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Responders
Kinds of Responders Terms modified by Responders Selected AbstractsPhylogenetic Comparative Methods Strengthen Evidence for Reduced Genetic Diversity among Endangered TetrapodsCONSERVATION BIOLOGY, Issue 5 2010PATRICK A. FLIGHT evolución de la historia de vida; extinción; heterocigosidad de proteínas; regresión filogenética; tamaño poblacional efectivo Abstract:,The fitness of species with little genetic diversity is expected to be affected by inbreeding and an inability to respond to environmental change. Conservation theory suggests that endangered species will generally demonstrate lower genetic diversity than taxa that are not threatened. This hypothesis has been challenged because the time frame of anthropogenic extinction may be too fast to expect genetic factors to significantly contribute. I conducted a meta-analysis to examine how genetic diversity in 894 tetrapods correlates with extinction threat level. Because species are not evolutionarily independent, I used a phylogenetic regression framework to address this issue. Mean genetic diversity of tetrapods, as assessed by protein heterozygosity, was 29.7,31.5% lower on average in threatened species than in their nonthreatened relatives, a highly significant reduction. Within amphibians as diversity decreased extinction risk increased in phylogenetic models, but not in nonphylogenetic regressions. The effects of threatened status on diversity also remained significant after accounting for body size in mammals. These results support the hypothesis that genetic effects on population fitness are important in the extinction process. Resumen:,Se espera que la adaptabilidad de una especie con poca diversidad genética sea afectada por la endogamia y una incapacidad para responder a cambios ambientales. La teoría de la conservación sugiere que las especies en peligro generalmente muestran menor diversidad genética que taxa que no están amenazados. Esta hipótesis ha sido cuestionada porque el período de tiempo de la extinción antropogénica puede ser muy rápido para esperar que los factores genéticos contribuyan significativamente. Realice un meta-análisis para examinar cómo se correlaciona la diversidad genética de 894 tetrápodos con el nivel de amenaza de extinción. Debido a que las especies no son independientes evolutivamente, utilice un marco de regresión filogenética para abordar este tema. La media de la diversidad genética de tetrápodos, medida como la heterocigosidad de proteínas, fue 29.7,31.5% menor en las especies amenazadas que en sus parientes no amenazados, una reducción altamente significativa. En anfibios, a medida que disminuía la diversidad el riesgo de extinción incrementaba en los modelos filogenéticos, pero no en las regresiones no filogenéticas. El efecto del estatus de amenaza sobre la biodiversidad también permaneció significativo después de considerar el tamaño corporal de mamíferos. Estos resultados dan soporte a la hipótesis de que los efectos genéticos sobre la adaptabilidad de la población son importantes en el proceso de extinción. [source] Academic Research Training for a Nonacademic Workplace: a Case Study of Graduate Student Alumni Who Work in ConservationCONSERVATION BIOLOGY, Issue 6 2009MATTHEW J. MUIR educación en conservación; formación de graduados; habilidades para el trabajo; programas universitarios Abstract:,Graduate education in conservation biology has been assailed as ineffective and inadequate to train the professionals needed to solve conservation problems. To identify how graduate education might better fit the needs of the conservation workplace, we surveyed practitioners and academics about the importance of particular skills on the job and the perceived importance of teaching those same skills in graduate school. All survey participants (n = 189) were alumni from the University of California Davis Graduate Group in Ecology and received thesis-based degrees from 1973 to 2008. Academic and practitioner respondents clearly differed in workplace skills, although there was considerably more agreement in training recommendations. On the basis of participant responses, skill sets particularly at risk of underemphasis in graduate programs are decision making and implementation of policy, whereas research skills may be overemphasized. Practitioners in different job positions, however, require a variety of skill sets, and we suggest that ever-increasing calls to broaden training to fit this multitude of jobs will lead to a trade-off in the teaching of other skills. Some skills, such as program management, may be best developed in on-the-job training or collaborative projects. We argue that the problem of graduate education in conservation will not be solved by restructuring academia alone. Conservation employers need to communicate their specific needs to educators, universities need to be more flexible with their opportunities, and students need to be better consumers of the skills offered by universities and other institutions. Resumen:,La educación en biología de la conservación a nivel licenciatura ha sido calificada como ineficaz e inadecuada para formar a los profesionales que se requieren para resolver problemas de conservación. Para identificar cómo la educación a nivel licenciatura puede satisfacer las necesidades del ámbito laboral en conservación, sondeamos a profesionales y académicos sobre la importancia de habilidades particulares del trabajo y la percepción de la importancia de esas mismas habilidades en la universidad. Todos los participantes en el sondeo (n = 189) fueron alumnos del Grupo de Graduados en Ecología de la Universidad de California en Davis y obtuvieron el grado basado en tesis entre 1973 y 2008. Los académicos y profesionales encuestados difirieron claramente en sus habilidades, aunque hubo considerablemente mayor acuerdo en las recomendaciones de capacitación. Con base en las respuestas de los participantes, los conjuntos de habilidades en riesgo de no ser consideradas en los programas educativos son la toma de decisiones y la implementación de políticas, mientras que las habilidades de investigación tienden a ser sobre enfatizadas. Sin embargo, los profesionales en diferentes puestos de trabajo requieren una variedad de conjuntos de habilidades, y sugerimos que los constantes llamados a ampliar la capacitación para responder a esta multitud de labores conducirán a un desbalance en la enseñanza de otras habilidades. Algunas habilidades, como el manejo de programas, pueden desarrollarse en proyectos colaborativos o de capacitación en el trabajo. Argumentamos que el problema de la educación en biología de la conservación a nivel licenciatura no se resolverá solo con la reestructuración de la academia. Los empleadores deben comunicar sus requerimientos específicos a los educadores, las universidades deben ser más flexibles con sus oportunidades y los estudiantes necesitan ser mejores consumidores de las habilidades ofrecidas por las universidades y otras instituciones. [source] Predation risk allocation or direct vigilance response in the predator interaction between perch (Perca fluviatilis L.) and pike (Esox lucius L.)?ECOLOGY OF FRESHWATER FISH, Issue 3 2005A. Vainikka Abstract , Predation risk allocation hypothesis predicts that a prey's response to predator depends on prey's previous experience on predator. Here we tested whether the group of three perch respond differentially to pike, predator of perch, depending on the timing of high constant (HC) and high unpredictable (HU) risk periods within low constant risk periods in short-term (10 h) experiments, and whether the response is stronger during a HU risk period than during a HC risk period. Perch clearly erected the dorsal fin in response to predation risk treatments (pike odour only, odour and visible pike). Decrease in activity and increase in shoaling behaviour were observed mainly during high risk periods. However, the perch's responses to pike did not differ statistically between periods of various levels of predation risk or depending on the timing of high risk situations within constant low risk periods, and thus, suggesting that perch respond mainly to changes in the current predation risk. Resumen 1. La hipótesis de la asignación de riesgo a la predación predice que la respuesta a un predador depende de la experiencia previa de la presa al predador. En este trabajo analizamos si un grupo de tres individuos de Perca fluviatilis respondían de forma distinta a la presencia de Esox lucius, (un predador común de esta especie) y si éstas dependían del momento en el que se producen periodos de alto riesgo constante y de alto riesgo impredecible, en experimentos de corto plazo (10 horas) de riesgo bajo y constante y si la respuesta era mayor durante perí odos de riesgo impredecible y alto que durante períodos de riesgo constante alto. 2. Claramente P. fluviatilis respondió levantando la aleta dorsal en respuesta a los tratamientos de riesgo a la predación (solamente olor y olor + visibilidad de E. lucius). Una menor actividad y una mayor tendencia a la formación de bancos fueron observados durante períodos de alto riesgo. Sin embargo, las respuesta de P. fluviatilis a E. lucius no difirieron estadísticamente entre períodos de varios niveles de riesgo a la predación o entre aquellos que dependieron del momento en el que se produjeron situaciones de alto riesgo dentro de períodos de bajo riesgo constante. 3. Concluimos que P. fluviatilis puede utilizar señales olfatorias como determinantes de respuestas al riesgo a la predación y responder a aumentos de riesgo, sin excluir la posibilidad de que amenazas repetidas decrezcan la intensidad de la respuesta. Nuestros resultados, obtenidos en experimentos realizados a pequeña escala temporal, no niegan la posibilidad de la P. fluviatilis y otras especies puedan balancear la alimentación con actividades anti-predación, de acuerdo a cambios en el riesgo de predación a lo largo de escalas temporales de varios días. [source] Topiramate in Patients with Learning Disability and Refractory EpilepsyEPILEPSIA, Issue 4 2002Kevin Kelly Summary: ,Purpose: Management of seizures in learning disabled people is challenging. This prospective study explored the efficacy and tolerability of adjunctive topiramate (TPM) in patients with learning disability and refractory epilepsy attending a single centre. Methods: Sixty-four patients (36 men, 28 women, aged 16,65 years) were begun on adjunctive TPM after a 3-month prospective baseline on unchanged medication. Efficacy end points were reached when a consistent response was achieved over a 6-month period at optimal TPM dosing. These were seizure freedom or ,50% seizure reduction (responder). Appetite, behaviour, alertness, and sleep were assessed by caregivers throughout the study. Results: Sixteen (25%) patients became seizure free with adjunctive TPM. There were 29 (45%) responders. A further 10 (16%) patients experiencing a more modest improvement in seizure control continued on treatment at the behest of their family and/or caregivers. TPM was discontinued in the remaining nine (14%) patients, mainly because of side effects. Final TPM doses and plasma concentrations varied widely among the efficacy outcome groups. Many patients responding well to adjunctive TPM did so on ,200 mg daily. Mean carer scores did not worsen with TPM therapy. Conclusions: TPM was effective as add-on therapy in learning-disabled people with difficult-to-control epilepsy. Seizure freedom is a realistic goal in this population. [source] Fluctuating Asymmetry of Responders Affects Offers in the Ultimatum Game Oppositely According to Attractiveness or Need as Perceived by ProposersETHOLOGY, Issue 7 2009Darine Zaatari The Ultimatum Game (UG) measures cooperative tendencies in humans. A proposer offers to split a given sum of money between self and a responder, who may accept or reject the offer. If accepted, each receives the proposed split; if rejected, nobody receives anything. We studied the effect of the putative responder's degree of facial symmetry (fluctuating asymmetry, FA) on the offer he/she received in opposite-sexed UGs. Symmetry is an important measure of biological quality so subjects were expected to receive higher offers when symmetrical than asymmetrical. In a sample of Jamaicans, individuals played two UGs with opposite-sexed responders, a symmetrical photo of a Lebanese and an asymmetrical one. Individuals do indeed give more to symmetrical responders (p = 0.032). When subjects are asked their motivation, a striking dichotomy emerges: those who cite ,attractiveness' as a motive, give strongly to symmetrical responders while those citing ,need' invariably give more to asymmetrical ones (p < 0.0001). Females also show a nearly significant tendency to cite need as a motive more often than do males. [source] Individual differences in the effects of chronic prazosin hydrochloride treatment on hippocampal mineralocorticoid and glucocorticoid receptorsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2007Mohamed Kabbaj Abstract The aim of this study was to investigate the noradrenergic regulation of mineralocorticoid receptors (MRs) and glucocorticoid receptors (GRs) in high responder (HR) and low responder (LR) male rats, an animal model of individual differences in hypothalamo-pituitary-adrenal axis activity and vulnerability to drugs of abuse. The effects of a chronic treatment with the noradrenergic ,1 antagonist (1-[4-amino-6,7-dimethoxy-2-quinazolinyl]-4-[2-furanylcarbonyl] piperazine) hydrochloride (prazosin) (0.5 mg/kg, i.p., 35 days) were assessed on stress-induced corticosterone (CORT) secretion and on hippocampal MRs and GRs in adrenally intact rats. In order to ascertain whether the effects of chronic prazosin treatment on hippocampal MRs and GRs were direct or indirect, through prazosin-induced CORT secretion, we also assessed the effects of the same treatment on adrenalectomized rats with CORT substitutive therapy. When compared with LR rats, HR rats exhibited a delayed return to the basal level of CORT following acute restraint stress; this was associated with a lower binding of MRs and GRs in HR rats than in LR rats. Chronic prazosin treatment had no effect in HR animals but markedly reduced hippocampal MRs and GRs, and increased stress-induced CORT secretion in LR rats. In LR adrenalectomized rats, prazosin reduced hipppocampal MRs but did not change GRs. Our results provide evidence of a differential regulation by noradrenaline of hippocampal MRs and GRs in HR and LR rats. These data could have clinical implications in terms of individual differences in the resistance to antidepressant treatments and individual differences in drug abuse. [source] Serum levels of IL-18 and sIL-2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroidsEXPERIMENTAL DERMATOLOGY, Issue 2 2010Deborah Lee Please cite this paper as: Serum levels of IL-18 and sIL-2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids. Experimental Dermatology 2010; 19: 145,147. Abstract:, This study was to determine which immunologic factors contribute to the prognosis of patients with alopecia areata (AA) who were receiving oral cyclosporine A and methylprednisolone. Patients with >25% hair regrowth were defined as responders, and patients exhibiting ,25% regrowth were poor-responders. The serum levels of IL-18 and soluble IL-2 receptor (sIL-2R) were measured at baseline in 21 patients with AA and 22 control subjects. The mean serum level of IL-18 in the patients with extensive AA was significantly higher than that in the control subjects. The mean serum concentration of sIL-2R in the AA patients significantly decreased after 1 month of treatment. The mean basal serum level of IL-18 was highest in the responder, whereas the baseline level of sIL-2R was significantly higher in the poor-responder group than other groups. In conclusion, increased serum sIL-2R level and lower IL-18 level at baseline was associated with a poor prognosis in patients with AA. [source] Advances in Latino Family Research: Cultural Adaptations of Evidence-Based InterventionsFAMILY PROCESS, Issue 2 2009GUILLERMO BERNAL PH.D. The stark contrast between frequent calls for research and practice that are applicable across a broad spectrum of cultural and ethnically diverse groups and the dearth of empirical knowledge about Latino families provided the impetus for this special issue on advances in Latino family research. A focus on empirically based practice frames the issue, focusing specifically on how concepts (expressed emotion, parenting style) can be used within interventions, how Latino parents perceive efforts to deliver evidence-based interventions, and how pilot projects that delivered culturally adapted interventions in three separate cities impacted family functioning. In all, the introduction highlights the complexities for researchers in meeting the needs of the field to ensure that effective interventions are applicable across cultural groups. Meeting the challenges is important to address the need of the growing Latino population. Advances in intervention research with ethnic minorities also stand to contribute to the advancement of intervention research broadly. This special issue provides examples of efforts that are underway to better understand what treatments work for Latino families, provided by whom, for what specific problems, and in which specific circumstances, paving the way to begin attempting to answer a challenge posed more than 40 years ago by Gordon Paul. RESUMEN El marcado contraste entre las frecuentes convocatorias para investigaciones y prácticas aplicables a un amplio espectro de grupos de distintas culturas y razas, y la escasez de conocimiento empírico sobre las familias latinas sirvieron como impulso para publicar este número especial sobre los avances en las investigaciones relativas a las familias latinas. La publicación está enmarcada en el análisis de la práctica sustentada empíricamente, centrándose específicamente en cómo los conceptos (emoción expresada, estilo de crianza de los hijos) pueden utilizarse dentro de las intervenciones, en cómo los padres latinos perciben las iniciativas de realizar intervenciones sustentadas empíricamente y en cómo los proyectos piloto que ofrecieron intervenciones adaptadas culturalmente en tres ciudades distintas influyeron sobre el desenvolvimiento familiar. En general, la introducción destaca las complicaciones que enfrentan los investigadores a la hora de responder a las necesidades del campo para garantizar que puedan aplicarse intervenciones eficaces a distintos grupos culturales. Resolver estas complicaciones es importante para responder a la necesidad de la población latina en aumento. Los avances en las investigaciones sobre intervenciones con minorías étnicas también contribuyen al avance de las investigaciones sobre intervenciones en general. La publicación especial ofrece ejemplos de iniciativas que están en marcha para comprender mejor qué tratamientos son eficaces para las familias latinas, quiénes deben proporcionarlos, para qué problemas específicos y en qué circunstancias específicas, allanando el camino para comenzar a responder un problema que planteó Gordon Paul hace más de 40 años. Palabras clave: Latinos/hispanos, familia, adaptación cultural, intervención, salud mental de los latinos [source] Massive factor-VIII infusion in Hæmophiliac with factor-VIII inhibitor, high responderHAEMOPHILIA, Issue 102 2010H. H. Brackmann No abstract is available for this article. [source] Electrical Stimulation of Sphenopalatine Ganglion for Acute Treatment of Cluster HeadachesHEADACHE, Issue 7 2010Mehdi Ansarinia MD (Headache 2010;50:1164-1174) Introduction., Cluster headaches (CH) are primary headaches marked by repeated short-lasting attacks of severe, unilateral head pain and associated autonomic symptoms. Despite aggressive management with medications, oxygen therapy, nerve blocks, as well as various lesioning and neurostimulation therapies, a number of patients are incapacitated and suffering. The sphenopalatine ganglion (SPG) has been implicated in the pathophysiology of CH and has been a target for blocks, lesioning, and other surgical approaches. For this reason, it was selected as a target for an acute neurostimulation study. Methods., Six patients with refractory chronic CH were treated with short-term (up to 1 hour) electrical stimulation of the SPG during an acute CH. Headaches were spontaneously present at the time of stimulation or were triggered with agents known to trigger clusters headache in each patient. A standard percutaneous infrazygomatic approach was used to place a needle at the ipsilateral SPG in the pterygopalatine fossa under fluoroscopic guidance. Electrical stimulation was performed using a temporary stimulating electrode. Stimulation was performed at various settings during maximal headache intensity. Results., Five patients had CH during the initial evaluation. Three returned 3 months later for a second evaluation. There were 18 acute and distinct CH attacks with clinically maximal visual analog scale (VAS) intensity of 8 (out of 10) and above. SPG stimulation resulted in complete resolution of the headache in 11 attacks, partial resolution (>50% VAS reduction) in 3, and minimal to no relief in 4 attacks. Associated autonomic features of CH were resolved in each responder. Pain relief was noted within several minutes of stimulation. Conclusion., Sphenopalatine ganglion stimulation can be effective in relieving acute severe CH pain and associated autonomic features. Chronic long-term outcome studies are needed to determine the utility of SPG stimulation for management and prevention of CH. [source] Relapse of hepatitis C in a pegylated-interferon-,-2b plus ribavirin-treated sustained virological responderHEPATOLOGY RESEARCH, Issue 6 2010Hideki Fujii A 41-year-old woman with chronic hepatitis C was treated with pegylated-interferon (PEG-IFN)-,-2b plus ribavirin for 24 weeks. She had hepatitis C virus (HCV) genotype 2a (1600 KIU/mL), and her liver histology showed mild inflammation and fibrosis. Four weeks after the start of the therapy, she achieved a rapid virological response (RVR) and then a sustained virological response (SVR). Serum alanine aminotransferase (ALT) levels remained within normal ranges and HCV RNA continued to be negative. However, ALT levels flared with the re-emergence of HCV RNA in the serum 1.5 years after discontinuation of therapy. HCV RNA obtained from sera before therapy and after relapse shared a 98.6% homology with the E2 region, and phylogenetic analyses indicated that they were the same HCV strain. These results eliminated the possibility of a re-infection and strongly indicated a late relapse of the disease. Therefore, follow-up is necessary for chronic hepatitis C patients after SVR, even if they respond well to therapy, including RVR. [source] Distinction between coeliac disease and refractory sprue: a simple immunohistochemical methodHISTOPATHOLOGY, Issue 1 2000N Patey-Mariaud de Serre Aims We recently showed that refractory sprue is distinct from coeliac disease, the former being characterized by abnormal intraepithelial T-lymphocytes expressing a cytoplasmic CD3 chain (CD3c), lacking CD3 and CD8 surface expression, and showing TCR, gene rearrangements. To take advantage of the abnormal phenotype of CD3c + CD8 , intraepithelial lymphocytes (IEL) in refractory sprue we developed a simple method to distinguish coeliac disease from refractory sprue. Methods and results Comparative immunohistochemical studies using anti-CD3 and anti-CD8 antibodies were applied on paraffin-embedded and frozen biopsy specimens in refractory sprue (n = 6), coeliac disease (n = 10), healthy controls (n = 5) and suspected refractory sprue (n = 6). Comparable results were obtained on fixed and frozen biopsy specimens. In four of the six patients with suspected refractory sprue, abnormal CD3c + CD8 , IEL and TCR, gene rearrangements were found, as in refractory sprue; the remaining two patients had normal (CD3 + CD8 +) IEL and no TCR, gene rearrangements. Both patients had coeliac disease, as one failed to comply with a gluten-free diet, while the other was a slow responder. Conclusion This simplified immunostaining method using anti-CD3 and anti-CD8 antibodies on paraffin sections can distinguish active coeliac disease from refractory sprue and should prove useful in clinical practice. [source] The Prevalence of Lying in America: Three Studies of Self-Reported LiesHUMAN COMMUNICATION RESEARCH, Issue 1 2010Kim B. Serota This study addresses the frequency and the distribution of reported lying in the adult population. A national survey asked 1,000 U.S. adults to report the number of lies told in a 24-hour period. Sixty percent of subjects report telling no lies at all, and almost half of all lies are told by only 5% of subjects; thus, prevalence varies widely and most reported lies are told by a few prolific liars. The pattern is replicated in a reanalysis of previously published research and with a student sample. Substantial individual differences in lying behavior have implications for the generality of truth,lie base rates in deception detection experiments. Explanations concerning the nature of lying and methods for detecting lies need to account for this variation. L'importance du mensonge aux États-Unis : trois études de mensonges auto-déclarés Kim B. Serota, Timothy R. Levine, Franklin J. Boster Cette étude aborde la fréquence et la distribution des mensonges déclarés par la population adulte. Un sondage national a demandéà 1 000 adultes américains de déclarer le nombre de mensonges racontés dans une période de 24 heures. 60 % des sujets ont rapporté ne pas avoir dit de mensonge du tout et près de la moitié de ces mensonges sont racontés par 5 % des sujets. L'importance des mensonges varie donc largement et la plupart des mensonges déclarés sont formulés par un petit nombre de menteurs prolifiques. Cette tendance se retrouve également dans une nouvelle analyse de recherches déjà publiées et dans l'échantillon étudiant. Des différences individuelles importantes dans les comportements mensongers ont également des conséquences pour la généralité d'un taux de référence vérité,mensonge dans les expériences de détection de la tromperie. Les explications concernant la nature du mensonge et les méthodes de détection de mensonges doivent prendre en compte cette variation. Mots clés : tromperie, mensonge, différences individuelles The Prevalence of Lying in America: Three Studies of Self-Reported Lies Research Question: This study addresses the frequency and the distribution of reported lying in the adult population. Significance: In the deception literature, consensus is that most people lie on a daily basis. Yet this view is founded on very little empirical evidence. This research tests the question of lying prevalence. Method: Survey research techniques and descriptive analysis are used to establish base rates and frequency distributions for reported lying behavior. Data source: A national survey asked 1,000 U.S. adults to report the number of lies told in a 24 hour period. Cross-validation is provided by re-analysis of previously reported diary and experimental data and by replication using a sample of 225 students. Findings: The oft-repeated average (arithmetic mean) of one to two lies per day is replicated but the study finds the distribution is highly skewed. On a typical day, 60% of subjects report telling no lies at all, and almost half or all lies are told by only 5% of subjects; thus, prevalence varies widely and most reported lies are told by a few prolific liars. The pattern is replicated in the re-analysis of previously published research and with the student sample. Implications: The findings of a highly skewed distribution render the average number of lies per day misleading. Substantial individual differences in lying behavior also have implications for the generality of truth-lie base-rates in deception detection experiments. Explanations concerning the nature of lying and methods for detecting lies need to account for this variation. Keywords: deception, lies, lying, communication, individual differences Die Prävalenz von Lügen in Amerika. Drei Studien zu selbstberichteten Lügen Forschungsfrage: Diese Studie untersucht die Häufigkeit und Verteilung von Lügen in der erwachsenen Bevölkerung. Zentralität: In der Literatur zu Täuschung besteht Konsens darüber, dass Menschen täglich Lügen. Allerdings basiert diese Feststellung auf wenigen empirischen Daten. Diese Untersuchung testet die Frage nach der Prävalenz von Lügen. Methode: Umfrage und beschreibende Analyse wurden angewandt, um eine Basisrate und Häufigkeitsdistribution für selbstberichtetes Lügenverhalten zu gewinnen. Datenquelle: In einer nationalen Umfrage wurden 1.000 US-amerikanische Erwachsene zur Zahl der Lügen befragt, die sie in 24 Stunden erzählten. Validiert wurden diese Aussagen durch eine erneute Analyse von bereits dokumentierten Tagebuchdaten und Experimentaldaten und durch die Replikation mit einer Stichprobe von 225 Studierenden. Ergebnisse: Der oft wiederholte Durchschnitt (arithmetische Mittel) von ein bis zwei Lügen pro Tag wurde in der Studie repliziert, allerdings zeigte sich auch, dass diese Verteilung schief ist. 60% der Befragten gaben an, an einem typischen Tag keine Lügen zu erzählen, fast die Hälfte aller Lügen wird von nur 5% der Befragten erzählt; die Prävalenz variiert stark und die meisten der berichteten Lügen werden durch wenige produktive Lügner erzählt. Dieses Muster wurde bei einer erneuten Analyse von vorher publizierten Daten und in der Studentenstichprobe repliziert. Implikationen: Die Ergebnisse dieser stark schiefen Verteilung zeigen, dass die durchschnittliche Zahl von Lügen pro Tag irreführend ist. Substantielle individuelle Unterschiede im Lügenverhalten haben Implikationen für die Verallgemeinerbarkeit von Wahrheit-Lüge-Basisraten in Täuschungserfassungs-Experimenten. Erklärungen zur Natur von Lügen und Methoden zur Erfassung von Lügen müssen diese Variation bedenken. Schlüsselworte: Täuschung, Lüge, Lügen, Kommunikation, individuelle Unterschiede La Prevalencia de la Mentira en América: Tres Estudios de Auto-reportes de Mentiras Kim B. Serota, Timothy R. Levine, Franklin J. Boster Michigan State University The authors thank Deborah Kashy Resumen Este estudio trata sobre la frecuencia y la distribución de los reportes de las mentiras de la población adulta. Una encuesta nacional preguntó a 1,000 adultos Estadounidenses que reporten el número de mentiras contadas en un período de 24-horas. 60% de los sujetos reportaron que no dicen mentiras para nada, y casi la mitad son contadas por solo un 5% de los sujetos; así, la prevalencia varía enormemente y muchos reportaron que las mentiras son contadas por pocos mentirosos prolíficos. La pauta es replicada en el re-análisis de investigación previamente publicada y con una muestra de estudiantes. Las diferencias individuales sustanciales en el comportamiento mentiroso tienen implicaciones también para la generalidad del índice basado en la verdad-mentira en los experimentos de detección de decepción. Las explicaciones concernientes a la naturaleza de la mentira y los métodos de detección de mentiras necesitan responder a esta variación. Palabras Claves: decepción, mentiras, mentir, comunicación, diferencias individuales [source] The genetic differences with whole genome linkage disequilibrium mapping between responder and non-responder in interferon-, and ribavirin combined therapy for chronic hepatitis C patientsINTERNATIONAL JOURNAL OF IMMUNOGENETICS, Issue 2 2008P.-J. Chen Summary Interferon-, and ribavirin combined therapy has been a mainstream treatment for hepatitis C infection. The efficacy of this combined treatment is around 30% to 60%, and the factors affecting the responsiveness are still poorly defined. Our study is intended to investigate the genetic differences between responder and non-responder patients. The genome-wide linkage disequilibrium screening for loci associated with genetic difference between two patient groups was conducted by using 382 autosomal short tandem repeat (STR) markers involving 92 patients. We have identified 19 STR markers displaying different allele frequencies between the two patient groups. In addition, based on their genomic location and biological function, we selected the CD81 and IL15 genes to perform single nucleotide polymorphism genotyping. In conclusion, this study may provide a new approach for identifying the associated polymorphisms and the susceptible loci for interferon-, and ribavirin combined therapy in patients with chronic hepatitis C. [source] Deficient Knowledge Nursing Diagnosis: Identifying the Learning Needs of Patients With Cardiac DiseaseINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2010Luzia Elaine Galdeano PhD Assistência ao paciente; avaliação de processos; conhecimento; doença das coronárias; enfermagem OBJECTIVES., To identify the learning needs of patients with cardiac disease and the aspects of the disease and anesthetic and surgical procedures about which Brazilian patients have the greatest gaps in knowledge. METHODS., Eighty preoperative patients answered a General Evaluation Questionnaire, a Questionnaire to Evaluate Patient Knowledge, and the Mini-Mental State Exam. FINDINGS., Fifty-nine patients had learning needs. More than 50% of the patients were mistaken or unable to answer questions about the disease, and the goals of and type of surgery to be performed and anesthesia to be used. CONCLUSIONS., Most patients had poor performance on the questionnaire that assessed their knowledge about coronary artery disease and its treatment. PRACTICE IMPLICATIONS., This study can contribute to health professionals' assessment of patients' knowledge. OBJETIVOS., Identificar as necessidades de aprendizagem de pacientes com doença cardíaca e os aspectos da doença arterial coronariana e da revascularização do miocárdio do nos quais os pacientes brasileiros apresentam conhecimento deficiente. MÉTODO., Oitenta pacientes responderam o Questionário para avaliação geral, o Questionário para avaliar o conhecimento e o Mini-Exame do Estado Mental. RESULTADOS., Cinqüenta e nove pacientes apresentaram necessidade de aprendizagem. Mais de 50% dos pacientes erraram ou não souberam responder as questões referentes ao nome da doença, aos sinais e sintomas de complicação da doença, aos objetivos e tipo de cirurgia e anestesia. CONCLUSÃO., Muitos pacientes não apresentaram bom desempenho no questionário para medir conhecimento em relação à Doença Arterial Coronária e seu tratamento. IMPLICAÇÕES PRÁTICAS., Este estudo poderá contribuir para a avaliação do conhecimento dos pacientes por profissionais da saúde. [source] Impact of the CYP2D6 genotype on post-operative intravenous oxycodone analgesiaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010S. T. ZWISLER Background: Oxycodone is a semi-synthetic opioid with a ,-receptor agonist-mediated effect in several pain conditions, including post-operative pain. Oxycodone is metabolized to its active metabolite oxymorphone by O -demethylation via the polymorphic CYP2D6. The aim of this study was to investigate whether CYP2D6 poor metabolizers (PMs) yield the same analgesia post-operatively from intravenous oxycodone as extensive metabolizers (EMs). Methods: Two hundred and seventy patients undergoing primarily thyroid surgery or hysterectomy were included and followed for 24 h post-operatively. The CYP2D6 genotype was blinded until study procedures had been completed for all patients. All patients received intravenous oxycodone as pain treatment for 24 h post-operatively and morphine 5 mg was used as escape medication. A responder was characterized as a patient without the need for escape medication and a positive evaluation in a questionnaire 24 h post-operatively. Results: Twenty-four patients were PM (8.9%) and 246 were EM (91.1%). One PM (4.17%, CI=0.1,21.1) was a non-responder and 42 EM (17.07%, CI=12.6,22.4) were non-responders. The non-responder rate did not differ between the two genotypes (P=0.14). There was no difference in the total consumption of oxycodone between the two genotypes (EM=14.7 mg, CI=13.0,16.4 and PM=13.0 mg, CI=8.9,17.0, P=0.42). The mean oxymorphone/oxycodone ratios were 0.0031 and 0.00081 in the EMs and PMs, respectively (P<0.0001). Conclusion: This study showed for the first time in patients that the oxymorphone formation depends on CYP2D6, but we found no difference in the post-operative analgesic effect of intravenous oxycodone between the two CYP2D6 genotypes. [source] Prevalence and impact of occult hepatitis B infection in chronic hepatitis C patients treated with pegylated interferon and ribavirin,JOURNAL OF MEDICAL VIROLOGY, Issue 5 2010Marion Levast Abstract The prevalence of occult hepatitis B, defined by absence of HBsAg and HBV DNA, ranges widely in patients with hepatitis C. This may influence the treatment of hepatitis C and the severity of liver disease. Sensitive and specific real-time PCR techniques are available commercially and can detect more reliably low HBV DNA levels. The aim of this study was to determine the prevalence of occult hepatitis B virus infection using the COBAS Taqman assay (Roche Diagnostics, Meylan, France) in the serum and liver of HBsAg negative patients with chronic hepatitis C and to evaluate its clinical consequences on liver pathology and its impact on the response to treatment with peg-IFN, and Ribavirin. HBV DNA detection was assessed retrospectively on 140 sera and 113 liver biopsies of HCV positive/HBsAg negative patients before treatment. A 4.4% (5/113) prevalence of occult hepatitis B was recorded in liver samples and in none of the sera. Anti-HBc was not detected in one, three of whom were sustained virological responders to treatment, one was relapsed responder and one was non-responder. Furthermore, in this cohort composed of 12% anti-HBs negative/anti-HBc positive and 20% anti-HBs positive/anti-HBc positive patients, anti-HBc was not associated with pre-therapeutic viral load, ALT serum levels, and histological activity or fibrosis. Using a commercial real-time PCR assay, we observed a low prevalence of occult B hepatitis. This, just as anti-HBC status, had no clinical impact in a large cohort of hepatitis C patients. It therefore does not appear useful to screen for occult hepatitis B in these patients with this test before beginning HCV treatment. J. Med. Virol. 82: 000,000, 2010. © 2010 Wiley-Liss, Inc. J. Med. Virol. 82: 747,754, 2010. © 2010 Wiley-Liss, Inc. [source] Vital signs for vital people: an exploratory study into the role of the Healthcare Assistant in recognising, recording and responding to the acutely ill patient in the general ward settingJOURNAL OF NURSING MANAGEMENT, Issue 5 2010JAYNE JAMES RN., Ortho. james j., butler-williams c., hunt j. & cox h. (2010) Journal of Nursing Management18, 548,555 Vital signs for vital people: an exploratory study into the role of the Healthcare Assistant in recognising, recording and responding to the acutely ill patient in the general ward setting Aim, To examine the contribution of the Healthcare Assistant (HCA) as the recogniser, responder and recorder of acutely ill patients within the general ward setting. Background, Concerns have been highlighted regarding the recognition and management of the acutely ill patient within the general ward setting. The contribution of the HCA role to this process has been given limited attention. Methods, A postal survey of HCAs was piloted and conducted within two district general hospitals. Open and closed questions were used. Results, Results suggest that on a regular basis HCAs are caring for acutely ill patients. Contextual issues and inaccuracies in some aspects of patient assessment were highlighted. It would appear normal communication channels and hierarchies were bypassed when patients' safety was of concern. Educational needs were identified including scenario-based learning and the importance of ensuring mandatory training is current. Conclusions and implications for nursing management, HCAs play a significant role in the detection and monitoring of acutely ill patients. Acknowledgement is needed of the contextual factors in the general ward setting which may influence the quality of this process. The educational needs identified by this study can assist managers to improve clinical supervision and educational input in order to improve the quality of care for acutely ill patients. [source] Synergism between nifedipine and cyclosporine A on the incorporation of [35S]sulfate into human gingival fibroblast cultures in vitroJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2006J. C. Flynn Background and Objective:, We assessed the effects of cyclosporine A and nifedipine on the in vitro incorporation of [35S]sulfate into gingival fibroblast cell cultures derived from responder and nonresponder subjects who had received an organ transplant followed by a therapeutic regimen using a combination of those drugs. Material and Methods:, ,Gingival fibroblasts were isolated from responder and nonresponder subjects and maintained in vitro. Prior to cell harvest, gingival interleukin-1, concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Cells were untreated or exposed to either 10,7,10,10 m nifedipine or 100,500 ng/ml cyclosporine A. Incorporation of [3H]proline or [35S]sulfate into the cell cultures was determined by liquid scintillation analysis. In addition, the effects of 400 ng/ml cyclosporine A + 10,7 m nifedipine and 400 ng/ml cyclosporine A + 10,10 m nifedipine on incorporation of [35S]sulfate into the cell cultures was determined. Data were compared by factorial analysis of variance (anova) and a posthoc Tukey's test. Results:, Gingiva from responders contained significantly more interleukin-1, than gingiva from nonresponders (p < 0.01). The cell cultures derived from responders incorporated significantly more [35S]sulfate than those derived from nonresponders following exposure to either cyclosporine A or 10,7 m nifedipine. In addition, the exposure of fibroblasts derived from gingival overgrowth to either 400 ng/ml cyclosporine A + 10,7 m nifedipine or 400 ng/ml cyclosporine A + 10,10 m nifedipine significantly increased or decreased, respectively, the incorporation of [35S]sulfate into the cultures. Conclusion:, ,The therapeutic combination of cyclosporine A and nifedipine could be a significant risk factor for gingival overgrowth in subjects susceptible to either agent. The mechanism for overgrowth could include edema secondary to increased sulfated-glycosaminoglycan (sGAG) synthesis by fibroblasts, but further investigation is required. [source] Early identification of haemodynamic response to pharmacotherapy is essential for primary prophylaxis of variceal bleeding in patients with ,high-risk' varicesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009P. SHARMA Summary Background, A beta-blocker is recommended for primary prophylaxis of variceal bleeding; however, only one-third have hepatic venous pressure gradient (HVPG) response. The role of addition of isosorbide-5-mononitrate (ISMN) to beta-blocker and benefits of HVPG-guided ,a la carte' approach remain unclear. Aim, To determine the benefits of HVPG-guided pharmacotherapy in primary prophylaxis of variceal bleeding using beta-blocker and ISMN. Patients and methods, Consecutive patients of cirrhosis, with high-risk varices, with no previous variceal bleeding were included. After baseline HVPG, patients received incremental propranolol to achieve HR of 55/min. After one-month, HVPG was repeated to determine response (<12 mmHg or ,20% reduction). ISMN was added in nonresponders and HVPG repeated. Patients were followed up for 24 months. Results, Of 56 patients (age 47 ± 13, males 79%) from 89 eligible patients, 21 (38%) responded to beta-blocker alone. Six additional patients responded to combination. Thus, overall 48% (27/56) patients responded. Variceal bleeding occurred in seven of 56 (13%) patients [one of 27 (4%) responder, five of 23 (22%) nonresponders and one of six (17%) with unknown response; P = N.S.]. The actuarial probability of variceal bleeding at median 24 months was 4% in responders and 22% in nonresponders (P < 0.05). Ten (18%) patients developed adverse effects to propranolol and six of 35 (17%) to nitrates requiring dose reduction. Risk factors of variceal bleed were grade IV varices and haemodynamic nonresponse. Conclusions, For primary prophylaxis, a beta-blocker is effective in 38% and addition of ISMN raises the response rate to about half of patients. The HVPG-guided ,a la carte' approach may be considered for these patients. [source] Predictors of the placebo response in functional dyspepsiaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2006N. J. TALLEY Summary Background, Trials in functional dyspepsia report placebo response rates of 30% to 40%. Aim, We aimed to identify predictors of the placebo response. Methods, Patients from primary, secondary and tertiary practices with functional dyspepsia defined by Rome II criteria were enrolled into one of four clinical trials; 220 patients were randomized to receive placebo. Scintigraphic assessment of gastric emptying at baseline was repeated at the end of the treatment in those with delayed emptying. After a 2 week run-in period, patients were followed for 8 weeks on placebo. Response was assessed on a weekly basis and a responder was defined as satisfactory relief of meal-related symptoms on at least 50% of weeks. Results, The mean age was 44 years (range 18,82) and 74% were female; 76 (35%) were placebo responders. The predominant symptom was an unstable measure over the trial. Independent predictors of a lower placebo response were lower body mass index and a more consistent predominant symptom pattern (both P < 0.05). No association was seen with age, gender, centre type, baseline symptom score, baseline or change in gastric emptying, or baseline quality of life. Conclusion, In functional dyspepsia, a consistent predominant symptom pattern and lower body mass index may be associated with a lower placebo response rate. [source] Goal attainment for spasticity management using botulinum toxinPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2006Stephen Ashford Abstract Background and Purpose. To determine whether goal attainment scaling (GAS) can demonstrate functional gains following injection of botulinum toxin (BTX) for spasticity in severely disabled patients. Method. Subjects were categorized as ,responder' (positive clinical outcome) and ,non-responder' (non-significant clinical outcome) on the basis of their overall clinical response. GAS scores for functional goals were calculated retrospectively and compared with standard outcome assessments undertaken at the time of intervention. Integrated care pathway (ICP) proformas were interrogated for 18 patients with acquired brain injuries. Mean age was 44.4 (SD 13.4) years. Results. Baseline GAS and Barthel scores were similar for the responder and non-responder groups. The outcome GAS score was significantly greater in the responder than in the non-responder group (Mann,Whitney U = 11.0; p = 0.011) as was the change in GAS score (Mann,Whitney U = 8.0; p = 0.004). GAS scores reflected change recorded in focal outcome measures. However, the Barthel Index measured change in only one case. Conclusions. This exploratory retrospective study provides preliminary support for the hypothesis that GAS provides a useful measure of functional gains in response to treatment with BTX, and is more sensitive than global measures such as the Barthel Index. Copyright © 2006 John Wiley & Sons, Ltd. [source] Impact of decision-making in a multidisciplinary perinatal teamPRENATAL DIAGNOSIS, Issue 2 2007Hilmar H. Bijma Abstract Objectives (1)To describe the characteristics of decision-making about management of unborn infants with serious anomalies by a multidisciplinary perinatal team. (2)To evaluate the impact of multidisciplinary team discussions on the degree to which decisions about the management of unborn infants with serious anomalies are supported. (3)To evaluate the impact of the team discussions on the arguments used by physicians for their preferences concerning management. Methods Prospective analysis of 78 cases discussed within the multidisciplinary perinatal team of a tertiary centre by means of an anonymous one-page questionnaire with structured questions pertaining to the opinion of the responder on medical management of each case. Results We did not find systematic differences between specialties prior to the discussion of cases. However, discussion with the multidisciplinary perinatal team improved decision-making about management of unborn infants with serious anomalies by enhancing the degree of support for the decisions taken. The discussions of the team did not change the physicians' arguments mentioned for their preferences. Conclusion Multidisciplinary team discussions improve decision-making about management of unborn infants with serious congenital anomalies. Copyright © 2006 John Wiley & Sons, Ltd. [source] Maxillomandibular Advancement for Persistent Obstructive Sleep Apnea After Phase I Surgery in Patients Without Maxillomandibular DeficiencyTHE LARYNGOSCOPE, Issue 10 2000Kasey K. Li DDS Abstract Objective To assess the outcomes of maxillomandibular advancement (MMA) for the treatment of persistent obstructive sleep apnea syndrome (OSA) after phase I reconstruction in patients who do not have maxillomandibular deficiency. Methods From January 1997 to September 1998, 25 patients previously treated with phase I reconstruction (uvulopalatoplasty, genioglossus advancement, and/or hyoid suspension) who did not have maxillary and mandibular deficiencies underwent MMA for persistent OSA. Variables examined include age, sex, body mass index (BMI), respiratory disturbance index (RDI), lowest oxygen saturation (LSAT), and cephalometric data. In addition, a minimum of 6 months after surgery, questionnaires containing a 10-cm visual analogue scale (0 = no change, 10 = drastic change) were mailed to the patients. The questionnaire subjectively assessed the patient's perception of the facial appearance after surgery, whether there was pain or discomfort of the temporomandibular joint, the overall satisfaction with the treatment outcomes, and whether the patient would recommend the operation to other patients. Results Nineteen (76%) questionnaires were completed and returned by 15 men and 4 women. The mean age was 45.3 ± 6.6 years and the mean BMI was 33.1 ± 7.1 kg/m2. The mean RDI improved from 63.6 ± 20.8 to 8.1 ± 5.9 events per hour, and the mean LSAT improved from 73.3 ± 13.2% to 88.1 ± 4.1%. One patient was defined as an incomplete responder (RDI >20). One patient reported transient pain and discomfort of the temporomandibular joint. Although all of the patients felt that there were changes in their facial appearance after surgery, 18 of the 19 patients gave either a neutral or a favorable response to their facial esthetic results. All of these patients were satisfied with the overall outcomes and would recommend the treatment to others. Conclusion MMA is a highly effective treatment for persistent OSA after phase I surgery in patients who otherwise do not have maxillomandibular deficiency. The patient satisfaction is extremely high. Furthermore, previous concerns of unfavorable postoperative facial esthetics and temporomandibular joint dysfunction do not appear to be significant. [source] Contribution of Naïve and Memory T-Cell Populations to the Human Alloimmune ResponseAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2009C. Macedo T-cell alloimmunity plays a dominant role in allograft rejection. The precise contribution of naïve and memory T cells to this response however remains unclear. To address this question, we established an ex vivo flow-cytometric assay that simultaneously measures proliferation, precursor frequency and effector molecule (IFN,, granzyme B/perforin) production of alloreactive T cells. By applying this assay to peripheral blood mononuclear cells from healthy volunteers, we demonstrate that the CD4+ and CD8+ populations mount similar proliferative responses and contain comparable frequencies of alloreactive precursors. Effector molecule expression, however, was significantly higher among CD8+ T cells. Analysis of sorted naïve and memory T cells showed that alloreactive precursors were equally present in both populations. The CD8+ effector and terminally differentiated effector memory subsets contained the highest proportion of granzyme B/perforin after allostimulation, suggesting that these cells present a significant threat to transplanted organs. Finally, we demonstrate that virus-specific lymphocytes contribute significantly to the alloresponse in certain responder,stimulator HLA combinations, underscoring the importance of T-cell cross-reactivity in alloimmunity. These results provide a quantitative assessment of the roles of naïve and memory T-cell subsets in the normal human alloimmune response and establish a platform for measuring T-cell alloreactivity pre- and posttransplantation. [source] Teaching Mass Casualty Triage Skills Using Immersive Three-dimensional Virtual RealityACADEMIC EMERGENCY MEDICINE, Issue 11 2008Dale S. Vincent MD Abstract Objectives:, Virtual reality (VR) environments offer potential advantages over traditional paper methods, manikin simulation, and live drills for mass casualty training and assessment. The authors measured the acquisition of triage skills by novice learners after exposing them to three sequential scenarios (A, B, and C) of five simulated patients each in a fully immersed three-dimensional VR environment. The hypothesis was that learners would improve in speed, accuracy, and self-efficacy. Methods:, Twenty-four medical students were taught principles of mass casualty triage using three short podcasts, followed by an immersive VR exercise in which learners donned a head-mounted display (HMD) and three motion tracking sensors, one for their head and one for each hand. They used a gesture-based command system to interact with multiple VR casualties. For triage score, one point was awarded for each correctly identified main problem, required intervention, and triage category. For intervention score, one point was awarded for each correct VR intervention. Scores were analyzed using one-way analysis of variance (ANOVA) for each student. Before and after surveys were used to measure self-efficacy and reaction to the training. Results:, Four students were excluded from analysis due to participation in a recent triage research program. Results from 20 students were analyzed. Triage scores and intervention scores improved significantly during Scenario B (p < 0.001). Time to complete each scenario decreased significantly from A (8:10 minutes) to B (5:14 minutes; p < 0.001) and from B to C (3:58 minutes; p < 0.001). Self-efficacy improved significantly in the areas of prioritizing treatment, prioritizing resources, identifying high-risk patients, and beliefs about learning to be an effective first responder. Conclusions:, Novice learners demonstrated improved triage and intervention scores, speed, and self-efficacy during an iterative, fully immersed VR triage experience. [source] 19 A Novel Approach to Residency Education in EMS: The MD-PM AmbulanceACADEMIC EMERGENCY MEDICINE, Issue 2008Angela Fiege Challenge:, Indiana University EM residents have actively provided prehospital care as crew members on a hospital-based air ambulance service. This service functions as a secondary responder for high acuity patients who have already had first tier evaluation and care. First response, ground EMS experiences have been observational only as residents have ridden along with a two-paramedic team on an urban ambulance service for 24 hours during their residency careers. Resident understanding of first response care and challenges faced by initial EMS providers has been limited to that gleaned during their observational period. Solution:, Most EM residencies do not provide opportunities for residents to function as first response providers. Therefore, we developed a Physician-Paramedic team to provide first response care within a busy metropolitan area. This two-member team operates within a "geozone" that includes a diverse patient population with both medical and trauma complaints. Unlike other residency ground EMS programs, the MD-PM truck responds primarily to all ambulance requests within their designated geozone and assists outside their designated geozone for multi-patient casualties in which a physician response would benefit patient care (fires, motor vehicle accidents, multiple gunshot victims). Residents on the MD-PM truck not only provide care equivalent to that expected of a nationally certified paramedic (IVs, drug administration, splinting, packaging), but also perform advanced skills such as RSI which is outside the scope of a traditional two-paramedic team. Immersion into the first response ground EMS system will provide valuable insight into the challenges of providing care outside of the hospital. [source] Goal attainment for spasticity management using botulinum toxinPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2006Stephen Ashford Abstract Background and Purpose. To determine whether goal attainment scaling (GAS) can demonstrate functional gains following injection of botulinum toxin (BTX) for spasticity in severely disabled patients. Method. Subjects were categorized as ,responder' (positive clinical outcome) and ,non-responder' (non-significant clinical outcome) on the basis of their overall clinical response. GAS scores for functional goals were calculated retrospectively and compared with standard outcome assessments undertaken at the time of intervention. Integrated care pathway (ICP) proformas were interrogated for 18 patients with acquired brain injuries. Mean age was 44.4 (SD 13.4) years. Results. Baseline GAS and Barthel scores were similar for the responder and non-responder groups. The outcome GAS score was significantly greater in the responder than in the non-responder group (Mann,Whitney U = 11.0; p = 0.011) as was the change in GAS score (Mann,Whitney U = 8.0; p = 0.004). GAS scores reflected change recorded in focal outcome measures. However, the Barthel Index measured change in only one case. Conclusions. This exploratory retrospective study provides preliminary support for the hypothesis that GAS provides a useful measure of functional gains in response to treatment with BTX, and is more sensitive than global measures such as the Barthel Index. Copyright © 2006 John Wiley & Sons, Ltd. [source] Brain Natriuretic Peptide Levels and Response to Cardiac Resynchronization Therapy in Heart Failure PatientsCONGESTIVE HEART FAILURE, Issue 5 2006Reynolds M. Delgado MD The authors used brain natriuretic peptide (BNP) as a reliable marker to identify nonresponders to cardiac resynchronization therapy (CRT) in patients with advanced heart failure. The study included 70 patients with left ventricular dysfunction (mean ejection fraction, 21±4%) and left bundle branch block (QRS duration, 164±25 milliseconds) treated with CRT. The authors reviewed data on New York Heart Association functional class, baseline ejection fraction, sodium, creatinine, QRS duration, and BNP levels 3 months before and after CRT therapy. The authors compared results of 42 patients who survived (973+192 days) after CRT implantation (responders) to those of 28 patients (nonresponders) who either expired (n=21) or underwent heart transplantation (n=5) or left ventricular assist device implantation (n=2) after an average of 371+220 days. Mean BNP levels after 3 months of CRT decreased in responders from 758±611 pg/mLto 479±451 pg/mL (P=.044), while in nonresponders there was increase in BNP levels from 1191 ±466 pg/mL to 1611 ±1583; P=.046. A rise in BNP levels was associated with poor response (death or need for transplantation or left ventricular assist device and impaired long-term outcome), which makes it a good predictor to identify such patients. [source] The use of protective gloves and the prevalence of hand eczema, skin complaints and allergy to natural rubber latex among dental personnel in the county of Uppsala, SwedenCONTACT DERMATITIS, Issue 1 2000Magnus Lindberg During the past decade, there has been an increasing problem with acrylate allergy and natural rubber latex (NRL) allergy among dental personnel. The aim of the present study was to evaluate the prevalence of these problems among dentists, dental nurses and dental hygienists in Uppsala county, Sweden. The study was based on a self-administered questionnaire sent to 690 persons with 527 responders (76%). The most common skin problem was dry skin, fissures and/or itching on the hands. Of the 72 persons (13.6%) reporting to have suffered from hand eczema during the past 12 months, 41 were patch tested with the TRUE Test standard series and the Swedish dental screening series. In the patch tested group, 9.8% reacted to 1 or more of the acrylates. In addition, 389 persons were tested for NRL allergy with the Pharmacia Upjohn CAP-RAST test, and of these, we found 7.2% to be positive. The prevalence of self-reported hand eczema and the number of positive CAP-RAST tests differed between the 3 occupations, with higher figures for the dentists. There was also a correlation between atopic eczema and hand eczema. Of those reporting skin symptoms, 67.7% connected them to the place of work and 28.8% related them to the use of gloves. [source] | ||||||||||||||||||||||||||||||||||||||||