue 11 2001W. Wesley Fields MD Abstract Despite the greatest economic expansion in history during the 1990s, the number of uninsured U.S. residents surpassed 44 million in 1998. Although this number declined for the first time in recent years in 1999, to 42.6 million, the current economic slow-down threatens once again to increase the ranks of the uninsured. Many uninsured patients use hospital emergency departments as a vital portal of entry into an access-improverished health care system. In 1986, Congress mandated access to emergency care when it passed the Emergency Medical Treatment and Labor Act (EMTALA). The EMTALA statute has prevented the unethical denial of emergency care based on inability to pay; however, the financial implications of EMTALA have not yet been adequately appreciated or addressed by Congress or the American public. Cuts in payments from public and private payers, as well as increasing demands from a larger uninsured population, have placed unprecedented financial strains on safety net providers. This paper reviews the financial implications of EMTALA, illustrating how the statute has evolved into a federal health care safety net program. Future actions are proposed, including the pressing need for greater public safety net funding and additional actions to preserve health care access for vulnerable populations. [source] Interplay between global patterns of environmental temperature and variation in nonshivering thermogenesis of rodent species across large spatial scalesGLOBAL CHANGE BIOLOGY, Issue 9 2009ENRIQUE RODRÍGUEZ-SERRANO Abstract The purpose of this study was to test for correlations of mass-independent nonshivering thermogenesis (NST) in rodent species with climatic factors such as maximum and minimum geographic temperature. We first analyzed whether the responses of rodents show a phylogenetic signal. If so, and if the NST over a broad geographical range is similar, then such responses probably reflect physiological evolutionary adaptation. Our results show that NST did not show phylogenetic signal, appears to be evolutionary labile and is negatively correlated with environmental temperature. We predicted that species evolved in cold climates will exhibit higher mass-independent NST than species from warmer habitats. Indeed, we observed that the relationships between mass-independent NST and minimum temperature (rs=,0.411, P=0.009) as well as between NST and maximum temperature (rs=,0.443, P=0.004) were both negatively and significantly correlated, thus supporting our predictions. Thus, thermal physiology may be a significant factor underlying the ecological and evolutionary success of animals. Finally we suggest that due to the pressing need to explain and predict the likely biological impact of climatic change, advances in this field are necessary. [source] Getting the biodiversity intactness index right: the importance of habitat degradation dataGLOBAL CHANGE BIOLOGY, Issue 11 2006MATHIEU ROUGET Abstract Given high-level commitments to reducing the rate of biodiversity loss by 2010, there is a pressing need to develop simple and practical indicators to monitor progress. In this context, a biodiversity intactness index (BII) was recently proposed, which provides an overall indicator suitable for policy makers. The index links data on land use with expert assessments of how this impacts the population densities of well-understood taxonomic groups to estimate current population sizes relative to premodern times. However, when calculated for southern Africa, the resulting BII of 84% suggests a far more positive picture of the state of wild nature than do other large-scale estimates. Here, we argue that this discrepancy is in part an artefact of the coarseness of the land degradation data used to calculate the BII, and that the overall BII for southern Africa is probably much lower than 84%. In particular, based on two relatively inexpensive, ground-truthed studies of areas not generally regarded as exceptional in terms of their degradation status, we demonstrate that Scholes and Biggs might have seriously underestimated the extent of land degradation. These differences have substantial bearing on BII scores. Urgent attention should be given to the further development of cost-effective ground-truthing methods for quantifying the extent of land degradation in order to provide reliable estimates of biodiversity loss, both in southern Africa and more widely. [source] Does early medical intervention have a role in the management of intracerebral haemorrhage?INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2008A. Bhalla Summary Introduction:, An increasing amount of research is now being directed towards the medical treatment of patients who have suffered an intracerebral haemorrhage (ICH). Despite this, no routine drug treatment to date has been shown to be unequivocally effective in unselected patients. Treatments/Discussion:, Approaches to treatment are based upon our understanding of the pathophysiological sequelae following ICH. Strategies to reduce haematoma growth, subsequent oedema formation and perihaematoma ischaemia are key targets for further research. Whether these therapies become valuable tools for the future is as yet unclear. Until then, the mainstay of the medical management of ICH remains individualised care. Conclusions:, There is now a pressing need for large prospective randomised controlled trials to determine the effectiveness of pharmacological therapies for this condition. [source] Doing sensory ethnography in consumer researchINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 4 2010Anu Valtonen Abstract This paper is a contribution to sensory-aware cultural consumer research. It suggests that while the audio-visual domain is unquestionably a crucial ingredient of contemporary consumer culture, there is a pressing need to explore the role of the other senses as well. The study works towards a practice-based culturalist approach to sensory ethnography, a perspective that allows consumer scholars to empirically account for the cultural aspects of the senses. Through an empirical case study on sport fishing, the paper scrutinizes the challenges and opportunities related to conducting sensory ethnography. In addition, it discusses the benefits of this approach in consumer research. [source] Using the moving average rule in a dynamic web recommendation systemINTERNATIONAL JOURNAL OF INTELLIGENT SYSTEMS, Issue 6 2007Yi-Jen Su In this, the Information Age, most people are accustomed to gleaning information from the World Wide Web. To survive and prosper, a Web site has to constantly enliven its content while providing various and extensive information services to attract users. The Web Recommendation System, a personalized information filter, prompts users to visit a Web site and browse at a deeper level. In general, most of the recommendation systems use large browsing logs to identify and predict users' surfing habits. The process of pattern discovery is time-consuming, and the result is static. Such systems do not satisfy the end users' goal-oriented and dynamic demands. Accordingly, a pressing need for an adaptive recommendation system comes into play. This article proposes a novel Web recommendation system framework, based on the Moving Average Rule, which can respond to new navigation trends and dynamically adapts recommendations for users with suitable suggestions through hyperlinks. The framework provides Web site administrators with various methods to generate recommendations. It also responds to new Web trends, including Web pages that have been updated but have not yet been integrated into regular browsing patterns. Ultimately, this research enables Web sites with dynamic intelligence to effectively tailor users' needs. © 2007 Wiley Periodicals, Inc. Int J Int Syst 22: 621,639, 2007. [source] Performativity and helping professions: social theory, power and practiceINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 3 2007Jason L. Powell Drawing on Judith Butler's conception of ,performativity', we would argue that the notion has important implications for contemporary debates in international social welfare over agency, subjection and ,resistance'. Professional social workers embedded in discursive institutions function according to particular expectations around performativity. In addition, this organisational context is complex with multiple demands. In light of technologies of surveillance and control in contemporary social work, performativity offers a response to the pressing need to expand notions of worker opposition beyond traditional forms of organised dissent towards the production of subjective space. [source] Utilization of research findings by graduate nurses and midwivesJOURNAL OF ADVANCED NURSING, Issue 2 2004V. Veeramah BSc MSc RMN RNT Background., There is mounting pressure on nurses and midwives in the United Kingdom to use research findings to inform their practice. However, many still find research difficult to understand and are poorly prepared by education to make use of it. Hence, there is a pressing need to evaluate the research education included in nursing and midwifery curricula. Aim., This paper reports a study assessing the impact of research education on the attitudes towards research and use of research findings in practice by graduate nurses and midwives. Method., A cross-sectional survey using a self-completed postal questionnaire was conducted with a sample of 340 nurse and midwife graduates in the South East of England. Findings., A response rate of 51% was obtained. A large number of respondents stated that their critical appraisal (96%) and search skills (87%) had improved following graduation and they reported using research findings in practice (16·8% all the time, 50·5% frequently and 32·6% sometimes). Furthermore, the majority expressed positive attitudes towards research and these were related to the research education received. However, a significant number reported finding statistics difficult to understand, lack of time to read research and limited access to research findings at their place of work. Also, a number of respondents would still like more help with searching the literature, implementing research findings in practice and developing their critical appraisal skills further. Conclusion., It is crucial that some of the major barriers to research utilization are addressed at both individual and organizational levels if evidence-based care is to become a reality. Also, health service managers should consider a number of strategies suggested by respondents to increase the use of research findings in clinical settings. [source] Interferon regulatory factor-1 acts as a powerful adjuvant in tat DNA based vaccination,JOURNAL OF CELLULAR PHYSIOLOGY, Issue 3 2010Arianna Castaldello Genetic vaccines are safe cost-effective approaches to immunization but DNA immunization is an inefficient process. There is, therefore, a pressing need for adjuvants capable of enhancing the immunogenicity and effectiveness of these vaccines. This is particularly important for diseases for which successful vaccines are still lacking, such as cancer and infectious diseases including HIV-1/AIDS. Here we report an approach to enhance the immunogenicity of DNA vaccines involving the use of transcription factors of the Interferon regulatory factor (IRF) family, specifically IRF-1, IRF-3, and IRF-7 using the tat gene as model antigen. Balb/c mice were immunized by three intramuscular inoculations, using a DNA prime-protein boost protocol, with a DNA encoding tat of HIV-1 and the indicated IRFs and immune responses were compared to those induced by vaccination with tat DNA alone. In vivo administration of plasmid DNA encoding IRF-1, or a mutated version of IRF-1 deleted of the DNA-binding domain, enhanced Tat-specific immune responses and shifted them towards a predominant T helper 1-type immune response with increased IFN-, production and cytotoxic T lymphocytes responses. Conversely, the use of IRF-3 or IRF-7 did not affect the tat -induced responses. These findings define IRF-1 and its mutated form as efficacious T helper 1-inducing adjuvants in the context of tat- based vaccination and also providing a new promising candidate for genetic vaccine development. J. Cell. Physiol. 224: 702,709, 2010. © 2010 Wiley-Liss, Inc. [source] Review: Microscale methods for high-throughput chromatography development in the pharmaceutical industryJOURNAL OF CHEMICAL TECHNOLOGY & BIOTECHNOLOGY, Issue 7 2009Sunil Chhatre Abstract Demands within the pharmaceutical sector to cut costs and improve process efficiencies have grown considerably in recent years. Major challenges exist for companies trying to establish financially viable and robust manufacturing processes for increasingly complex therapeutics. These issues have driven the investigation of miniaturised process-design techniques by which to identify suitable operating conditions using small volumes of feed material typical of that available in the early stages of bioprocess development. Such techniques are especially valuable for the optimisation of chromatographic separations, which often represent a significant percentage of manufacturing costs and hence for which there is a pressing need to determine the best operating policies. Several methods employing microlitre volumes of sample and resin have been explored recently, which are aimed at the high-throughput and cost-effective exploration of the design space for chromatographic separations. This methodology paper reviews these microscale approaches and describes how they work, gives examples of their application, discusses their advantages and disadvantages and provides a comparative assessment of the different methods, along with a summary of the challenges that remain to be overcome in relation to these techniques. Copyright © 2009 Society of Chemical Industry [source] Mapping space for water: screening for urban flash floodingJOURNAL OF FLOOD RISK MANAGEMENT, Issue 1 2008B. Hankin Abstract This paper builds on the ,Flooding from Other Sources' project (HA4a), funded as part of Defra's Making Space for Water strategy. The HA4a study concluded that flood risk mapping is feasible for many of the sources of flooding that were investigated, which are not currently covered by the Environment Agency Flood Map, using existing flow modelling and GIS tools. However, there are some major constraints in terms of the need to undertake extensive data collection to allow the generation of useful flood maps that are not dominated by modelling uncertainties. The project anticipated that different levels of data collection and modelling might be needed for different purposes, given the hierarchical nature of UK flood risk assessment and management in the United Kingdom under PPS25 and the EC Floods Directive. This paper compares and contrasts three different approaches to urban flood modelling using topographic analysis, blanket extreme rainfall and semi-coupled sewer/overland routing. The UK summer floods 2007 have highlighted the pressing need for mapping the risk from urban flash flooding, and the Pitt Review has recommended that areas at high risk from surface waters should be urgently identified. This can be done now at some level of detail, and we can be guided as to what level, from our increasing knowledge of vulnerable populations, from records of historical flooding and by using some of the screening methods described herein. [source] Emulsion-Based Delivery Systems for Lipophilic Bioactive ComponentsJOURNAL OF FOOD SCIENCE, Issue 8 2007D.J. McClements ABSTRACT:, There is a pressing need for edible delivery systems to encapsulate, protect, and release bioactive lipids within the food, medical, and pharmaceutical industries. The fact that these delivery systems must be edible puts constraints on the type of ingredients and processing operations that can be used to create them. Emulsion technology is particularly suited for the design and fabrication of delivery systems for encapsulating bioactive lipids. This review provides a brief overview of the major bioactive lipids that need to be delivered within the food industry (for example, ,-3 fatty acids, carotenoids, and phytosterols), highlighting the main challenges to their current incorporation into foods. We then provide an overview of a number of emulsion-based technologies that could be used as edible delivery systems by the food and other industries, including conventional emulsions, multiple emulsions, multilayer emulsions, solid lipid particles, and filled hydrogel particles. Each of these delivery systems could be produced from food-grade (GRAS) ingredients (for example, lipids, proteins, polysaccharides, surfactants, and minerals) using simple processing operations (for example, mixing, homogenizing, and thermal processing). For each type of delivery system, we describe its structure, preparation, advantages, limitations, and potential applications. This knowledge can be used to facilitate the selection of the most appropriate emulsion-based delivery system for specific applications. [source] PROPOSAL OF ECTOCARPUS SILICULOSUS (ECTOCARPALES, PHAEOPHYCEAE) AS A MODEL ORGANISM FOR BROWN ALGAL GENETICS AND GENOMICS,JOURNAL OF PHYCOLOGY, Issue 6 2004Akira F. Peters The emergence of model organisms that permit the application of a powerful combination of genomic and genetic approaches has been a major factor underlying the advances that have been made in the past decade in dissecting the molecular basis of a wide range of biological processes. However, the phylogenetic distance separating marine macroalgae from these model organisms, which are mostly from the animal, fungi, and higher plant lineages, limits the latters' applicability to problems specific to macroalgal biology. There is therefore a pressing need to develop similar models for the macroalgae. Here we describe a survey of potential model brown algae in which particular attention was paid to characteristics associated with a strong potential for genomic and genetic analysis, such as a small nuclear genome size, sexuality, and a short life cycle. Flow cytometry of nuclei isolated from zoids showed that species from the Ectocarpales possess smaller haploid genomes (127,290 Mbp) than current models among the Laminariales (580,720 Mbp) and Fucales (1095,1271 Mbp). Species of the Ectocarpales may complete their life histories in as little as 6 weeks in laboratory culture and are amenable to genetic analyses. Based on this study, we propose Ectocarpus siliculosus (Dillwyn) Lyngbye as an optimal choice for a general model organism for the molecular genetics of the brown algae. [source] Malaria in Brazilian Military Personnel Deployed to AngolaJOURNAL OF TRAVEL MEDICINE, Issue 5 2000COL L. Jose Sanchez Background: Malaria represents one of the most important infectious disease threats to deployed military forces; most personnel from developed countries are nonimmune personnel and are at high risk of infection and clinical malaria. This is especially true for forces deployed to highly-endemic areas in Africa and Southeast Asia where drug-resistant malaria is common. Methods: We conducted an outbreak investigation of malaria cases in Angola where a total of 439 nonimmune Brazilian troops were deployed for a 6-month period in 1995,1996. A post-travel medical evaluation was also performed on 338 (77%) of the 439 soldiers upon return to Brazil. Questionnaire, medical record, thick/thin smear, and serum anti- Plasmodium falciparum antibody titer (by IFA) data were obtained. Peak serum mefloquine (M) and methylmefloquine (MM) metabolite levels were measured in a subsample of 66 soldiers (42 cases, 24 nonmalaria controls) who were taking weekly mefloquine prophylaxis (250 mg). Results: Seventy-eight cases of malaria occurred among the 439 personnel initially interviewed in Angola (attack rate = 18%). Four soldiers were hospitalized, and 3 subsequently died of cerebral malaria. Upon return to Brazil, 63 (19%) of 338 soldiers evaluated were documented to have had clinical symptoms and a diagnosis of malaria while in Angola. In addition, 37 (11%) asymptomatically infected individuals were detected upon return (< 1% parasitemia). Elevated, post-travel anti- P. falciparum IFA titers (, 1:64) were seen in 101 (35%) of 292 soldiers tested, and was associated with a prior history of malaria in-country (OR = 3.67, 95% CI 1.98,6.82, p < .001). Noncompliance with weekly mefloquine prophylaxis (250 mg) was associated with a malaria diagnosis in Angola (OR = 3.75, 95% CI 0.97,17.41, p = .03) but not with recent P. falciparum infection (by IFA titer). Mean peak levels (and ratios) of serum M and MM were also found to be lower in those who gave a history of malaria while in Angola. Conclusions: Malaria was a significant cause of morbidity among Brazilian Army military personnel deployed to Angola. Mefloquine prophylaxis appeared to protect soldiers from clinical, but not subclinical, P. falciparum infections. Mefloquine noncompliance and an erratic chemoprophylaxis prevention policy contributed to this large outbreak in nonimmune personnel. This report highlights the pressing need for development of newer, more efficacious and practical, prophylactic drug regimens that will reduce the malaria threat to military forces and travelers. [source] Recent trends in the total characterization of new-generation base fluidsLUBRICATION SCIENCE, Issue 2 2001I. D. Singh Abstract The quality of lubricating base oils used worldwide is changing rapidly as a result of stringent environmental regulation and the pressing need for oils to perform well under severe operating conditions. For example, although the base oil market in India now depends entirely on conventional group I base oils, group II and III base oils will soon be mandatory in lubrication formulation. These oils are generally more stable towards oxidation due to the virtual absence of heteroatom-containing compounds and to their low aromatic content. The analytical procedures developed over the years for the characterization of new and used group I mineral base oils will not be successful for all the requirements of these new oils. Thus, a systematic study is required to test the universal validity of characterisation methodology for these new-generation base fluids. This paper focuses on the use of various analytical techniques for base oil characterization and the methodology required for the total characterization of new-generation base oils. [source] Capillary Hemodynamics and Oxygen Pressures in the Aging MicrocirculationMICROCIRCULATION, Issue 4 2006DAVID C. POOLE ABSTRACT Healthy aging acts to redistribute blood flow (Q,) and thus O2 delivery (Q,O2) among and within the exercising muscles such that Q,O2 to highly oxidative muscle fibers may be compromised. Within the microcirculation of old muscles capillary hemodynamics are altered and the matching of Q,O2 to oxidative requirements (V,O2) is impaired such that at exercise onset the microvascular O2 pressure falls below that seen in their younger counterparts. This is important because the microvascular O2 pressure denotes the sole driving force for blood-myocyte O2 transfer and any compromise may slow V,O2 kinetics and reduce exercise tolerance. This review considers the microcirculatory evidence for a reduced perfusive (Q,O2) and diffusive O2 flux within aged muscle and highlights the pressing need for intravital microscopy studies of the muscle microcirculation during exercise. [source] Is There a Role for Statins in Atrial Fibrillation?PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2009DAVID E. DAWE M.D. 3-Hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statins) are some of the most commonly prescribed drugs in the world. While lipid modification remains the primary function of statins, there has been increasing interest in its potential pleiotropic effects, particularly as an anti-inflammatory agent in its role as an antiarrhythmic. Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice and carries with it a significant burden in both morbidity and mortality. Treatment for AF currently involves either rate or rhythm control where both have demonstrable associated risks. Rate control necessitates anticoagulation, which can cause life-threatening bleeding, while rhythm control has a poor side-effect profile that may lead to greater mortality and may not completely eliminate the need for anticoagulation. Considering this pressing need for novel therapeutic interventions in AF, this long overdue systematic review explores the potential role of statins in the treatment and prevention of AF. Physicians, especially cardiologists, need to be aware of the host of currently available literature and, more importantly, need to be stimulated to generate discussion and formulate studies that will help debate the issues under the most erudite standards. [source] Closed-Loop Supply Chains: An Introduction to the Feature Issue (Part 1)PRODUCTION AND OPERATIONS MANAGEMENT, Issue 3 2006V. Daniel R. Guide Jr. Closed-loop supply chains (CLSC) have product returns at the center of attention. Our view is that CLSC are best managed from a business perspective where organizations seek to maximize value recovery. The research in the feature issue, and our experiences, shows that there are still numerous, unresolved, managerially relevant issues that deserve further investigation. We also observe that there is a pressing need to validate the assumptions in our models using interdisciplinary, industry-driven research. The time is right for production and operations management to play a central role in the sustainability movement slowly taking hold in practice. [source] A glimpse into the clinical proteome of human malaria parasites Plasmodium falciparum and Plasmodium vivaxPROTEOMICS - CLINICAL APPLICATIONS, Issue 11 2009Pragyan Acharya Abstract Malaria causes a worldwide annual mortality of about a million people. Rapidly evolving drug-resistant species of the parasite have created a pressing need for the identification of new drug targets and vaccine candidates. By developing fractionation protocols to enrich parasites from low-parasitemia patient samples, we have carried out the first ever proteomics analysis of clinical isolates of early stages of Plasmodium falciparum (Pf) and P. vivax. Patient-derived malarial parasites were directly processed and analyzed using shotgun proteomics approach using high-sensitivity MS for protein identification. Our study revealed about 100 parasite-coded gene products that included many known drug targets such as Pf hypoxanthine guanine phosphoribosyl transferase, Pf L -lactate dehydrogenase, and Plasmepsins. In addition, our study reports the expression of several parasite proteins in clinical ring stages that have never been reported in the ring stages of the laboratory-cultivated parasite strain. This proof-of-principle study represents a noteworthy step forward in our understanding of pathways elaborated by the parasite within the malaria patient and will pave the way towards identification of new drug and vaccine targets that can aid malaria therapy. [source] Politics and the numinous: evolution, spiritual emergency, and the re-emergence of transpersonal consciousnessPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 3 2008Mick Collins Abstract Philosopher Herbert Marcuse observed in 1964 that modern people's materialistic and consumer-based lifestyles have resulted in societies becoming more one dimensional, which has contributed to a growing attitude of ,uncritical conformity'. Marcuse advocated that in order to transcend a one-dimensional existence people will have to engage and actualize their human potential. The increasing environmental and ecological crisis that is confronting the world today identifies a pressing need for change and adaptation at all levels of society including governments, businesses, individual and collective consciousness. The transformation of a one-dimensional consumer-based society will require people and societies to engage different dimensions of conscious experience in order to bring about change. This article discusses how developments within human consciousness have evolved in conjunction with spiritual capacities and how collective ritual encounters with the numinous have contributed to developments in the human brain, mind and culture. I propose that the modern phenomenon of spiritual emergencies can be evaluated from an evolutionary perspective, which may be revealing transformational patterns within consciousness that go beyond a one-dimensional materialistic existence. Spiritual emergency reinforces the need for spiritual awareness to challenge the one-sided materialistic consciousness prevalent within modern consumer based societies. The process of psycho-spiritual transformation could lead to a resacralized socio-political vision and validation of a re-emergent transpersonal consciousness. Copyright © 2008 John Wiley & Sons, Ltd. [source] WHAT WORKS BEST WHEN CONTRACTING FOR SERVICES?PUBLIC ADMINISTRATION, Issue 4 2007AN ANALYSIS OF CONTRACTING PERFORMANCE AT THE LOCAL LEVEL IN THE US During the last decade the field of public administration has undergone a period of renewed interest in the topic of performance and effectiveness. Key contributions to the growing stream of research on public sector performance include work focusing on the adoption and implementation of performance measurement in the public sector (see, for example, Julnes and Holzer 2001; Behn 2003); theoretical and empirical research on management's effect on organizational performance (see, for example, O'Toole and Meier 1999; Meier and O'Toole 2002); and efforts to identify the determinants of organizational effectiveness (see, for example, Rainey and Steinbauer 1999; Brewer and Selden 2004). Surprisingly, this literature includes very few studies that explicitly address the issue of performance in contracting for services (exceptions include Domberger and Hensher 1993; Romzek and Johnstone 2002). In the United States alone, hundreds of billions of dollars are contracted out every year, and innumerable policies and programmes are implemented, at least in part, through contractual arrangements between public agencies and private providers (Savas 2000; DeHoog and Salamon 2002; Kelman 2002; Cooper 2003). Moreover, contracting for services appears to be a growing trend in Western Europe and other regions (Kettl 2000; Savas 2000). With the stakes so high, there is a pressing need for research that identifies factors and practices that contribute to success in contracting for services. This paper takes on the challenge by developing a model of contracting performance and testing it using Substantively Weighted Analytic Techniques (SWAT), a new methodology that allows researchers to isolate high performance among a large number of observations in order to identify variables practitioners can manipulate to improve practice (Meier and Gill 2000). [source] Effects of stress management on PNI-based outcomes in persons with HIV diseaseRESEARCH IN NURSING & HEALTH, Issue 2 2003Nancy L. McCain Abstract A pretest,posttest, repeated-measures design was used to evaluate the effects of two stress management interventions on a battery of outcomes derived from a psychoneuroimmunological (PNI) framework. The effects of cognitive-behavioral relaxation training groups (CBSM) and social support groups (SSG) were compared with a WAIT-listed control group on the outcomes of psychosocial functioning, quality of life, neuroendocrine mediation, and somatic health. Participants were 148 individuals (119 men, 29 women), diagnosed with HIV disease; 112 (76%) completing the study groups. Using analysis of covariance, the CBSM group was found to have significantly higher postintervention emotional well-being and total quality-of-life scores than did either the SSG or WAIT groups. SSG participants had significantly lower social/family well-being scores immediately postintervention and lower social support scores after 6 months. The findings point to a pressing need for further, well-controlled research with these common intervention modalities. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:102,117, 2003 [source] The Use of Extant Non-Indigenous Tortoises as a Restoration Tool to Replace Extinct Ecosystem EngineersRESTORATION ECOLOGY, Issue 1 2010Christine J. Griffiths We argue that the introduction of non-native extant tortoises as ecological replacements for extinct giant tortoises is a realistic restoration management scheme, which is easy to implement. We discuss how the recent extinctions of endemic giant Cylindraspis tortoises on the Mascarene Islands have left a legacy of ecosystem dysfunction threatening the remnants of native biota, focusing on the island of Mauritius because this is where most has been inferred about plant,tortoise interactions. There is a pressing need to restore and preserve several Mauritian habitats and plant communities that suffer from ecosystem dysfunction. We discuss ongoing restoration efforts on the Mauritian offshore Round Island, which provide a case study highlighting how tortoise substitutes are being used in an experimental and hypothesis-driven conservation and restoration project. The immediate conservation concern was to prevent the extinction and further degradation of Round Island's threatened flora and fauna. In the long term, the introduction of tortoises to Round Island will lead to valuable management and restoration insights for subsequent larger-scale mainland restoration projects. This case study further highlights the feasibility, versatility and low-risk nature of using tortoises in restoration programs, with particular reference to their introduction to island ecosystems. Overall, the use of extant tortoises as replacements for extinct ones is a good example of how conservation and restoration biology concepts applied at a smaller scale can be microcosms for more grandiose schemes and addresses more immediate conservation priorities than large-scale ecosystem rewilding projects. [source] Toward the development of new medicinal leads with selectivity for protein kinase C isozymesTHE CHEMICAL RECORD, Issue 4 2005Kazuhiro Irie Abstract Tumor promoters such as phorbol esters bind strongly to protein kinase C (PKC) isozymes to induce their activation. Since each PKC isozyme is involved in diverse biological events in addition to tumor promotion, the isozymes serve as promising therapeutic targets. Tumor promoters bind to the C1A and/or C1B domain of conventional (,, ,I, ,II, and ,) and novel PKC isozymes (,, ,, ,, and ,). As these C1 domains play differential roles in PKC activation and their translocation in cells, the development of agents with binding selectivity for individual C1 domains is a pressing need. For this purpose, we established a synthetic C1 peptide library of all PKC isozymes. The library enabled us to identify indolactam-V (1) as a promising lead compound. Our diverse structure,activity studies on 1 indicated that the position of the hydrophobic substituent on the indole ring dominates the PKC isozyme- and C1 domain-selective binding rather than conformation of the nine-membered lactam. Moreover, we suggested that the indole ring of 1 could be involved in the CH/, interaction with Pro-11 of the C1B domain of PKC,. This invaluable information will lead to the structural optimization of the PKC, ligand as exemplified by the design and synthesis of naphtholactam-V8 (21). © 2005 The Japan Chemical Journal Forum and Wiley Periodicals, Inc. Chem Rec 5: 185,195; 2005: Published online in Wiley InterScience (www.interscience.wiley.com) DOI 10.1002/tcr.20044 [source] Effects of a distance learning program on physicians' opioid- and benzodiazepine-prescribing skillsTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2006Deana Midmer BScN Abstract Introduction: Opioid misuse is common among patients with chronic nonmalignant pain. There is a pressing need for physicians to increase their confidence and competence in managing these patients. Methods: A randomized controlled trial of family physicians (N = 88) attending 1 of 4 continuing medical education events helped to determine the effectiveness of e-mail case discussions in changing physician behavior. Before random assignment, participants completed a pretest and attended a 3-hour didactic session on prescribing opioids and benzodiazepines. The intervention group participated in 10 weeks of e-mail case discussions, with designated participants responding to questions on cases. An addictions physician facilitated the discussion. Several months after the e-mail discussion, participants took part in a mock telephone consultation; a blinded researcher posing as a medical colleague asked for advice about 2 cases involving opioid and benzodiazepine prescribing. Using a checklist, the researcher recorded the questions asked and advice given by the physician. Results: On post-testing, both groups expressed greater optimism about treatment outcomes and were more likely to report using a treatment contract and providing advice about sleep hygiene. There were no significant differences between pretesting and post-testing between the groups on the survey. During the telephone consultation, the intervention group asked significantly more questions and offered more advice than the control group (odds ratio for question items, 1.27 [p = .03]; advice items, 1.33 [p = .01). Discussion: Facilitated by electronic mail and a medical expert, case discussion is an effective means of improving physician performance. Telephone consultation holds promise as a method for evaluating physicians' assessment and management skills. [source] Fatty acid requirements in ontogeny of marine and freshwater fishAQUACULTURE RESEARCH, Issue 5 2010Douglas R. Tocher Abstract Essential fatty acid (EFA) requirements vary qualitatively and quantitatively with both species and during ontogeny of fish, with early developmental stages and broodstock being critical periods. Environment and/or trophic level are major factors, with freshwater/diadromous species generally requiring C18 polyunsaturated fatty acids (PUFA) whereas marine fish have a strict requirement for long-chain PUFA, eicosapentaenoic, docosahexaenoic and arachidonic acids. Other than marine fish larvae, defining precise quantitative or semi-quantitative EFA requirements in fish have received less attention in recent years. However, the changes to feed formulations being forced upon the aquaculture industry by the pressing need for sustainable development, namely the replacement of marine fish meal and oils with plant-derived products, have reintroduced EFA into the research agenda. It is particularly important to note that the physiological requirements of the fish to prevent deficiency pathologies and produce optimal growth may not parallel the requirements for maintaining nutritional quality. For instance, salmonids can be successfully cultured on vegetable oils devoid of long-chain n-3 PUFA but not without potentially compromising their health benefits to the human consumer. Solving this problem will require detailed knowledge of the biochemical and molecular basis of EFA requirements and metabolism. [source] | ||||||||||||||||||||||||||||||||||||||||