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Selected AbstractsENDOVASCULAR REPAIR OF POPLITEAL ARTERY ANEURYSMS: TECHNIQUES, CURRENT EVIDENCE AND RECENT EXPERIENCEANZ JOURNAL OF SURGERY, Issue 6 2006Ray Siauw Endovascular repair of popliteal artery aneurysms is a new technique, which has emerged as an alternative to open surgical bypass. However, evidence to support its use is limited. We present a review of current literature relevant to this technique. The MEDLINE search terms were popliteal artery, aneurysm, endovascular, endoluminal and stent. Fifty-eight articles were yielded, of which 21 were studies of endovascular repair by implantation of stent or stent graft of true aneurysms of the popliteal artery. There was only one randomized study. Small numbers of endovascular interventions are reported, with variations in study design and endovascular techniques. Long-term follow-up data is lacking; however, early results have been promising with high rates of initial treatment success. Early thrombosis of stent grafts occurs in approximately 10%, but this does not herald limb loss. Endovascular treatment offers potential benefits over traditional surgery, but needs to be studied further with a large-scale multicentre randomized trial. [source] Building and Contesting Neoliberalism at the Local Level: Reflections on the Symposium and on Recent Experience in BoliviaINTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 1 2010MIKE GEDDES Abstract This final article first reflects on the previous articles in the symposium, positioning the diverse trajectories of local governance which they exhibit in relation to two contrasting ideal types , the one neoliberal, the other contesting neoliberalism from a progressive, left perspective. Differences between these ideal types, and among the actually existing patterns of local governance discussed in the symposium (in relation to their economic and social objectives and governance institutions and practices) are highlighted. The second part of the article offers a consideration of local governance in Bolivia, a country which encapsulates some of the key issues at stake in the ongoing struggles to either build, or contest, neoliberalism at the local level. Here a distinction is advanced between ,expansive' and ,consolidatory' moments of neoliberal local governance, which may take the form of consecutive phases, but may have different, overlapping temporalities. In conclusion, it is suggested the challenges which the impact of the financial crisis and global recession pose both to neoliberal forms of local governance and to contestatory forces should be a primary concern for future research. Résumé Ce dernier article revient d'abord sur les articles précédents du symposium, pour replacer les diverses voies de gouvernance locale présentées par rapport à deux idéaltypes mis en opposition: l'un néolibéral, l'autre contestant le néolibéralisme d'un point de vue progressiste de gauche. Il met en évidence les différences entre ces idéaltypes, et entre les modèles actuels de gouvernance locale débattus dans le symposium (en lien avec leurs objectifs économiques et sociaux et avec les institutions et pratiques de gouvernance). La seconde partie s'intéresse à la gouvernance locale en Bolivie, un pays qui incarne certains des principaux enjeux dans les luttes en cours visant à bâtir ou à contester un néolibéralisme au niveau local. Une distinction est proposée entre les moments d',expansion' et de ,consolidation' de la gouvernance locale néolibérale, lesquels peuvent se présenter de manière consécutive, mais aussi sur des plages temporelles différentes en chevauchement. Pour conclure, les défis que les conséquences de la crise financière et la récession mondiale posent aux formes néolibérales de gouvernance locale ainsi qu'aux forces contestataires devraient constituer une priorité dans les recherches à venir. [source] Application of devices for safe laparoscopic hepatectomyHPB, Issue 4 2008H. KANEKO Abstract The continuing evolution of a variety of laparoscopic instrument and device has been gradually applied to the laparoscopic hepatectomy in many countries. Recent experience has persuaded us that there are great potential benefits derived from laparoscopic hepatectomy and much has been learned about patient selection, the grade of surgical difficulty with respect to tumor location, and the required instrumentation. Among these efforts, various ways of hepatic parenchymal transection with mechanical devices have been attempted and continuing to innovate to perform safe laparoscopic hepatectomy Important technologic developments and improved endoscopic procedures are being established equipment modifications. For safe laparoscopic hepatectomy, it is important to have all necessary equipment. The intraoperative laparoscopic ultrasonography, microwave coagulators, ultrasonic dissection, argon beam coagulators, laparoscopic coagulation shears, endolinear staplers and TissueLink monopolar sealer are essential. This procedure is in need that well experienced endoscopic surgeon and well-experienced liver surgeon should be collaborated in laparoscopic hepatectomy and the indications are strictly followed based upon the location and size of tumors. Finally critical determinant for success and safe laparoscopic hepatectomy is through familiarity with the relevant laparoscopic instruments and equipments. Laparoscopic hepatectomy is expected to develop further in the future as a new surgical instrument, equipment and method, which improves patients' quality of life. [source] Privacy and Commercial Use of Personal Data: Policy Developments in the United StatesJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 1 2003Priscilla Regan In the online and offline worlds, the value of personal information , especially information about commercial purchases and preferences , has long been recognised. Exchanges and uses of personal information have also long sparked concerns about privacy. Public opinion surveys consistently indicate that overwhelming majorities of the American public are concerned that they have lost all control over information about themselves and do not trust organisations to protect the privacy of their information. Somewhat smaller majorities favour federal legislation to protect privacy. Despite public support for stronger privacy protection, the prevailing policy stance for over thirty years has been one of reluctance to legislate and a preference for self-regulation by business to protect privacy. Although some privacy legislation has been adopted, policy debates about the commercial uses of personal information have been dominated largely by business concerns about intrusive government regulation, free speech and the flow of commercial information, costs, and effectiveness. Public concerns about privacy, reflected in public opinion surveys and voiced by a number of public interest groups, are often discredited because individuals seem to behave as though privacy is not important. Although people express concern about privacy, they routinely disclose personal information because of convenience, discounts and other incentives, or a lack of understanding of the consequences. This disconnect between public opinion and public behaviour has been interpreted to support a self-regulatory approach to privacy protections with emphasis on giving individuals notice and choice about information practices. In theory the self-regulatory approach also entails some enforcement mechanism to ensure that organisations are doing what they claim, and a redress mechanism by which individuals can seek compensation if they are wronged. This article analyses the course of policy formulation over the last twenty years with particular attention on how policymakers and stakeholders have used public opinion about the commercial use of personal information in formulating policy to protect privacy. The article considers policy activities in both Congress and the Federal Trade Commission that have resulted in an emphasis on "notice and consent." The article concludes that both individual behaviour and organisational behaviour are skewed in a privacy invasive direction. People are less likely to make choices to protect their privacy unless these choices are relatively easy, obvious, and low cost. If a privacy protection choice entails additional steps, most rational people will not take those steps. This appears logically to be true and to be supported by behaviour in the physical world. Organisations are unlikely to act unilaterally to make their practices less privacy invasive because such actions will impose costs on them that are not imposed on their competitors. Overall then, the privacy level available is less than what the norms of society and the stated preferences of people require. A consent scheme that is most protective of privacy imposes the largest burden on the individual, as well as costs to the individual, while a consent scheme that is least protective of privacy imposes the least burden on the individual, as well as fewer costs to the individual. Recent experience with privacy notices that resulted from the financial privacy provisions in Gramm-Leach-Bliley supports this conclusion. Finally, the article will consider whether the terrorist attacks of 11 September have changed public opinion about privacy and what the policy implications of any changes in public opinion are likely to be. [source] What Macroeconomic Measures Are Needed for Free Trade to Flourish in the Western Hemisphere?LATIN AMERICAN POLITICS AND SOCIETY, Issue 2 2004Barry Eichengreen ABSTRACT Recent experience has made clear the importance of macroeconomic stability, and exchange rate stability in particular, in generating support for regional integration. The tensions created by exchange-rate and financial volatility are clearly evident in the recent history of Mercosur and may also hinder the development of a Free Trade Area of the Americas. This essay argues that ambitious schemes for a single regional currency are not a practical response to this problem. Nor would a system of currency pegs or bands be sufficiently durable to provide a lasting solution. Instead, countries must solve this problem at home. In practice, this means adopting sound and stable monetary policies backed by a clear and coherent operating strategy, such as inflation targeting. With such policies in place, exchange rate volatility can be reduced to levels compatible with regional integration. [source] The efficiency of natural gas futures marketsOPEC ENERGY REVIEW, Issue 2 2003Ahmed El Hachemi Mazighi Recent experience with the emergence of futures markets for natural gas has led to many questions about the drivers and functioning of these markets. Most often, however, studies lack strong statistical support. The objective of this article is to use some classical statistical tests to check whether futures markets for natural gas (NG) are efficient or not. The problem of NG market efficiency is closely linked to the debate on the value of NG. More precisely, if futures markets were really efficient, then: 1) spot prices would reflect the existence of a market assessment, which is proof that speculation and the manipulation of prices are absent; 2) as a consequence, spot prices could give clear signals about the value of NG; and 3) historical series on spot prices could serve as "clean" benchmarks in the pricing of NG in long-term contracts. On the whole, since the major share of NG is sold to power producers, the efficiency of futures markets implies that spot prices for NG are driven increasingly by power prices. On the other hand, if futures markets for natural gas fail the efficiency tests, this will reflect: 1) a lack of liquidity in futures markets and/or possibilities of an excess return in the short term; 2) a pass-through of the seasonality of power demand in the gas market; 3) the existence of a transitory process, before spot markets become efficient and give clear signals about the value of NG. Using monthly data on three segments of the futures markets, our findings show that efficiency is almost completely rejected on both the International Petroleum Exchange in London (UK market) and the New York Mercantile Exchange (US market). On the NYMEX, the principle of "co-movement" between spot and forward prices seems to be respected. However, the autocorrelation functions of the first differences in the price changes show no randomness of price fluctuations for three segments out of four. Further, both the NYMEX and the IPE fail, with regard to the hypothesis that the forward price is an optimal predictor of the spot price. Consequently, unless we have an increase in the liquidity of spot markets and an increase in the relative share of NG spot trading, futures markets cannot be considered as efficient. [source] Anthracycline-fludarabine-containing regimens with or without rituximab in the treatment of patients with advanced follicular lymphoma,CANCER, Issue 9 2009Stefano Luminari MD Abstract BACKGROUND: Recent experience has suggested that there has been a stepwise improvement in the survival outcomes of patients who have follicular lymphoma with the introduction of new treatment options. In the current study, the authors report the results of 2 subsequent phase 2 trials of 238 previously untreated patients. METHODS: In a trial of bleomycin, epidoxorubicin, cyclophosphamide, vincristine, and prednisone (BACOP) plus fludarabine, mitoxantrone, and dexamethasone (FND), 144 patients received 2 BACOP treatments followed by 4 FND treatments. In a trial of BACOP plus fludarabine and rituximab (FR), 94 patients received 3 BACOP treatments followed by 4 FR treatments. RESULTS: The complete remission (CR) rate for BACOP/FND was 62%. After a median follow-up of 60 months, the failure-free survival (FFS) and overall survival (OS) rates at 4 years were 53% and 77%, respectively. The CR rate for BACOP/FR was 79%. After a median follow-up of 36 months, the FFS and OS rates at 4 years were 56% and 97%, respectively, which were significant compared with the CR and OS rates achieved with BACOP/FND. Twenty-five of 42 bcl -2-positive patients attained a molecularly negative CR and had improved FFS. No significant differences were observed between the 2 trials in the percentage of infections or neutropenia. CONCLUSIONS: The CR and OS rates achieved with BACOP/FR were better, and overall toxicity did not increase. Furthermore, patients who received rituximab had a better FFS compared with patients who received chemotherapy alone. Finally, although conclusions between nonrandomized groups may depend on differences in observed and unobserved prognostic features, the current results suggested that the addition of rituximab to anthracycline-fludarabine,containing regimens have a favorable effect on the prognosis of patients with advanced follicular lymphoma. Cancer 2009. © 2009 American Cancer Society. [source] Clinical significance of suprascapular nerve mobilizationCLINICAL ANATOMY, Issue 8 2005Kale D. Bodily Abstract The anatomy of the suprascapular nerve is important to surgeons when focal nerve lesions necessitate surgical repair. Recent experience with a patient who had a complete suprascapular nerve lesion in the retroclavicular region (combined with axillary and musculocutaneous nerve lesions) is presented to illustrate that successful direct nerve repair is possible despite resection of a neuroma. Specifically, we found that neurolysis and mobilization of the suprascapular nerve and release of the superior transverse scapular ligament provided the necessary nerve length to achieve direct nerve repair after the neuroma was removed. A combined supraclavicular and infraclavicular approach to the suprascapular nerve provided excellent visualization, especially in the retroclavicular region. Postoperatively, the patient recovered complete shoulder abduction and external rotation with the direct repair, an outcome uncommonly achieved with interpositional grafting. Based on our operative experience, we set out to quantify the length that the suprascapular nerve could be mobilized with neurolysis. Mobilization of the nerve and release of the superior transverse scapular ligament generated an average of 1.6 cm and 0.7 cm of extra nerve length respectively, totaling 2.3 cm of additional usable nerve length overall. The ability to expose the suprascapular nerve in the retroclavicular/infraclavicular region and to mobilize the suprascapular nerve for possible direct repair has not been previously emphasized and is clinically important. This surgical approach and technique permits direct nerve repair after resection of a focal neuroma in the retroclavicular or infraclavicular region, thus avoiding interpositional grafting, and improving outcomes. Clin. Anat. 18:573,579, 2005. © 2005 Wiley-Liss, Inc. [source] Tacrolimus and Sirolimus: When Bad Things Happen to Good DrugsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2006B. Kaplan Recent experiences with combinations of calcineurin inhibitor plus sirolimus compared to calcineurin inhibitor plus mycophenolate remind us that claims based on early anecdotal experiences with immunosuppressive protocols must be greeted with caution until controlled trials are available. See also article by Gallon et al in this issue on page 1617. [source] Effects of search experience in a resource-heterogeneous environment on the oviposition decisions of the seed beetle, Callosobruchus maculatus (F.)ECOLOGICAL ENTOMOLOGY, Issue 4 2006ROU-LING YANG Abstract 1.,This study investigates how female seed beetles, Callosobruchus maculatus, distribute their eggs on various-sized seeds when the size of seed was varied during the egg-laying period. 2.,Beetles were allowed to lay eggs on one of three arrays of 64 adzuki beans (Vigna angularis). Each array contained four size classes of seed, ranging from small (5.0,5.5 mm diameter) to large (6.5,7.0 mm), but differed in how they were distributed within the environment. In the most heterogeneous condition (the 64-patch design), the four sizes were interspersed, while in the least heterogeneous condition (the four-patch design) they were grouped into four separate blocks. Thus, a beetle exploring the 64-patch design would frequently encounter all four seed sizes, whereas a beetle exploring the four-patch design would only rarely encounter a change in bean size. 3.,Beetles experiencing greater seed size heterogeneity were more likely to lay eggs on larger seeds, whereas those in the blocked condition were more likely to oviposit on small seeds. Beetle responses to seed size heterogeneity suggest that the degree of preference for large seeds depends on a female's recent experience. 4.,Female beetles exhibited size discrimination throughout their egg-laying process; however, there was a trade-off between seed size and egg discrimination (i.e. avoiding those seeds already containing developing eggs) in response to the change in fitness gained from either laying on larger seeds or lower egg-load seeds during the egg-laying process. 5.,Our model provides the first evidence that evolving seed size discrimination ability is adaptive for the seed beetle with egg-discrimination ability. [source] Paediatric lap-belt injury: A 7 year experienceEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2006Michael Shepherd Abstract Objective:, To highlight the injuries that result from lap-belt use and make recommendations for prevention, the recent experience of a regional paediatric trauma centre was reviewed. Methods:, Retrospective review of admissions to Starship Children's Hospital from 1996 to 2003, with significant injury following involvement in a motor vehicle crash, while wearing a lap-belt. Patients were identified from two prospectively collected databases and discharge coding data. Results:, In total, 19 patients were identified over the 7 year period. The morbidity sustained includes 15 patients with hollow viscus injury, 13 laparotomies, 7 spinal fractures, 2 paraplegia and 1 fatality. A total of 11 patients required laparotomy with a median delay of 24 h. Of patients in the present series, 58% were aged less than 8 years and thus were inappropriately restrained. Conclusions:, Lap-belt use can result in a range of life-threatening injuries or permanent disability in the paediatric population. The incidence of serious lap-belt injury does not appear to be decreasing. Morbidity and mortality could be reduced by the use of three-point restraints, age appropriate restraints and booster seats. [source] Feature: UNESCO World Heritage and the Joggins cliffs of Nova ScotiaGEOLOGY TODAY, Issue 4 2004Howard J. Falcon-Lang UNESCO World Heritage status is the highest honour that may be bestowed on a palaeontological site. In addition to heightening conservation status, it confers international recognition of a locality's ,outstanding universal value' and often triggers the release of substantial regional development funds. Despite these incentives it is, perhaps, not surprising that only a handful of fossil sites have successfully navigated the World Heritage selection process. In this feature, we draw on our recent experience of developing a World Heritage bid for the Pennsylvanian ,Coal Age' locality of Joggins, Nova Scotia. As well as demonstrating the huge significance of Joggins, we hope that our findings will provide valuable guidelines for the assessment of World Heritage fossil sites in general. [source] The interaction of ground, TBM and segment lining with closed shield machines / . Interaktion Untergrund, Tunnelvortriebsmaschine und Tübbingausbau bei geschlossenen SchildmaschinenGEOMECHANICS AND TUNNELLING, Issue 5 2010Dipl.-Ing. Mechanised tunnelling - Maschineller Vortrieb Abstract The article explains the interaction of the overall system of ground, TBM and segment lining based on recent experience of projects using TBMs with active face support in Austria and abroad. The alternating dependencies and their consequences for tunnel construction are discussed in more detail. Of particular interest is the influence of the support medium and how it functions at the face and the tunnel side walls. The interaction of support pressure, thrust force and the centre of gravity of the TBM and its effect on steering behaviour are also considered. The effects of the compression of the segment tube by the TBM (prestress) are considered in relation to the improvement of the bedding and the problem of floating. Der Beitrag beleuchtet die Interaktion des Gesamtsystems "Untergrund , Tunnelvortriebsmaschine , Tübbingausbau" basierend auf aktuellen Erfahrungen zuletzt realisierter Projekte im In- und Ausland bei TVM-Einsätzen mit aktiver Ortsbruststützung. Dabei wird insbesondere auf die wechselweisen Abhängigkeiten und deren Auswirkungen auf die Tunnelherstellung eingegangen. Ein Schwerpunkt liegt beim Einfluss des Stützmediums und der zugehörigen Wirkungsweise an der Ortsbrust und der Tunnellaibung. Berücksichtigung findet die Wechselwirkung von Stützdruck, Vortriebskraft und der Schwerpunktlage der TVM auf deren Steuerverhalten. Die Auswirkung des Zusammendrückens der Tübbingröhre durch die TVM (Vorspannung) wird in Bezug auf die Bettungsverbesserung und die Problematik des Aufschwimmens betrachtet. [source] Public Provision for Urban Water: Getting Prices and Governance RightGOVERNANCE, Issue 4 2008EDUARDO ARARAL Public sector monopolies are often associated with inefficiencies and inability to meet rising demand. Scholars attribute this to fundamental problems associated with public provision: (1) a tradition of below-cost pricing due to populist pressures, (2) owner,regulator conflicts of interest, and (3) perverse organizational incentives arising from non-credible threat of bankruptcy, weak competition, rigidities, and agency and performance measurement problems. Many governments worldwide have shifted to private provision, but recent experience in urban water utilities in developing countries has shown their limitations because of weak regulatory regimes compounded by inherent problems of information, incentives, and commitment. This article examines the paradoxical case of the Phnom Penh Water Supply in Cambodia to illustrate how public provision of urban water can be substantially improved by getting prices and governance right. Findings have implications for the search for solutions to provide one billion people worldwide with better access to potable water. [source] ,What Werre Amounteth': The Military Experience of Knights of the Shire, 1369,1389HISTORY, Issue 320 2010ANDY KING The Commons in parliament played an increasingly influential role in English politics in the last years of the reign of Edward III, and the reign of his grandson, Richard II. War was the central issue which dominated political debate in parliament. But when they debated war, how many of the knights of the shire knew whereof they spoke? This article discusses the collective military experience of the knights of the shire, assessing their military service in relation to their parliamentary careers. It will look at whether knights of the shire were generally men whose military careers were over or whether they were still militarily active and, in particular, how many of them had recent experience of the doleful record of English failure in the wars since 1369. Finally, it will consider what impact the military experience of knights of the shire had on political debate in parliament and to what degree was the Commons' criticism of the crown's conduct of the wars shaped by the personal military experience of the knights of the shires. [source] Ownership, corporate governance and industrial relations in the banking and telecommunications sectors: the case of GreeceINDUSTRIAL RELATIONS JOURNAL, Issue 3 2010Stella ZambarloukouArticle first published online: 10 MAY 2010 ABSTRACT The article examines how changes in ownership and corporate governance have affected industrial relations systems by drawing on the recent experience of Greece in two sectors: banking and telecommunications. The findings show that despite the seeming institutional stability in industrial relations arrangements, substantive change has taken place in the aforementioned sectors, which has resulted in the decentralisation of bargaining procedures. [source] The interaction between corporate rescue and labour legislation: lessons to be drawn from the South African experienceINTERNATIONAL INSOLVENCY REVIEW, Issue 1 2005Anneli Loubser One of the main advantages of a successful corporate rescue is that it prevents or at least limits the job losses caused by a business failure. For this reason, labour legislation which is designed to protect the employees of a company in the event of its winding-up, should take cognisance of the effects such legislation may have on any rescue attempts. As the recent experience in South Africa has shown, ignoring corporate rescue in legislation dealing with labour law in the context of the winding-up of a company may have the unintended effect of seriously hampering any corporate rescue attempt. Copyright © 2004 John Wiley & Sons, Ltd. [source] International Regimes: The Case of Western Corporate GovernanceINTERNATIONAL STUDIES REVIEW, Issue 2 2006DAVID A. DETOMASI Accounting and financial scandals of unprecedented scale have recently occurred in the United States, Europe, and elsewhere. Much of the cause for these scandals has been attributed to the poor corporate governance standards practiced by the offending companies, leading researchers to re-examine how corporate governance affects economic development. One topic receiving significant research attention has been whether national corporate governance systems are likely to converge, what form that convergence may take, and what barriers currently inhibit convergence. This essay argues that the tools of regime theory hold significant potential for helping to structure empirical inquiry into the process of corporate governance convergence. It then draws upon the recent experience of Western corporate governance systems to illustrate how a consensus on norms, values, and principles in the issue area of corporate governance is emerging. The essay concludes by drawing out the implications of the developing corporate governance regime for emerging market economies and the general topic of global governance. It also poses questions for continued empirical research in the area of corporate governance and international relations. [source] Contemporary Results of Total Aortic Arch ReplacementJOURNAL OF CARDIAC SURGERY, Issue 3 2004Thoralf M. Sundt M.D. The results of surgical intervention reported from large centers are improving; however, the degree to which these results are reproducible by other surgeons is less clear. We therefore reviewed our recent experience with total aortic arch replacement. Methods: Between July 1, 1997 and July 1, 2001 19 patients underwent complete aortic arch replacement, with or without concomitant procedures. We retrospectively reviewed perioperative results retrieved from the computerized database and clinical records. Results: The mean age of the study population was 68 ± 8.3 years (range 52 to 82), with women predominating (11 women, 8 men). All patients had hypertension. Patient history indicated active or past tobacco abuse in 16 patients (80%); cerebrovascular disease in 3, and peripheral vascular disease in 7 patients. Associated procedures included an elephant trunk in 12 (63%), replacement of the upper descending thoracic aorta in 5 (26%), concomitant coronary artery bypass in 5 (26%), and aortic root replacement in 3 (16%). One patient underwent replacement of the entire aorta from sinotubular ridge to iliac bifurcation in a single procedure. Brachiocephalic reconstruction with a "Y-graft" permitting early antegrade cerebral perfusion was performed in 12 patients. Retrograde cerebral perfusion was performed in ten patients (53%). Perioperatively, death occurred in two patients (11%) and stroke in two (11%). Conclusions: With cautious application, techniques developed in high-volume centers can also achieve satisfactory results when used at centers with a more modest case volume. (J Card Surg 2004;19:235-239) [source] Multivessel Off-Pump Coronary Artery Bypass Grafting Can Be Taught to Trainee SurgeonsJOURNAL OF CARDIAC SURGERY, Issue 5 2003David Jenkins F.R.C.S. The purpose of this study was to address the reproducibility of the OPCAB in a unit where this technique is used extensively. Methods: Registry data, notes, and charts of 64 patients who were operated on by four trainee cardiac surgeons over a period of thirteen months at Harefield Hospital, were reviewed retrospectively. These trainees were part of an accredited training program for cardiothoracic training and were trained by a single consultant trainer in a cardiac unit after it had an established recent experience in performing nonselective OPCAB for all in-coming patients. Five (7.8%) patients (with 17 distal anastomoses) consented and underwent early postoperative angiography to check the quality of the grafts and anastomoses. Results: The mean age of the study patients was 65.6 and the mean Parsonnet score was 9.4. There was a mean of 2.9 grafts per patient and circumflex territory anastomoses were performed in 48 (75%) patients. No operation required conversion to Cardiopulmonary Bypass (CPB). Angiography of the five patients revealed 17 satisfactory (100%) distal anastomoses. Conclusion: With appropriate training, it is possible for trainees to learn OPCAB and perform multivessel revascularization in relatively high-risk patients with good results. [source] Partial Anomalous Pulmonary Venous Connection: Correction by Intra-atrial Baffle and Cavo-atrial AnastomosisJOURNAL OF CARDIAC SURGERY, Issue 2 2002O. Baron M.D. An intra-atrial baffle, combined with cavo-atrial anastomosis, has been proposed to avoid these complications. The authors report their recent experience with this operative technique. From January 1997 to December 2000, 7 patients with a mean age of 13.5 ± 9 (2,31) years were operated according to this technique. Only one child did not have an associated atrial septal defect. The mean number of pulmonary veins connected to the superior vena cava was 2.5 ± 0.5. The immediate postoperative course was uneventful for the seven patients. The mean follow-up was 20 ± 17 months. No patient developed arrhythmia or superior vena cava or pulmonary vein obstruction at echocardiography. This surgical technique appears to constitute an attractive alternative when pulmonary veins drain abnormally into the superior vena cava above the cavo-atrial junction. [source] Women's physical aggression in bars: an event-based examination of precipitants and predictors of severityAGGRESSIVE BEHAVIOR, Issue 4 2007R. Lorraine Collins Abstract Although women drink in bars and experience aggression in bar settings, much of the research has focused on men's experiences of aggression in bars. We used data from questionnaires and face-to-face interviews to examine the contributors to the occurrence and severity of women's experience of specific incidents of aggression in bars. Young women (n=92) provided event-based descriptions of their most recent experience of physical aggression in a bar during the past 24 months. Most aggression in bars was precipitated by rowdy behavior and involved female opponents who were strangers. The severity and overall aggressiveness of the respondent's behaviors were positively associated with initiating the incident and having a female opponent. The severity and overall aggressiveness of the opponent's behaviors were negatively associated with initiating the incident and positively associated with having a female opponent. This study adds to the paucity of research on women's aggression in bars and expands our understanding of women's roles as perpetrator and victim of such aggression. Aggr. Behav. 33:304,313, 2007. © 2007 Wiley-Liss, Inc. [source] Diffusion, Use and Impact of the Internet in Hong Kong: A Chain Process ModelJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 2 2002Jonathan J. H. Zhu Hong Kong appears to be a dream venue for the Internet as a mass medium: There are a well-developed telecommunications infrastructure, a population with both financial resources and bilingual (Chinese and English) abilities, and a legal environment in which there is virtually no government regulation of content. However, recent experience with the slow adoption of other new media in Hong Kong, including cable TV and interactive TV, has sounded a cautionary note about the potential use and impact of the Internet in this technologically sophisticated city. Based on a telephone survey of 1,000 adult residents, this paper examines the adoption, use, and social impact of the Internet in Hong Kong using a chain process model that was initially developed by Dutton, Rogers, and Jun (1987) for research on home computing. The results show that Internet adoption is affected by a full range of factors, including one's personal characteristics, socioeconomic status, socio-cultural settings, and perceived compatibility of the Internet. On the other hand, Internet use is primarily affected by socioeconomic status and perceived compatibility. The study also found that both adoption and use of the Internet have observable impact on leisure activities and concerns for privacy and other Internet-related negative consequences. However, these effects are not overarching but rather confined to specific attitudes and behavior. [source] Sexual Assault Nurse Examiners' Experiences Providing Expert Witness Court TestimonyJOURNAL OF FORENSIC NURSING, Issue 1 2007Rebecca Campbell Nurses from a national random sample of SANE programs were interviewed about their most recent experience providing expert witness court testimony (N = 110). Forty-three percent of the SANEs characterized this experience "fine" with no difficulties, but 58% mentioned that they had encountered problems. Challenges they faced while testifying are explored in depth and implications for forensic nursing practice are discussed. [source] Organizing and delivering training for acute mental health services: a discussion paperJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005P. E. BEE phd bsc Recent policy statements that address the quality of care provided by acute mental health services have highlighted an urgent need for specialist nurse education and training. However, examples of how to design and implement such training initiatives are sparse. Drawing on recent experience of developing an innovative training programme for acute psychiatric settings, this paper seeks to examine some of the key issues associated with current training provision for acute inpatient mental health workers. The methodological and practical concerns surrounding this type of initiative are discussed with the main aspects of programme content, service user participation, team training and organizational challenges being explored. Resulting from this work, several recommendations regarding the content, organization and delivery of future training initiatives are made. [source] PREFERENCE FOR ONE OF TWO IDENTICAL STIMULI: EXPECTATIONS, EXPLICIT INSTRUCTIONS AND PERSONAL TRAITSJOURNAL OF SENSORY STUDIES, Issue 2010KATHRYN W. CHAPMAN ABSTRACT Most consumers, given two identical food samples, express a preference for one, rather than choosing a no-preference option. The stability and potential causes of this seemingly irrational preference were examined across three trials under different conditions, specifically, when the first test pair was identical or different, and when participants were explicitly told that the pairs would often be identical. Choice of no preference typically increased from the first to second trial, especially for groups who saw a pair of different samples on the first trial. The explicit instruction that samples might be the same failed to reduce expressing a preference on the initial trial although it had some effect on later trials. Analysis, by individuals, of sequences of preference or no-preference responses across trials support independence of sequential responses and argue against stable personal traits as a predictor of preference choice. PRACTICAL APPLICATIONS More research needs to be done to understand the origins and operation of biases in preference tests. When tested under conditions in which the samples differ only slightly, participants tend to avoid the no-preference option. This is potentially important when interpreting the results of preference tests and assigning practical significance to their outcomes. Also, single trial testing may produce somewhat different results from multi-trial testing, the latter allowing for examination of effects of variation in recent experience. [source] The usefulness of a diagnostic biopsy clinic in a genitourinary medicine setting: recent experience and a review of the literatureJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2006I Palamaras Abstract Genital diseases include a wide range of lesions e.g. infectious and inflammatory. In most cases a clinical diagnosis is reached without the need for a biopsy. Nonetheless, a genital biopsy is safe and may help to confirm the diagnosis. We established a dedicated diagnostic biopsy clinic in 2003. Our objective was to evaluate the effectiveness of our diagnostic biopsy clinic and compare it with other Genitourinary medicine (GUM) clinics in the UK. A retrospective case-note study was performed on 71 patients referred to the biopsy clinic with persistent genital lesions over a 12-month period. Forty-seven biopsies were performed (71% biopsy rate). 43 specimens (92%) were appropriate for histopathological diagnosis. Of these 15% were lichen planus, 15% lichen sclerosis, 10% psoriasis, 7.5% each: eczema, Zoon's and non-specific balanitis. The remainder represented a variety of other conditions. In 27 cases (68%) the clinical diagnosis was consistent with the histological result. The possibility of self-referral and walk-in nature of our GUM service substantially decrease the waiting times for assessment of anogenital disorders. We had a lower biopsy rate for the diagnosis of non-specific balanitis (7.5%) compared with the average rate (21.5%) in 14 UK GUM clinics and good agreement between clinical and histological diagnosis. An empirical first treatment, with simple emollients before biopsy, appears to be a safe clinical approach for the treatment of non-specific balanitis. A multidisciplinary approach (GUM physicians, dermatologists and urologists/gynaecologists) could help prevent unnecessary biopsies and improve correlation between clinical and histological diagnosis. [source] Early and late outcome of cardiac surgery in patients with liver cirrhosisLIVER TRANSPLANTATION, Issue 7 2007Farzan Filsoufi Liver cirrhosis is a major risk factor in general surgery. Few studies have reported on the outcome of cardiac surgery in these patients. Herein we report our recent experience in this high-risk patient population according to the Child-Turcotte-Pugh classification and Model for End-Stage Liver Disease (MELD) score. Between January 1998 and December 2004, 27 patients (mean age 58 ± 10 yr, 20 male) with cirrhosis who underwent cardiac surgery were identified. Patients were in Child-Turcotte-Pugh class A (n = 10), B (n = 11), and C (n = 6) and mean MELD score was 14.2 ± 4.2. Operative mortality was 26% (n = 7). Stratified mortality according to Child-Turcotte-Pugh class was 11%, 18%, and 67% for class A, B, and C, respectively. No mortality occurred in patients who had revascularization without the use of cardiopulmonary bypass (n = 5). The 1-yr survival was 80%, 45%, and 16% for Child-Turcotte-Pugh class A, B, and C, respectively (P = 0.02). Major postoperative complications occurred in 22%, 56%, and 100% for Child-Turcotte-Pugh class A, B, and C, respectively. Child-Turcotte-Pugh classification was a better predictor of hospital mortality (P = 0.02) compared to MELD score (P = 0.065). In conclusion, our results suggest that cardiac surgery can be performed safely in patients with Child-Turcotte-Pugh class A and selected patients with class B. Operative mortality remains high in class C patients. Careful patient selection is critical in order to improve surgical outcome in patients with cirrhosis. Liver Transpl, 2007. © 2007 AASLD. [source] Revenue authorities: are they the right vehicle for improved tax administration?PUBLIC ADMINISTRATION & DEVELOPMENT, Issue 3 2001Nick Devas It is now well recognised that reforms to tax administration are as important as tax policy changes for overall fiscal reform. One institutional model of tax administration, which has been quite widely adopted in Africa in recent years, is that of the semi-independent Revenue Authority. This approach is based on the executive agency model, widely adopted in the UK and elsewhere, as a way of improving performance of certain governmental functions. This article looks at the arguments for and against the Revenue Authority model, and examines a number of practical issues in the design of such an agency. It draws on the recent experience of Revenue Authorities in a number of countries. It concludes that the Revenue Authority model can offer an appropriate institutional framework for reforming tax administration, particular where low pay rates and rigid civil service systems inhibit effective management. However, Revenue Authorities do not solve all problems, and can only be expected to deliver results if they form part of a wider reform. Copyright © 2001 John Wiley & Sons, Ltd. [source] Forty-five years in climatology,a personal odysseyTHE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 1 2008WAYNE R. ROUSE This article presents a personal perspective on an academic and research vocation spanning a period of over 45 years. It starts with my early involvement in geography and climatology and terminates with my recent experience in a large interdisciplinary research venture. The presentation highlights, with specific examples, the importance of mentors. Also emphasized is the indispensable input of colleagues and graduate students to successful research endeavours. Most of my career has been centred on McMaster University, and I naturally draw on my experiences there. There have been great changes in the research world over the past few decades. Although the number of faculty and graduate students at McMaster remained relatively constant, the research output per person more than doubled. This is attributed in large part to the accelerating technological advancements in our ability to measure and our ability to process and manipulate data. In the environmental sciences, this has revolutionized the spatial and temporal scope of the scientific questions that can be addressed. Such major changes have stimulated a marked trend towards interdisciplinary research that has evolved from mainly wishful talking to active pursuit in a search to understand complex environmental interactions. Important among these is gaining insights into the processes and feedbacks driving climate change, whether natural or anthropologically induced. Equally important is gaining an understanding of the potential impacts resulting from climate change. My perception of my successes, failures and near misses divides chronologically into three periods that cover research in the early years, research in the central subarctic and research in the Mackenzie River Basin. Quarante-cinq ans en climatologie , une odyssée personnelle Cet article propose un regard personnel sur une carrière universitaire et en recherche échelonnée sur plus de 45 ans, de mes premières contributions à la géographie et la climatologie à mes expériences actuelles au sein d'un projet de recherche interdisciplinaire. L'importance du rôle des mentors est illustrée par des exemples. Le concours indispensable apporté par les collègues et les étudiants des cycles supérieurs au succès des démarches de recherche est également souligné. La majeure partie de mes expériences professionnelles s'est déroulée à l'université McMaster et c'est pourquoi il est naturel pour moi d'y faire référence. De grands changements ont bouleversé le monde de la recherche depuis quelques décennies. Malgré le fait que le nombre de professeurs et d'étudiants des cycles supérieurs soit demeuré relativement stable, la publication de résultats de recherche par personne a plus que doublé. Ceci est attribuable en grande partie au développement rapide des technologies qui nous permettent d'évaluer, de traiter et de manipuler les données. Nous assistons donc à une révolution dans le domaine des sciences environnementales au niveau des dimensions spatiales et temporelles des questions scientifiques que nous pouvons aborder. Ces changements d'envergure alimentent une tendance nette en faveur de la recherche interdisciplinaire qui a évolué d'un v,u pieux à une entreprise active visant à comprendre les interactions environnementales d'un haut niveau de complexité. Il est essentiel de mieux prendre conscience des processus et rétroactions qui interviennent dans les changements climatiques naturels ou d'origine anthropiques. Il est aussi très important de mieux comprendre les effets induits par les changements climatiques. Ma manière de percevoir mes réussites, échecs et quasi-succès se divise chronologiquement en trois époques: les recherches durant les premières années, les recherches menées dans le subarctique, et les recherches sur le bassin du fleuve Mackenzie. [source] | |||||||||||||||||||||||||||||||||||||