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Problem Areas (problem + area)

Distribution by Scientific Domains

Medical Sciences	38%
Business, Economics, Finance and Accounting	19%
Psychology	15%
Chemistry	11%
Engineering	7%
2 Other Domains	10%

Selected Abstracts

Depressive symptoms in the first year from diagnosis of Type 2 diabetes: results from the DESMOND trial

DIABETIC MEDICINE, Issue 8 2010
T. C. Skinner
Diabet. Med. 27, 965,967 (2010) Abstract Aims, To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Methods,Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. Results, The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18,22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes; these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology. Conclusions, The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes. [source]

Not all roads lead to Rome,a review of quality of life measurement in adults with diabetes

DIABETIC MEDICINE, Issue 4 2009
J. Speight
Abstract Aims Quality of life (QoL) is recognized widely as an important health outcome in diabetes, where the burden of self-management places great demands on the individual. However, the concept of QoL remains ambiguous and poorly defined. The aim of our review is to clarify the measurement of QoL in terms of conceptualization, terminology and psychometric properties, to review the instruments that have been used most frequently to assess QoL in diabetes research and make recommendations for how to select measures appropriately. Methods A systematic literature search was conducted to identify the ten measures most frequently used to assess QoL in diabetes research (including clinical trials) from 1995 to March 2008. Results Six thousand and eight-five abstracts were identified and screened for instrument names. Of the ten instruments most frequently used to assess ,QoL', only three actually do so [i.e. the generic World Health Organization Quality of Life (WHOQOL) and the diabetes-specific Diabetes Quality of Life (DQOL) and Audit of Diabetes-Dependent Quality of Life (ADDQoL)]. Seven instruments more accurately measure health status [Short-Form 36 (SF-36), EuroQoL 5-Dimension (EQ-5D)], treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)] and psychological well-being [Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Well-Being Questionnaire (W-BQ), Problem Areas in Diabetes (PAID)]. Conclusions No single measure can suit every purpose or application but, when measures are selected inappropriately and data misinterpreted, any conclusions drawn are fundamentally flawed. If we value QoL as a therapeutic goal, we must ensure that the instruments we use are both valid and reliable. QoL assessment has the proven potential to identify ways in which treatments can be tailored to reduce the burden of diabetes. With careful consideration, appropriate measures can be selected and truly robust assessments undertaken successfully. [source]

Development and validation of the Diabetes Obstacles Questionnaire (DOQ) to assess obstacles in living with Type 2 diabetes

DIABETIC MEDICINE, Issue 8 2007
H. Hearnshaw
Abstract Aims To develop and validate an easy-to-use questionnaire to identify obstacles to self management in Type 2 diabetes. Methods The Diabetes Obstacles Questionnaire (DOQ) was developed from earlier research and the literature. It was completed by 180 people with Type 2 diabetes, recruited from 22 general practices in the UK. Responders also completed a quality-of-life questionnaire (ADDQoL) and the Problem Areas in Diabetes (PAID) scale. Results From analysis of the 176 usable questionnaires, 36 items of the original 113 items were deemed redundant. The remaining 77 items were assembled into eight sub-scales covering Medication, Self Monitoring, Knowledge and Beliefs, Diagnosis, Relationships with Health-Care Professionals, Lifestyle Changes, Coping, and Advice and Support. Each sub-scale had a factor structure of no more than three factors, had Cronbach's alpha of more than 0.75, and a Kaiser,Meyer,Olkin of more than 0.75. Each sub-scale correlated significantly with the PAID scale (P < 0.01), demonstrating criterion validity. Construct validity was shown by significant correlation between HbA1c and the sub-scales which relate to managing blood glucose levels: Self Monitoring, Relationship with Health-Care Professionals, Lifestyle Changes and Coping. Construct validity was further shown by significant correlation between QoL scores and Medication, Lifestyle Changes and Coping. Discussion The DOQ, comprising eight sub-scales, is a usable, valid instrument for both clinical and research settings. It helps to identify in detail the obstacles which an individual finds in living with Type 2 diabetes. [source]

Higher Education Classroom Fail to Meet Needs of Faculty and Students

JOURNAL OF INTERIOR DESIGN, Issue 2 2000
Lennie Scott-Webber Ph.D.
OBJECTIVES: The objectives of this study were (1) to determine differences between faculty and student opinions about university classrooms when the User's Environmental Interaction Framework (UEIF) model's quadrants were considered together, (2) to determine the positive, negative, and different effects between these populations within each UEIF quadrant, and (3) to determine faculty and student use. RESEARCH DESIGN: The User's Environmental Framework (UEIF) guided the research at a large university. This framework has four quadrants: environmental/value dimensions, and behavioral/internal responses, prox-emics concepts, and interactional influences. The study had two parts: (1) a 48-question questionnaire, and (2) behavioral observations surveying both faculty and students (120 subjects) who used 15 general purpose classrooms. ANALYSIS: Stepwise Discriminant Analysis determined which subset of questions best separates student from faculty responses. Canonical Discriminant Analysis further explained relationships. KEY FINDINGS: Return rate was 67% and four observations of each classroom were conducted. Faculty and students agreed on the majority of the items. Subjects felt lighting, air quality, maintenance, equipment, and general comfort were adequate. There was a lack of commitment to the classrooms and subjects had little desire to stay in these rooms. Faculty and students disagreed on 10 questions. Faculty felt the classrooms did not convey a positive experience relating to noise control, seating flexibility, and lacked provision for social interaction. Students found signage inadequate and felt classrooms were uninspiring, nonanticipatory, and lacking symbolic meaning. Behavioral observations supported these concerns. CONCLUSION: Results indicate that general purpose classrooms on this campus do not meet all needs of faculty or students. Problem areas can be addressed through thoughtful knowledge-based interior design solutions. "I have to use a lecture format because I can't change the seating around to include group discussion." "I have to send students out into the hallway if I want to utilize a team approach in my teaching, because the seating is fixed." "I have to move the furniture at the front of the room out of my way as it looks like a used furniture store." "Technology is not integrated, nor easily accessible. It is provided ad hoc, and looks it." [source]

The Creation of Emergency Health Care Standards for Catastrophic Events

ACADEMIC EMERGENCY MEDICINE, Issue 11 2006
Robert A. Wise MD
The creation of health care standards by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in a defined area with known events follows a predictable process. A problem area (e.g., hand hygiene) is identified from multiple sources. The JCAHO then calls together experts from around the country, and through debate and the comparison of positions of various people within the health care arena, a new standard informed by these views can be developed. Once developed, it is vetted and becomes established as a Joint Commission standard. But what happens when an event has never happened, cannot be reliably predicted, and, one hopes, will never come to pass? How can one create any meaningful standards? This is the situation when considering a number of scenarios related to disasters and mass casualty events. [source]

The needs of carers of patients with anorexia and bulimia nervosa

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2008
Holmer Graap
Abstract Objective This study aims to assess the degree of distress and the need for support of carers of patients with anorexia and bulimia nervosa (BN). Methods Thirty-two carers filled out the General Health Questionnaire (GHQ-12) and the Burden Inventory (BI). In addition, they were interviewed with a semi-structured research interview, the Carers' Needs Assessment (CNA), to assess relevant problem areas as well as the needs for helpful interventions. Patients were interviewed with the Eating Disorder Examination (EDE) to assess the severity of the eating disorder. All patients met criteria for anorexia (n,=,16) or BN (n,=,16) according to DSM-IV criteria. Results The mean duration of illness was 5.6 years. The mean age of the carers was 41 years. Most of the carers were mothers or partners. In the CNA we found high numbers of problems as well as high numbers of needed interventions. The most frequently mentioned problem area was ,disappointment caused by the chronic course of the illness, concerns about the patient's future' and the most frequently reported need for support was ,counselling and support by a professional'. In three problem areas carers of persons suffering from anorexia nervosa (AN) reported significantly higher scores than carers of persons suffering from BN. Conclusions Our results suggest that carers themselves have high levels of needs which are usually not addressed in clinical practice. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Evaluation of a digital camera image applied to PCB inspection

HUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 4 2008
Bernard C. Jiang
Rapid advancement and widespread digital camera applications have made it possible to replace charge-coupled device (CCD) cameras in automatic inspections for industrial applications. However, most digital camera applications using the automatic exposure mode may not be effective in some of the inspection environments. The reflection from a board surface in printed circuit board (PCB) inspections is one such problem area. The objective of this study is to develop a methodology to evaluate the effectiveness of using digital cameras for inspection. The indices used for evaluating digital camera image quality are the perceived image quality, the visual resolution, and the noise. An experiment was designed and conducted to determine the optimal camera parameter combination for attaining the best image quality. The desirability function was used to compare various digital camera parameter settings in considering three image quality indices for selecting the best camera-operating conditions. Based on the developed model and the subjective image quality index, the overall image quality improved 9.4% and 13.86%, respectively. The developed methodology can be used to: (a) determine the digital camera image quality, (b) provide an improved model for determining the automatic exposure setting for digital camera designers, and (c) adjust the digital camera parameters for automatic inspection. © 2008 Wiley Periodicals, Inc. [source]

Antimalarial drug quality in Africa

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2007
A. A. Amin PhD
Abstract Background and objective: There are several reports of sub-standard and counterfeit antimalarial drugs circulating in the markets of developing countries; we aimed to review the literature for the African continent. Methods: A search was conducted in PubMed in English using the medical subject headings (MeSH) terms: ,Antimalarials/analysis'[MeSH] OR ,Antimalarials/standards'[MeSH] AND ,Africa'[MeSH]' to include articles published up to and including 26 February 2007. Data were augmented with reports on the quality of antimalarial drugs in Africa obtained from colleagues in the World Health Organization. We summarized the data under the following themes: content and dissolution; relative bioavailability of antimalarial products; antimalarial stability and shelf life; general tests on pharmaceutical dosage forms; and the presence of degradation or unidentifiable impurities in formulations. Results and discussion: The search yielded 21 relevant peer-reviewed articles and three reports on the quality of antimalarial drugs in Africa. The literature was varied in the quality and breadth of data presented, with most bioavailability studies poorly designed and executed. The review highlights the common finding in drug quality studies that (i) most antimalarial products pass the basic tests for pharmaceutical dosage forms, such as the uniformity of weight for tablets, (ii) most antimalarial drugs pass the content test and (iii) in vitro product dissolution is the main problem area where most drugs fail to meet required pharmacopoeial specifications, especially with regard to sulfadoxine,pyrimethamine products. In addition, there are worryingly high quality failure rates for artemisinin monotherapies such as dihydroartemisinin (DHA); for instance all five DHA sampled products in one study in Nairobi, Kenya, were reported to have failed the requisite tests. Conclusions: There is an urgent need to strengthen pharmaceutical management systems such as post-marketing surveillance and the broader health systems in Africa to ensure populations in the continent have access to antimalarial drugs that are safe, of the highest quality standards and that retain their integrity throughout the distribution chain through adequate enforcement of existing legislation and enactment of new ones if necessary, and provision of the necessary resources for drug quality assurance. [source]

Network influences on scholarly communication in developmental dyslexia: A longitudinal follow-up

JOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 14 2003
Claudia A. Perry
Author cocitation analysis was used to explore ongoing changes in the intellectual structure of the hybrid problem area of developmental dyslexia for the period 1994,1998, and to address ambiguities in results raised by an earlier study of these researchers for the years 1976,1993. Results suggest that: (1) discrepancies between the structure of the sociometric (personal) and author cocitation networks reflect real differences, not temporal factors; (2) differences between cocitation patterns and reports in the literature, and corresponding delays in the visibility of emerging perspectives, are likely due to the "inertia" of aggregate cocitation data and/or by shifts by neuroscience-vision researchers to publication in more prominent journals; (3) a sharp rise in link density for the neuroscience-vision subgroup indicates increased cohesiveness and growing maturation for this emerging perspective; (4) shifts in subgroup membership, link density, patterns of coauthorship, and multiple factor loadings suggest possible convergence between other subgroups in the network and identify individuals who may play boundary-spanning roles within the network; and (5) changing patterns of cocitation throughout the network suggest the increasing influence of studies relating to neurobiological mechanisms underlying dyslexia. The possible contributions of such boundary spanners in addressing the substantial information and communication challenges posed by the increased interdisciplinary character of scholarship in general, also are discussed. [source]

European perspectives: a carer's view

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
Ursula Brand
Objective:,To present the work of the European Federation of Associations of Families of Mentally Ill People (EUFAMI) and discuss issues of concern to family carers. Method:,The problem areas identified and discussed by family carers are presented on the basis of questionnaire surveys organized by EUFAMI. Addresses of national organisations of family carers are included. Results:,A range of problem areas are identified; they include subsistence and welfare payments for the severely mentally ill, some shortage of general hospital units, problems of care co-ordination, issues of respect for family carers and family involvement. Conclusion:,The aim of best practice in mental health care throughout Europe has not yet been reached. Key activities of EUFAMI are aimed at empowerment of families and best practice in psychiatry in Europe. [source]

Brief interventions: good in theory but weak in practice

DRUG AND ALCOHOL REVIEW, Issue 1 2004
Professor ANN M. ROCHE Director
Abstract A substantial body of research evidence has accumulated in support of the efficacy of brief interventions for a number of alcohol and drug-related problem areas, most notably alcohol and tobacco. This evidence has been used to exhort a range of professional groups such as general practitioners (GPs), and more recently emergency department hospital staff to engage in brief interventions. Internationally, however, these secondary prevention efforts have largely failed. Why have these proven interventions not been embraced by frontline workers? This is a little-asked question as efforts to press-gang unwilling professionals to take up the cudgel continue. This paper examines the characteristics of brief interventions and their principal delivery agents and explores reasons for the failure to move from efficacy to effectiveness. Given the prevention potential that rests with brief intervention, these are crucial questions to address. A key feature of brief intervention delivery also examined is the role of GPs versus the less well-explored option of the practice nurse. It will be proposed that perhaps we have the right vehicle but the wrong driver and that until closer scrutiny is made of this issue efforts in this key prevention area will continue to fail to achieve optimum results. [source]

From scrubland to vintage wine: Australia's response to substance-related problems in the last 40 years,

DRUG AND ALCOHOL REVIEW, Issue 3 2003
FAChAM (Hon), FAFPHM, FRACP, FRCPC, Professor JAMES G. RANKIN MB
Abstract Over the last 40 years Australia's response to substance-related problems compared with most western nations has been outstandingly good. Since the 1960s concerns about problems of substance use have expanded from a focus on alcohol to include tobacco and a wide range of other licit as well as illicit psychoactive substances. During this period there have been major advances in our knowledge and understanding of substance-related problems and effective methods of prevention, intervention and treatment. In parallel has been the development of a large number of non-government, government and professional organizations concerned with problems of substance use. These groups, individually and collectively, have contributed to the development of policies, plans, resources and programmes to prevent and minimize substance-related harm. Although significant progress in these endeavours took place between 1960 and 1986, there has been accelerated growth since and largely as a result of the establishment of the National Campaign Against Drug Abuse in 1986 and the ensuing National Drug Strategy and the Illicit Drug Strategy. However, much of this more recent success was possible because of the existence of the organizations, networks and infrastructures established in the earlier period and the Nation's general health, social and educational programmes. These initiatives have been associated with reductions in alcohol and tobacco use and related problems and evidence of reductions in some problem areas associated with illicit drug use. Despite these gains, there have been areas of failure and missed opportunities. Finally, it is critical to ensure that past achievements and opportunities for continued successful initiatives are not undermined by identifiable impediments and risks that could imperil the philosophy, goals, infrastructure and programmes that form the basis for Australia's success to date. [source]

The needs of carers of patients with anorexia and bulimia nervosa

Outcomes of the International Union of Crystallography Commission on Powder Diffraction Round Robin on Quantitative Phase Analysis: samples 2, 3, 4, synthetic bauxite, natural granodiorite and pharmaceuticals

JOURNAL OF APPLIED CRYSTALLOGRAPHY, Issue 4 2002
Nicola V. Y. Scarlett
The International Union of Crystallography (IUCr) Commission on Powder Diffraction (CPD) has sponsored a round robin on the determination of quantitative phase abundance from diffraction data. The aims of the round robin have been detailed by Madsen et al. [J. Appl. Cryst. (2001), 34, 409,426]. In summary, they were (i) to document the methods and strategies commonly employed in quantitative phases analysis (QPA), especially those involving powder diffraction, (ii) to assess levels of accuracy, precision and lower limits of detection, (iii) to identify specific problem areas and develop practical solutions, (iv) to formulate recommended procedures for QPA using diffraction data, and (v) to create a standard set of samples for future reference. The first paper (Madsen et al., 2001) covered the results of sample 1 (a simple three-phase mixture of corundum, fluorite and zincite). The remaining samples used in the round robin covered a wide range of analytical complexity, and presented a series of different problems to the analysts. These problems included preferred orientation (sample 2), the analysis of amorphous content (sample 3), microabsorption (sample 4), complex synthetic and natural mineral suites, along with pharmaceutical mixtures with and without an amorphous component. This paper forms the second part of the round-robin study and reports the results of samples 2 (corundum, fluorite, zincite, brucite), 3 (corundum, fluorite, zincite, silica flour) and 4 (corundum, magnetite, zircon), synthetic bauxite, natural granodiorite and the synthetic pharmaceutical mixtures (mannitol, nizatidine, valine, sucrose, starch). The outcomes of this second part of the round robin support the findings of the initial study. The presence of increased analytical problems within these samples has only served to exacerbate the difficulties experienced by many operators with the sample 1 suite. The major difficulties are caused by lack of operator expertise, which becomes more apparent with these more complex samples. Some of these samples also introduced the requirement for skill and judgement in sample preparation techniques. This second part of the round robin concluded that the greatest physical obstacle to accurate QPA for X-ray based methods is the presence of absorption contrast between phases (microabsorption), which may prove to be insurmountable in some circumstances. [source]

Outcomes of the International Union of Crystallography Commission on Powder Diffraction Round Robin on Quantitative Phase Analysis: samples 1a to 1h

JOURNAL OF APPLIED CRYSTALLOGRAPHY, Issue 4 2001
Ian C. Madsen
The International Union of Crystallography (IUCr) Commission on Powder Diffraction (CPD) has sponsored a round robin on the determination of quantitative phase abundance from diffraction data. Specifically, the aims of the round robin were (i) to document the methods and strategies commonly employed in quantitative phase analysis (QPA), especially those involving powder diffraction, (ii) to assess levels of accuracy, precision and lower limits of detection, (iii) to identify specific problem areas and develop practical solutions, (iv) to formulate recommended procedures for QPA using diffraction data, and (v) to create a standard set of samples for future reference. Some of the analytical issues which have been addressed include (a) the type of analysis (integrated intensities or full-profile, Rietveld or full-profile, database of observed patterns) and (b) the type of instrument used, including geometry and radiation (X-ray, neutron or synchrotron). While the samples used in the round robin covered a wide range of analytical complexity, this paper reports the results for only the sample 1 mixtures. Sample 1 is a simple three-phase system prepared with eight different compositions covering a wide range of abundance for each phase. The component phases were chosen to minimize sample-related problems, such as the degree of crystallinity, preferred orientation and microabsorption. However, these were still issues that needed to be addressed by the analysts. The results returned indicate a great deal of variation in the ability of the participating laboratories to perform QPA of this simple three-component system. These differences result from such problems as (i) use of unsuitable reference intensity ratios, (ii) errors in whole-pattern refinement software operation and in interpretation of results, (iii) operator errors in the use of the Rietveld method, often arising from a lack of crystallographic understanding, and (iv) application of excessive microabsorption correction. Another major area for concern is the calculation of errors in phase abundance determination, with wide variations in reported values between participants. Few details of methodology used to derive these errors were supplied and many participants provided no measure of error at all. [source]

Auditor,Provided Consultancy Services and their Associations with Audit Fees and Audit Opinions

JOURNAL OF BUSINESS FINANCE & ACCOUNTING, Issue 5-6 2002
Michael Firth
This study examines the relationships between non,audit services fees (consultancy fees) paid to auditors and (1) audit fees, and (2) the occurrence of qualified audit opinions. The positive association between consultancy fees and audit fees is shown to be due to certain company specific events that generate a demand for consultancy services as well as requiring additional audit effort. Identified company specific events are mergers and acquisitions, new share issues, new accounting and information systems, new CEOs, and corporate restructurings. When these events are absent, there is no statistically significant relationship between audit fees and consultancy fees after controlling for company size. Companies that have relatively high consultancy fees are more likely to receive a clean audit opinion. This may be due to the non,audit work clearing up problem areas at the client company or it may be due to high consultancy fees impairing auditor independence. With the available data it is not possible to distinguish between these two reasons. [source]

A new look at manufacturing using CAM-I's capacity management model

JOURNAL OF CORPORATE ACCOUNTING & FINANCE, Issue 3 2003
Andrew Muras
A capacity management model helps managers evaluate capacity by providing a visual presentation of problem areas. This can lead to much-needed insight to address many management issues in manufacturing and production. This article outlines an application of the capacity model developed by the Consortium for Advanced Manufacturing-International (CAM-I), along with the synergistic efforts of product costing and process improvement initiatives. © 2003 Wiley Periodicals, Inc. [source]

Managing international trade of food products: A survey of German and Australian companies

AGRIBUSINESS : AN INTERNATIONAL JOURNAL, Issue 1 2004
Christian Fischer
The major obstacles encountered in the management of international marketing are higher transaction costs and risks relative to home market business activities. More specifically, for food products there are six main problem areas, which arise from the literature: (1) education and training of export staff (including foreign language skills and knowledge of foreign business partners' mentality); (2) trade fair activities; (3) special food product logistics and marketing problems; (4) trade terms, export documentation and billing, and foreign exchange risk management; (5) provision of foreign market information; and (6) government assistance. Results from a questionnaire-based survey of companies from Germany and Australia engaging in exporting and/or importing of food products suggest that staff education/training and logistics are the most important factors affecting success in international markets. Implications of this study are that agribusinesses must give special attention to staff recruitment and training and to the mastering of food product logistics if they want to compete successfully internationally. [EconLit citations: F140, Q130, Q170]. © 2004 Wiley Periodicals, Inc. Agribusiness 20: 61,80, 2004. [source]

Syndrome specificity and behavioural disorders in young adults with intellectual disability: cultural differences in family impact

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2006
J. Blacher
Background This study examined whether behaviour problems and adaptive behaviour of low functioning young adults, and well-being of their families, varied by diagnostic syndrome [intellectual disability (ID) only, cerebral palsy, Down syndrome, autism], as well as by cultural group. Methods Behaviour disorders in young adults with moderate to severe ID were assessed from information provided by 282 caregivers during in-home interviews. The sample consisted of 150 Anglo participants, and 132 Latino, primarily Spanish-speaking, participants drawn from Southern California. Results Behaviour disorders and maternal well-being showed the same pattern across disability syndromes. Autism was associated with the highest scores in multiple behaviour problem areas as well as maternal reports of lower well-being. Down syndrome was associated with the lowest behaviour problem scores and the highest maternal well-being. When behaviour problems were controlled for, diagnostic groups accounted for no additional variance in maternal stress or depression. The pattern of behaviour problems and well-being did not differ by sample (Anglo vs. Latino), although level on well-being measures did. Latina mothers reported significantly higher depression symptoms and lower morale, but also higher positive impact from their child than did Anglo mothers. Conclusions Caregivers of young adults with autism report more maladaptive behaviour problems and lower personal well-being, or stress, relative to other diagnostic groups, regardless of cultural group. However, cultural differences exist in caregiver reports of depression, morale, and positive perceptions. Implications for service provision aimed at families of children with challenging behaviour problems are discussed in the context of culture. [source]

Tattoo removal by non-professionals , medical and forensic considerations

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2010
S Karsai
Abstract Tattoos are common phenomena in the western world and the demand for their removal has become widespread in the recent years. The introduction of quality-switched lasers has provided an effective removal method that is increasingly being exploited by tattoo studios themselves. Dermatologists, however, are frequently confronted with complications and side effects of tattoo removals that were performed by non-professionals. The objective of this study is to assess potential risks and pitfalls of laser tattoo removal when performed by medical laymen. The methods followed are systematic and evidence-based review of the literature. Four major problem areas were identified: rare but potentially severe allergic or toxic effects of decomposition products of the tattoo pigments; bodily harm caused by out-of-specification usage of the laser devices; malignant disease that is obscured within the area of a tattoo and requires meticulous dermatological diagnosis; and insufficient pre-operative consultation of patients about the risks, side effects and realistic expectations on the therapeutic outcome. We came to a conclusion that tattoo laser removal by medical laymen is unacceptable from the point of view of patient safety and the laws need to ban this practice swiftly. [source]

Combating plant diseases,the Darwin connection

PEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 11 2009
Derek W Hollomon
Abstract Although Darwin knew of plant diseases, he did not study them as part of his analysis of natural selection. Effective plant disease control has only been developed after his death. This article explores the relevance of Darwin's ideas to three problem areas with respect to diseases caused by fungi: emergence of new diseases, loss of disease resistance bred into plants and development of fungicide resistance. Darwin's concept of change through natural or artificial selection relied on selection of many small changes, but subsequent genetic research has shown that change can also occur through large steps. Appearance of new diseases can involve gene duplication, transfer or recombination, but all evidence points to both host plant resistance and fungicide susceptibility being overcome through point mutations. Because the population size of diseases such as rusts and powdery and downy mildews is so large, all possible point mutations are likely to occur daily, even during moderate epidemics. Overcoming control measures therefore reflects the overall fitness of these mutants, and much resource effort is being directed towards assessment of their fitness, both in the presence and in the absence of selection. While recent developments in comparative genomics have caused some revision of Darwin's ideas, experience in managing plant disease control measures clearly demonstrates the relevance of concepts he introduced 150 years ago. It also reveals the remarkable speed and the practical impact of adaptation in wild microorganism populations to changes in their environment, and the difficulty of stopping or delaying such adaptation. Copyright © 2009 Society of Chemical Industry [source]

Living with chronic renal failure: patients' experiences of their physical and functional capacity

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2003
Susanne Heiwe
Abstract Background and Purpose Several studies have shown that patients with chronic renal failure have reduced physical exercise capacity compared with the expected norm. There are, however, few qualitative studies showing ways in which patients experience their condition in terms of physical and functional capacity, and the limitations this imposes on their daily lives. The aim of the present study was to describe and analyse ways in which patients with chronic renal failure, in the pre-dialysis phase and patients undergoing haemodialysis or peritoneal dialysis, experienced their physical and functional capacity in their daily lives. Method Semi-structured interviews were used to collect data, which were then analysed according to a contextual analysis within a phenomenographic approach. Results Analysis yielded a system of categories describing patients' experiences of mental and physical fatigue, physical and functional capacity, in terms of effect on performance and endurance, and their experience of temporal stress, in terms of lack of time as well as lack of peace in their daily lives. Conclusions The results of the study will contribute to our understanding of how these patients experience their daily lives, and will help when meeting patients with chronic renal failure. This knowledge enables physiotherapists to focus rehabilitation training on problem areas that are important to patients themselves. Copyright © 2003 Whurr Publishers Ltd. [source]

WHO on Health and Sustainable Development

POPULATION AND DEVELOPMENT REVIEW, Issue 2 2001
Article first published online: 27 JAN 200
Ten years after the United Nations Conference on Environment and Development, also known as the "Earth Summit," held in Rio de Janeiro in June 1992, the United Nations will convene another summit of world governments and other major actors to assess global change during the last decade. The meeting will be held in Johannesburg, 2,11 September 2002. One of the reports prepared for the 30 April,2 May 2001 session of the preparatory committee for the Johannesburg meeting discusses developments in global health. The report, prepared by the World Health Organization with "contributions from other United Nations agencies and international organizations" and formally presented as a Report of the Secretary-General (E/CN. 17/2001 /PC/6), is reproduced below in full. It notes some of the remarkable gains in health during the past decade and, in greater detail, enumerates the major problem areas and outlines future trends and challenges. The document is available at «http://www.un.org/esa/sustdev/health.htm#doc». [source]

Process improvement evaluation approach using flow diagrams

QUALITY ASSURANCE JOURNAL, Issue 3 2006
Paul C. Constant Jr.
Abstract Maintaining company processes will afford optimum operation and enhance the company's quality management system. A vital part of maintaining processes is their periodic evaluation. An important part of the monitoring and evaluation process is the flow diagram. A detailed flow diagram is an important tool that affords ease in visualizing the total process and is an aid in locating problem areas. The evaluation of a process is broken down into 15 steps. These steps cover gathering pertinent information, such as problem symptoms from knowledgeable sources and carrying these through their route to potential problem areas to the problems, potential causes, and the root cause of the problem. Knowing the problems brings about the need to assess their impact on the process operation as well as what changes to the process are needed and what impact these changes will have on the product , its improved quality and cost , and other vital information, such as, production rate increase, competition status, and company image. With this information, the appropriate changes are made according to a process change action plan. The plan is executed, and the process is continuously monitored according to a monitoring and evaluation plan. The paper ends with conclusions. Copyright © 2006 John Wiley & Sons, Ltd. [source]

AL01 SURGICAL AUDIT IN DIFFICULT SITUATIONS

ANZ JOURNAL OF SURGERY, Issue 2009
A. J. Green
Approved peer reviewed surgical audit activity is a necessary for annual and Triannual Professional Standards requirements. Surgeons working in large hospitals, usually as part of surgical teams have resources to facilitate this. There are situations where the surgeon or surgeons need to organise a process themselves and may need more assistance. Three problem areas that will be particularly discussed include: 1Audit for remote surgeons 2Audit for urban/suburban surgeons with no teaching hospital attachments (often in smaller private facilities with no audit programs) 3Regional surgeons particularly in the Specialities eg ENT, Urology, Plastics where there are small numbers (1,3) Practical ways to achieve successful audits will be addressed [source]