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Serious Implications (serious + implication)
Selected AbstractsSchizophrenia and weight management: a systematic review of interventions to control weightACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2003G. Faulkner Objective: Weight gain is a frequent side effect of antipsychotic medication which has serious implications for a patient's health and well being. This study systematically reviews the literature on the effectiveness of interventions designed to control weight gain in schizophrenia. Method: A systematic search strategy was conducted of major databases in addition to citation searches. Study quality was rated. Results: Sixteen studies met the inclusion criteria. Five of eight pharmacological intervention studies reported small reductions in weight (<5% baseline body weight). All behavioural (including diet and/or exercise) interventions reported small reductions in, or maintenance of, weight. Conclusion: Weight loss may be difficult but it is not impossible. Given the inconsistent results, the widespread use of pharmacological interventions cannot be recommended. Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control. [source] The capacity of Australian ED to absorb the projected increase in intern numbersEMERGENCY MEDICINE AUSTRALASIA, Issue 2 2010Anthony Chong Abstract As a reaction to the medical workforce shortage in Australia, a large expansion of undergraduate medical education has occurred through the provision of funding of additional medical student places. As a consequence, the number of medical graduates is anticipated to increase by as much as 90% with a peak in numbers anticipated in 2012. With ED already under pressure, this increase has serious implications for ED, particularly the delivery of intern and student teaching. This integrated review describes potential challenges that might arise from the predicted increase in intern numbers working in ED. A structured literature search was conducted from which 44 directly relevant articles were identified. We discuss the possible impact of an increased number of medical graduates on emergency medical staff, education, supervision and feedback to interns, and given the potential impacts on the education of junior doctors; we review the purpose and implementation of the Australian Curriculum framework for Junior Doctors in relation to their learning requirements. Although there is consensus by most postgraduate bodies that the core emergency term in emergency medicine should be retained, the impact of increased intern numbers might dramatically affect the clinical experiences, supervision and educational resources in the ED. This might necessitate cultural changes in medical education and ED function. [source] The epidemiology of depression in diabetesEUROPEAN DIABETES NURSING, Issue 3 2008K Winkley BSc, PhD Lecturer in Diabetes, Psychology Abstract Depression is characterised by a period of low mood and loss of interest in everyday activities, and its prevalence in people with diabetes is thought to be twice as high as for those without the condition. Depression in diabetes is associated with a number of adverse outcomes such as increased morbidity, mortality and poor quality of life. As diabetes is increasingly common amongst the economically active, this has serious implications for health services and in the UK, the National Health Service (NHS) has recognised that depression in people with diabetes is a significant problem and recommends screening for depression in this group. Risk factors for depression in diabetes are almost identical to those in people without diabetes, but less is known about its course when people have diabetes, although the available evidence suggests it is more chronic. Research into the mechanisms by which depression is bad for people with diabetes suggests that biological, psychological and social factors play a part but the inter-relationships between these factors are likely to be complex and are not yet fully understood. Depression in people with diabetes can be treated successfully with pharmacological and psychological treatments at least in the short-term, but we do not yet know which treatments are successful in the long-term. Further research into the pathological mechanisms of depression and its treatment are needed if we are to continue to improve the health and lives of people with diabetes. Copyright © 2008 FEND [source] HIV-1 impairs in vitro priming of naïve T cells and gives rise to contact-dependent suppressor T cellsEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 8 2010Karlhans F. Che Abstract Priming of T cells in lymphoid tissues of HIV-infected individuals occurs in the presence of HIV-1. DC in this milieu activate T cells and disseminate HIV-1 to newly activated T cells, the outcome of which may have serious implications in the development of optimal antiviral responses. We investigated the effects of HIV-1 on DC,naïve T-cell interactions using an allogeneic in vitro system. Our data demonstrate a dramatic decrease in the primary expansion of naïve T cells when cultured with HIV-1-exposed DC. CD4+ and CD8+ T cells showed enhanced expression of PD-1 and TRAIL, whereas CTLA-4 expression was observed on CD4+ T cells. It is worth noting that T cells primed in the presence of HIV-1 suppressed priming of other naïve T cells in a contact-dependent manner. We identified PD-1, CTLA-4, and TRAIL pathways as responsible for this suppresion, as blocking these negative molecules restored T-cell proliferation to a higher degree. In conclusion, the presence of HIV-1 during DC priming produced cells with inhibitory effects on T-cell activation and proliferation, i.e. suppressor T cells, a mechanism that could contribute to the enhancement of HIV-1 pathogenesis. [source] HABITAT FRAGMENTATION AND BIODIVERSITY: TESTING FOR THE EVOLUTIONARY EFFECTS OF REFUGIAEVOLUTION, Issue 6 2004Jon R. Bridle Abstract Concordant areas of endemism among taxa have important implications both for understanding mechanisms of speciation and for framing conservation priorities. Here we discuss the need for careful testing of phylogeographic data for evidence of such concordance, with particular reference to the Indonesian island of Sulawesi. This is because there are good reasons to question whether concordance between taxa is likely to be a common pattern, and because of the serious implications of incorrectly concluding that the biodiversity of a given area can be partitioned in this way. [source] Screening for the BRCA1-ins6kbEx13 mutation: potential for misdiagnosis,,HUMAN MUTATION, Issue 5 2007Susan J Ramus Abstract Misdiagnosis of a germline mutation associated with an inherited disease syndrome can have serious implications for the clinical management of patients. A false negative diagnosis (mutation missed by genetic screening) limits decision making about intervention strategies within families. More serious is the consequence of a false positive diagnosis (genetic test suggesting a mutation is present when it is not). This could lead to an individual, falsely diagnosed as a mutation carrier, undergoing unnecessary clinical intervention, possibly involving risk-reducing surgery. As part of screening 283 ovarian cancer families for BRCA1 mutations, we used two different methods (mutation specific PCR and multiplex ligation-dependant probe amplification) to screen for a known rearrangement mutation L78833.1:g.44369_50449dup (ins6kbEx13). We found false positive and false negative results in several families. We then tested 61 known carriers or non-carriers from an epidemiological study of BRCA1 and BRCA2 mutation carriers (the EMBRACE study). These data highlight the need for caution when interpreting analyses of the ins6kbEx13 mutation and similar mutations, where characterising the exact sequence alteration for a deleterious mutation is not a part of the routine genetic test. © 2007 Wiley-Liss, Inc. [source] Scaling of geological discontinuity normal load,deformation response using fractal geometryINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 8 2001Michael E. Plesha Abstract The mechanical behaviour of discontinuities in rock, such as joints, is known to be size-dependent. It is also suspected that the behaviour of larger size features, such as faults, is also size-dependent. This size dependence has serious implications for performing numerical response simulations of geological media. In this paper, we develop a new mathematical theory for scaling of one particular discontinuity property, namely the interface normal stiffness. To accomplish this, we idealize an interface to have fractal geometry, and we develop analytical relations which show that the interface normal stiffness, which is commonly thought to be a size-independent property, is in fact a size-dependent property and has fractal characteristics that may be exploited to develop a fundamental theory for scaling. Copyright © 2001 John Wiley & Sons, Ltd. [source] Implications of seasonal and diurnal variations of wind velocity for power output estimation of a turbine: a case study of GrenadaINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 13 2003D. Weisser Abstract This case study highlights the importance of taking into consideration diurnal variations of wind velocity for wind energy resources assessment. Previous studies of wind energy distribution that are based on the two-parameter Weibull density function have so far neglected to consider time of day fluctuations in wind speed, instead concentrating primarily on seasonal deviations. However, this has serious implications where such a wind energy model is the underpinning of calculations for the potential power production from a wind turbine and in particular where the timing of the energy output is essential to meet electricity loads. In the case of Grenada the energy output from a wind turbine during the day is approximately two times the output at night thereby fluctuating enormously around the seasonal mean distribution. When this is not taken into account the economic and technological viability of a wind turbine project may be overestimated or not even be identified. This work shows how a wind energy resources assessment based on the Weibull distribution model can be done and how the power output of a horizontal axis turbine is calculated. An analysis of the recorded wind data confirms the application of the Weibull density function as a suitable tool for modelling wind regimes. Copyright © 2003 John Wiley & Sons, Ltd. [source] The Eviction of Critical Perspectives from Gentrification ResearchINTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 4 2006TOM SLATER Recent years have seen an extraordinary resurgence of interest in the process of gentrification, accompanied by a surge of articles published on the topic. This article looks at some recent literature , both scholarly and popular , and considers the reasons why the often highly critical perspectives on gentrification that we saw in earlier decades have dwindled. Whilst a number of reasons could be put forward, three in particular are discussed. First, the resilience of theoretical and ideological squabbles over the causes of gentrification, at the expense of examining its effects; second, the demise of displacement as a defining feature of the process and as a research question; and third, the pervasive influence of neoliberal urban policies of ,social mix' in central city neighbourhoods. It is argued that the ,eviction' of critical perspectives from a field in which they were once plentiful has serious implications for those at risk from gentrification, and that reclaiming the term from those who have sugarcoated what was not so long ago a ,dirty word' (Smith, 1996) is essential if political challenges to the process can be effective. [source] Impact of the post-World War II generation on intensive care needs in NorwayACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2010J. H. LAAKE Background: A high birth rate during the first two decades following World War II has increased the proportion of elderly people in present-day society and, consequently, the demand for health-care services. The impact on intensive care services may become dramatic because the age distribution of critically ill patients is skewed towards the elderly. We have used registry data and population statistics to forecast the demand for intensive care services in Norway up until the year 2025. Methods: Data collected by the Norwegian intensive care registry (NIR), showing the age distribution in Norwegian intensive care units (ICU) during the years 2006 and 2007, were used with three different Norwegian prognostic models of population growth for the years 2008,2025 to compute the expected increase in intensive care unit bed-days (ICU bed-days). Results: The elderly were overrepresented in Norwegian ICUs in 2006,2007, with patients from 60 to 79 years of age occupying 44% of ICU bed-days. Population growth from 2008 to 2025 was estimated to be from 11.1 to 26.4%, depending on the model used. Growth will be much larger in the age group 60,79 years. Other factors kept unchanged, this will result in an increase in the need for intensive care (ICU bed-days) of between 26.1 and 36.9%. Conclusion: The demand for intensive care beds will increase markedly in Norwegian hospitals in the near future. This will have serious implications for the planning of infrastructure, education of health care personnel, as well as financing of our health care system. [source] Intention to 'leave' or 'stay' in nursingJOURNAL OF NURSING MANAGEMENT, Issue 3 2007GERALDINE McCARTHY PhD Background, Turnover in nursing and midwifery has recently become a problem in the Republic of Ireland and Irish health-care managers are constantly challenged to retain qualified nurses. The literature suggests that intention to stay or leave employment is the final step in the decision-making process. It is, therefore, reasonable to suggest that understanding ,intent to stay or leave' might facilitate nurse managers in introducing of appropriate retention strategies. Aim, The aim of this study was to investigate registered nurses ,intent to stay or leave' employment. Methods, A cross-sectional quantitative design was utilized. A questionnaire was designed and these were randomly distributed to 352 registered nurses at 10 hospital sites throughout the Republic of Ireland. Results, Almost 60% of the sample, comprising of young, female, college educated nurses, expressed an intent to leave their current post. The most statistically significant predictors of intent to leave were ,kinship responsibilities' (P < 0.05) and ,job satisfaction' (P < 0.0001). Conclusion, ,Intent to leave' has serious implications for workforce planning. Investigating the impact of focussed interventions in relation to job satisfaction and kinship responsibilities may be key retention strategies for nurse managers. [source] The circular definition of populations and its implications for biological samplingMOLECULAR ECOLOGY, Issue 5 2009THOMAS D. HARWOOD Abstract Application of population-based theoretical models to the study of real world populations requires the relationship between the real and theoretical populations to be defined. Otherwise, it is not possible to take a representative field sample or census of a population. I demonstrate that the concept of a biological population is based on a circular definition and is logically untenable. A population is composed of a number of individuals whose membership of the population is determined by their relationship to the rest of the population. This has serious implications for common practice in a range of ecological and evolutionary disciplines. [source] South Africa's export trade in asbestos: Demise of an industryAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2010John S. Harington DSc Abstract Background South Africa's export of each of its three types of asbestos, crocidolite, amosite, and chrysotile, and the total amounts to 84 countries in metric tonnes is examined over a 24-year period, 1980,2003. Methods For convenience, the countries are divided into nine world regional groups, Europe, Eastern Europe, North America with the Caribbean, South America, Africa, Middle East, Far East, South Asia, and Oceania. Results The three greatest importing countries of total asbestos in metric tonnes were all in the Far East region, ranging from Japan, South Korea to Thailand, and followed by USA and Italy. All exports to all countries diminished steadily as the South African trade came virtually to an end by 2003, due to ever increasing international pressure. Conclusion The export trade has changed significantly since 1960 from being dominantly to European countries to being directed in recent years to the Far East, with serious implications for asbestos-related ill-health in those countries. Am. J. Ind. Med. 53:524,534, 2010. © 2010 Wiley-Liss, Inc. [source] Mobility, Violence and the Gendering of HIV in Papua New GuineaTHE AUSTRALIAN JOURNAL OF ANTHROPOLOGY, Issue 2 2008Katherine Lepani The links between gender, sexuality and violence hold serious implications for HIV transmission and its social and economic effects. In Papua New Guinea, enduring and pervasive patterns of male sexual behaviour involving coercion, violence and gang rape are highly conducive to the transmission of HIV and other sexually transmitted infections and have a critical bearing on women's sexual autonomy and health. The realities of violence are intensified by the widespread view that women are responsible for the spread of the virus. This paper engages the theme of mobility to consider the fluid and dynamic character of gender relations and sexuality in contemporary Papua New Guinea, and to gain perspective on constructions of modern masculinity and the discursive representations of gender violence in the context of the escalating HIV epidemic. [source] Carnivore biodiversity in Tanzania: revealing the distribution patterns of secretive mammals using camera trapsANIMAL CONSERVATION, Issue 2 2010N. Pettorelli Abstract Biodiversity monitoring is critical to assess the effectiveness of management activities and policy change, particularly in the light of accelerating impacts of environmental change, and for compiling national responses to international obligations and agreements. Monitoring methods able to identify species most likely to be affected by environmental change, and pinpoint those changes with the strongest impacts, will enable managers to target efforts towards vulnerable species and significant threats. Here we take a new approach to carnivore monitoring, combining camera-trap surveys with ecological niche factor analysis to assess distribution and patterns of habitat use of mammalian carnivore assemblages across northern Tanzania. We conducted 11 surveys over 430 camera-trap stations and 11 355 trap-days. We recorded 23 out of 35 carnivore species known to occur in Tanzania and report major extensions to the known distribution of the bushy-tailed mongoose Bdeogale crassicauda, previously thought to be rare. Carnivore biodiversity tended to be higher in national parks than in game reserves and forest reserves. We explored habitat use for seven species for which we had sufficient information. All species tended to be found near rivers and southern Acacia commiphora woodlands (except one mongoose species), and avoided deciduous shrubland, favouring deciduous woodland and/or open grassland. All species tended to avoid croplands suggesting that habitat conversion to agriculture could have serious implications for carnivore distribution. Our study provides a first example where camera-trap data are combined with niche analyses to reveal patterns in habitat use and spatial distribution of otherwise elusive and poorly known species and to inform reserve design and land-use planning. Our methodology represents a potentially powerful tool that can inform national and site-based wildlife managers and policy makers as well as international agreements on conservation. [source] HIP FRACTURE RATES IN SOUTH AUSTRALIA: INTO THE NEXT CENTURYANZ JOURNAL OF SURGERY, Issue 2 2000L. S. Chipchase Background: Fractures of the femoral neck already represent a major public health problem in Australia. This situation is set to worsen as the population ages. The present study estimates the number of patients over 50 years of age with femoral neck fractures that is expected to impact on the South Australian healthcare service into the next century. Methods: Population projections from the Australian Bureau of Statistics 1996 census were combined with age- and gender-specific incidence rates for fractures of the femoral neck for persons over the age of 50 in South Australia. Projections for the expected number of hip fractures in this State were then calculated. Results: Assuming there are no changes in the age- and gender-specific incidence of fracture rates, the number of fractures in South Australia is estimated to increase by approximately 66% by the year 2021 and 190% by 2051. Conclusion: Based on the population projections and the assumption that conditions contributing to hip fractures remain constant, the number of fractured neck of femurs will increase in far greater proportion than the overall population in the next century. The results of the present study indicate the serious implications for the South Australian healthcare system if there is no reduction in incidence rates. [source] | |||||||||||||||||||