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Several Factors (several + factor)
Selected AbstractsThe Influence of Several Factors on Reliability for Complex Reading Comprehension TestsJOURNAL OF EDUCATIONAL MEASUREMENT, Issue 2 2002Guemin Lee The purpose of this study was to investigate the effects of items, passages, contents, themes, and types of passages on the reliability and standard errors of measurement for complex reading comprehension tests. Seven different generalizability theory models were used in the analyses. Results indicated that generalizability coefficients estimated using multivariate models incorporating content strata and types of passages were similar in size to reliability estimates based upon a model that did not include these factors. In contrast, incorporating passages and themes within univariate generalizability theory models produced non-negligible differences in the reliability estimates. This suggested that passages and themes be taken into account when evaluating the reliability of test scores for complex reading comprehension tests. [source] Clinical trials and statistical analyses: what should dermatologists look for in a report?DERMATOLOGIC THERAPY, Issue 3 2009Mohamed Alosh ABSTRACT Clinicians need to evaluate the quality of individual clinical studies and synthesize the information from multiple clinical studies to provide insights in selecting appropriate therapies for patients. Understanding the key statistical principles that underlie a clinical trial and how they may be implemented can help clinicians properly interpret the efficacy and safety findings of clinical trials. Several factors should be considered when evaluating clinical studies reported in the literature, as important differences might exist among reported studies, thereby impacting the reliability of their findings. Studies vary in terms of study design, conduct, analysis, and presentation of findings. The key features to consider when evaluating clinical trials are inferential intent (exploratory versus confirmatory), choice of control group, randomization, extent of blinding, prespecification of analyses, appropriate handling of missing data, and multiple end points. Making comparisons across studies is extremely difficult and rarely statistically justified. However, this article will point out issues to keep in mind when evaluating multiple studies, such as variations in design and study populations. [source] Reduced plasma total homocysteine concentrations in Type 1 diabetes mellitus is determined by increased renal clearanceDIABETIC MEDICINE, Issue 3 2005B. A. J. Veldman Abstract Introduction Elevated plasma levels of total homocysteine are related to the development of vascular complications. Patients with diabetes mellitus are particularly at risk for the development of these complications. Several factors determine plasma total homocysteine including renal function. Aims As early Type 1 diabetes is characterized by a relative glomerular hyperfiltration, increased renal clearance could contribute to decreased levels of homocysteine as observed in Type 1 diabetes mellitus. Therefore we investigated the relationship between plasma total homocysteine and the glomerular filtration rate (GFR). Methods In 92 Type 1 diabetes patients and 44 control subjects, we measured GFR and effective renal plasma flow (ERPF) by means of continuous infusion of inulin and p-aminohippurate. Fasting plasma total homocysteine was measured using high performance liquid chromatography. Results GFR (121 ± 21 resp. 104 ± 14 ml/min; P < 0.001) and ERPF (563 ± 127 resp. 516 ± 121 ml/min; P = 0.05) were significantly higher in Type 1 diabetes patients as compared with control subjects. Plasma total homocysteine was reduced in Type 1 diabetes patients as compared with control subjects (11.0 ± 4.5 resp. 13.4 ± 7 µmol/l; P = 0.01). Plasma total homocysteine was strongly correlated with GFR (Type 1 diabetes patients: r = ,0.43, P < 0.001; control subjects: r = ,0.39, P = 0.01). Conclusion GFR is a major determinant of plasma total homocysteine levels in Type 1 diabetes patients as well as control subjects. The reduced plasma total homocysteine levels in diabetes patients can be explained by an increased GFR. [source] Pathological gambling: an increasing public health problemACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2001Article first published online: 7 JUL 200 Gambling has always existed, but only recently has it taken on the endlessly variable and accessible forms we know today. Gambling takes place when something valuable , usually money , is staked on the outcome of an event that is entirely unpredictable. It was only two decades ago that pathological gambling was formally recognized as a mental disorder, when it was included in the DSM-III in 1980. For most people, gambling is a relaxing activity with no negative consequences. For others, however, gambling becomes excessive. Pathological gambling is a disorder that manifests itself through the irrepressible urge to wager money. This disorder ultimately dominates the gambler's life, and has a multitude of negative consequences for both the gambler and the people they interact with, i.e. friends, family members, employers. In many ways, gambling might seem a harmless activity. In fact, it is not the act of gambling itself that is harmful, but the vicious cycle that can begin when a gambler wagers money they cannot afford to lose, and then continues to gamble in order to recuperate their losses. The gambler's ,tragic flaw' of logic lies in their failure to understand that gambling is governed solely by random, chance events. Gamblers fail to recognize this and continue to gamble, attempting to control outcomes by concocting strategies to ,beat the game'. Most, if not all, gamblers try in some way to predict the outcome of a game when they are gambling. A detailed analysis of gamblers' selfverbalizations reveals that most of them behave as though the outcome of the game relied on their personal ,skills'. From the gambler's perspective, skill can influence chance , but in reality, the random nature of chance events is the only determinant of the outcome of the game. The gambler, however, either ignores or simply denies this fundamental rule (1). Experts agree that the social costs of pathological gambling are enormous. Changes in gaming legislation have led to a substantial expansion of gambling opportunities in most industrialized countries around the world, mainly in Europe, America and Australia. Figures for the United States' leisure economy in 1996 show gross gambling revenues of $47.6 billion, which was greater than the combined revenue of $40.8 billion from film box offices, recorded music, cruise ships, spectator sports and live entertainment (2). Several factors appear to be motivating this growth: the desire of governments to identify new sources of revenue without invoking new or higher taxes; tourism entrepreneurs developing new destinations for entertainment and leisure; and the rise of new technologies and forms of gambling (3). As a consequence, prevalence studies have shown increased gambling rates among adults. It is currently estimated that 1,2% of the adult population gambles excessively (4, 5). Given that the prevalence of gambling is related to the accessibility of gambling activities, and that new forms of gambling are constantly being legalized throughout most western countries, this figure is expected to rise. Consequently, physicians and mental health professionals will need to know more about the diagnosis and treatment of pathological gamblers. This disorder may be under-diagnosed because, clinically, pathological gamblers usually seek help for the problems associated with gambling such as depression, anxiety or substance abuse, rather than for the excessive gambling itself. This issue of Acta Psychiatrica Scandinavica includes the first national survey of problem gambling completed in Sweden, conducted by Volberg et al. (6). This paper is based on a large sample (N=9917) with an impressively high response rate (89%). Two instruments were used to assess gambling activities: the South Oaks Gambling Screen-Revised (SOGS-R) and an instrument derived from the DSM-IV criteria for pathological gambling. Current (1 year) and lifetime prevalence rates were collected. Results show that 0.6% of the respondents were classified as probable pathological gamblers, and 1.4% as problem gamblers. These data reveal that the prevalence of pathological gamblers in Sweden is significantly less than what has been observed in many western countries. The authors have pooled the rates of problem (1.4%) and probable pathological gamblers (0.6%), to provide a total of 2.0% for the current prevalence. This 2% should be interpreted with caution, however, as we do not have information on the long-term evolution of these subgroups of gamblers; for example, we do not know how many of each subgroup will become pathological gamblers, and how many will decrease their gambling or stop gambling altogether. Until this information is known, it would be preferable to keep in mind that only 0.6% of the Swedish population has been identified as pathological gamblers. In addition, recent studies show that the SOGS-R may be producing inflated estimates of pathological gambling (7). Thus, future research in this area might benefit from the use of an instrument based on DSM criteria for pathological gambling, rather than the SOGS-R only. Finally, the authors suggest in their discussion that the lower rate of pathological gamblers obtained in Sweden compared to many other jurisdictions may be explained by the greater availability of games based on chance rather than games based on skill or a mix of skill and luck. Before accepting this interpretation, researchers will need to demonstrate that the outcomes of all games are determined by other factor than chance and randomness. Many studies have shown that the notion of randomness is the only determinant of gambling (1). Inferring that skill is an important issue in gambling may be misleading. While these are important issues to consider, the Volberg et al. survey nevertheless provides crucial information about gambling in a Scandinavian country. Gambling will be an important issue over the next few years in Sweden, and the publication of the Volberg et al. study is a landmark for the Swedish community (scientists, industry, policy makers, etc.). This paper should stimulate interesting discussions and inspire new, much-needed scientific investigations of pathological gambling. Acta Psychiatrica Scandinavica Guido Bondolfi and Robert Ladouceur Invited Guest Editors References 1.,LadouceurR & WalkerM. The cognitive approach to understanding and treating pathological gambling. In: BellackAS, HersenM, eds. Comprehensive clinical psychology. New York: Pergamon, 1998:588 , 601. 2.,ChristiansenEM. Gambling and the American economy. In: FreyJH, ed. Gambling: socioeconomic impacts and public policy. Thousand Oaks, CA: Sage, 1998:556:36 , 52. 3.,KornDA & ShafferHJ. Gambling and the health of the public: adopting a public health perspective. J Gambling Stud2000;15:289 , 365. 4.,VolbergRA. Problem gambling in the United States. J Gambling Stud1996;12:111 , 128. 5.,BondolfiG, OsiekC, FerreroF. Prevalence estimates of pathological gambling in Switzerland. Acta Psychiatr Scand2000;101:473 , 475. 6.,VolbergRA, AbbottMW, RönnbergS, MunckIM. Prev-alence and risks of pathological gambling in Sweden. Acta Psychiatr Scand2001;104:250 , 256. 7.,LadouceurR, BouchardC, RhéaumeNet al. Is the SOGS an accurate measure of pathological gambling among children, adolescents and adults?J Gambling Stud2000;16:1 , 24. [source] Impact of hemoglobin level on survival in definitive chemoradiotherapy for T4/M1 lymph node esophageal cancerDISEASES OF THE ESOPHAGUS, Issue 3 2008S. Zenda SUMMARY., We retrospectively investigated the impact of the pre-chemoradiotherapy hemoglobin level (pre-CRT Hb level) for T4 and/or M1 lymph node (LYM) squamous cell carcinoma of the esophagus. Chemotherapy consisted of protracted infusion with 5-fluorouracil (5-FU) at 400 mg/m2/day on days 1,5 and 8,12, combined with cisplatin at 40 mg/m2/day on days 1 and 8, repeated twice at a 5-week interval. Concurrent radiation therapy was started on day 1 and delivered at 2 Gy/day for five days a week for a total radiation dose of 60 Gy, with a two-week break after a cumulative dose of 30 Gy. Several factors considered to be related with treatment outcome were evaluated by univariate and multivariate analysis. A total of 48 patients with T4/M1 LYM (lymphocyte) esophageal cancer treated with chemoradiotherapy (CRT) between September 2002 and April 2005 were enrolled. The complete response rate to this regimen was 44% and median survival time was 13.6 months, with a median follow-up period of 26.8 months. Median pre-CRT Hb level was 13.5 (10.4,15.3) g/dL. The CR rate in patients with a pre-CRT Hb level of 13 g/dL or less was only 24% but it was 60% in those with a level that was more than 13 g/dL (P=0.01). As for survival, anovarevealed that a pre-CRT Hb of 13 g/dL or less was a significant prognostic factor with a hazard ratio of 0.45 (95% confidence interval [CI]); 0.21,0.97, P=0.04), while on manova, including performance status, tumor size, TNM stage and pre-CRT Hb level, a pre-CRT Hb level of 13 g/dL or less was the only significant prognostic factor, with a hazard ratio of 0.35 (95% CI; 0.13,0.90, P=0.03). In conclusion, the pre-CRT Hb level may be an important determinant of outcome in patients with T4/M1 LYM squamous cell carcinoma of the esophagus. [source] Dichotic listening deficits in children with dyslexiaDYSLEXIA, Issue 1 2008Deborah W. Moncrieff Abstract Several auditory processing deficits have been reported in children with dyslexia. In order to assess for the presence of a binaural integration type of auditory processing deficit, dichotic listening tests with digits, words and consonant,vowel (CV) pairs were administered to two groups of right-handed 11-year-old children, one group diagnosed with developmental dyslexia and an age-matched control group. Dyslexic children performed more poorly than controls from their left ears when listening to digits and words and from their right ears when listening to CVs. Direction of ear advantage varied across individuals in both groups when tested with digits and CVs, but ear advantage was stable with words. Several factors that may have contributed to inconsistencies in direction of ear advantage are discussed. When the children were tested in a directed response mode, degree of ear advantage differed significantly between groups with both words and digits. More dyslexic than control children demonstrated clinically significant reductions in dichotic listening performance, but no uniform pattern of deficit emerged. Only the double correct score and the left ear score with CV pairs were predictive of word recognition performance in dyslexic children. Binaural integration deficits are present in some children with dyslexia. Auditory processing disorder assessment may help delineate factors that underlie or are associated with reading impairment in this population. Copyright © 2007 John Wiley & Sons, Ltd. [source] The role of soil in the collapse of 18 piers of Hanshin Expressway in the Kobe earthquakeEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 5 2006George Mylonakis Abstract An investigation is presented of the collapse of a 630 m segment (Fukae section) of the elevated Hanshin Expressway during the 1995 Kobe earthquake. The earthquake has, from a geotechnical viewpoint, been associated with extensive liquefactions, lateral soil spreading, and damage to waterfront structures. Evidence is presented that soil,structure interaction (SSI) in non-liquefied ground played a detrimental role in the seismic performance of this major structure. The bridge consisted of single circular concrete piers monolithically connected to a concrete deck, founded on groups of 17 piles in layers of loose to dense sands and moderate to stiff clays. There were 18 spans in total, all of which suffered a spectacular pier failure and transverse overturning. Several factors associated with poor structural design have already been identified. The scope of this work is to extend the previous studies by investigating the role of soil in the collapse. The following issues are examined: (1) seismological and geotechnical information pertaining to the site; (2) free-field soil response; (3) response of foundation-superstructure system; (4) evaluation of results against earlier studies that did not consider SSI. Results indicate that the role of soil in the collapse was multiple: First, it modified the bedrock motion so that the frequency content of the resulting surface motion became disadvantageous for the particular structure. Second, the compliance of soil and foundation altered the vibrational characteristics of the bridge and moved it to a region of stronger response. Third, the compliance of the foundation increased the participation of the fundamental mode of the structure, inducing stronger response. It is shown that the increase in inelastic seismic demand in the piers may have exceeded 100% in comparison with piers fixed at the base. These conclusions contradict a widespread view of an always-beneficial role of seismic SSI. Copyright © 2005 John Wiley & Sons, Ltd. [source] An Electrochemical DNA Biosensor for the Detection of the Apa I Polymorphism in the Vitamin D Receptor Gene Using Meldola's Blue as a Hybridization IndicatorELECTROANALYSIS, Issue 5 2010Nilay Aladag Abstract Electrochemical detection of nucleic acid base mismatches related to Apa I single nucleotide polymorphism (SNP) in the vitamin D receptor gene was performed successfully using 7-dimethyl-amino-1,2-benzophenoxazinium salt (Meldola's blue, MDB) with 10.9,pmol/100,,L of detection limit. MDB reduction signals obtained from probe, mismatch(probe-SNP containing target) and hybrid(probe-target) modified pencil graphite electrode(PGE) increased respectively. The sensor was able to clearly distinguish perfect match from mismatch DNA in a 30,min. detection time. Several factors affecting on the hybridization and indicator response are studied to maximize sensitivity and selectivity. The advantages of the biosensor are discussed in comparison with previous electrochemical assays for DNA hybridization. [source] Analyses of alkaloids in different products by NACE-MSELECTROPHORESIS, Issue 22 2007Chen-Wen Chiu Abstract A simple method for the separation and characterization of five nicotine-related alkaloids by NACE employing UV and MS detections is described here for the first time. Several factors, including NACE parameters (compositions of running solution) and MS parameters (such as nature and flow rate of sheath liquid, pressure of nebulization gas, and flow rate of dry gas), were optimized in order to obtain both an adequate CE separation and high MS signals for the alkaloid compounds used in this study. A reliable CE separation of five alkaloids was achieved in 50,mM ammonium formate that was dissolved in an ACN/methanol mixture (50:50, v/v) of pH*,4.0 (apparent pH 4.0). The optimal electrospray MS measurement was carried out in the positive ionization mode using a coaxial sheath liquid composed of isopropyl alcohol and water in the ratio of 80:20 v/v at a flow rate of 180,,L/h. In addition, the proposed NACE method was also applied in the analyses of alkaloids in several products including chewing gums, beverages, and tobaccos. This NACE-MS method was found to provide a better detection ability and separation resolution for the analysis of nicotine alkaloids when compared to other aqueous CE-MS reports. [source] Electronic gel protein transfer and identification using matrix-assisted laser desorption/ionization-mass spectrometryELECTROPHORESIS, Issue 9 2004Jonathan W. Cooper Abstract An electronic protein transfer technique is described for achieving the rapid and efficient recovery of sodium dodecyl sulfate (SDS)-protein complexes from polyacrylamide gels. This process involves the use of small-dimension capillaries in physical contact with a resolved protein band within the polyacrylamide gel, providing a large potential drop and high electric field strength at the capillary/gel interface. Several factors controlling the electronic protein transfer, including the applied electric field strength, the electrophoresis buffer concentration, and the capillary dimension, are studied to further enhance the use of field-amplification for sample stacking of extracted SDS-protein complexes. As a result of sample stacking, the extracted proteins from a 50 ng gel loading are present in a narrow (,80 nL) and highly concentrated (0.46 mg/mL or 3.3×10,5 M for cytochrome c) solution plug. Three model proteins with molecular mass ranging from 14 kDa (cytochrome c) to 116 kDa (,-galactosidase) are stained by Coomassie blue and electrophoretically extracted from gels with protein loadings as low as 50 ng. The capillary format of the electronic protein transfer technique allows direct deposition of extracted proteins onto a matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) target. Various matrices and solvent compositions are evaluated for the analysis of extracted and concentrated SDS-protein complexes using MALDI-MS. The electronic protein transfer technique, when operated under optimized conditions, is demonstrated for the effective (>70% recovery), speedy (less than 5 min), and sensitive MS identification of gel resolved proteins (as low as 50 ng). [source] Association of serum sialic acid and MMP-9 with lipids and inflammatory markersEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2 2000Kalela Background Inflammation of the arterial wall has emerged to be an important contributor to the process of atherosclerosis, the major cause of coronary heart disease. Several factors are currently under investigation as inflammatory markers of atherosclerosis. Serum sialic acid and matrix metalloproteinase-9 may provide such markers. We studied their association with the lipid profile and with the inflammatory markers C-reactive protein and leukocyte count in a clinically healthy population of men. Materials and methods Cardiovascular risk-related laboratory tests were carried out in 65 consecutive male employees in connection with an occupational health survey in 1996. The subjects were divided into tertiles on the basis of serum sialic acid or matrix metalloproteinase-9 concentration. Results In a stepwise polychotomous logistic regression model adjusting for coronary heart disease risk factors, serum sialic acid concentration was not associated with markers of inflammation but rather with the lipid risk factors of atherosclerosis: inversely with HDL cholesterol (OR = 0.081, 95% CI 0.0068,0.97) and positively with total cholesterol (OR = 2.4, 95% CI 1,5.6). Matrix metalloproteinase-9 levels had a significant positive correlation with the leukocyte count (OR = 2.3, 95% CI 1.4,4). Conclusions Serum sialic acid does not appear to be an indicator of inflammation but is somehow connected with the level of total and HDL cholesterol. Serum matrix metalloproteinase-9 may provide a useful marker of inflammation because it correlates with the leukocyte count and is not associated with the lipid profile. [source] DIVERGENCE WITH GENE FLOW IN THE ROCK-DWELLING CICHLIDS OF LAKE MALAWIEVOLUTION, Issue 5 2000Patrick D. Danley Abstract Within the past two million years, more than 450 species of haplochromine cichlids have diverged from a single common ancestor in Lake Malawi. Several factors have been implicated in the diversification of this monophyletic clade, including changes in lake level and low levels of gene flow across limited geographic scales. The objectives of this study were to determine the effect of recent lake-level fluctuations on patterns of allelic diversity in the genus Metriaclima, to describe the patterns of population structure within this genus, and to identify barriers to migration. This was accomplished through an analysis of allele frequencies at four microsatellite loci. Twelve populations spanning four species within Metriaclima were surveyed. The effect of lake-level fluctuations can be seen in the reduced genetic diversity of the most recently colonized sites; however, genetic diversity is not depressed at the species level. Low levels of population structure exist among populations, yet some gene flow persists across long stretches of inhospitable habitat. No general barrier to migration was identified. The results of this study are interpreted with respect to several speciation models. Divergence via population bottlenecks is unlikely due to the large allelic diversity observed within each species. Genetic drift and microallopatric divergence are also rejected because some gene flow does occur between adjacent populations. However, the reduced levels of gene flow between populations does suggest that minor changes in the selective environment could cause the divergence of populations. [source] Ground Water Chlorinated Ethenes in Tree Trunks: Case Studies, Influence of Recharge, and Potential Degradation MechanismGROUND WATER MONITORING & REMEDIATION, Issue 3 2004Don A. Vroblesky Trichloroethene (TCE) was detected in cores of trees growing above TCE-contaminated ground at three sites: the Carswell Golf Course in Texas, Air Force Plant PJKS in Colorado, and Naval Weapons Station Charleston in South Carolina. This was true even when the depth to water was 7.9 m or when the contaminated aquifer was confined beneath ,3 m of clay. Additional ground water contaminants detected in the tree cores were cis,1,2-dichloroethene at two sites and tetrachloroethene at one site. Thus, tree coring can be a rapid and effective means of locating shallow subsurface chlorinated ethenes and possibly identifying zones of active TCE dechlorination. Tree cores collected over time were useful in identifying the onset of ground water contamination. Several factors affecting chlorinated ethene concentrations in tree cores were identified in this investigation. The factors include ground water chlorinated ethene concentrations and depth to ground water contamination. In addition, differing TCE concentrations around the trunk of some trees appear to be related to the roots deriving water from differing areas. Opportunistic uptake of infiltrating rainfall can dilute prerain TCE concentrations in the trunk. TCE concentrations in core headspace may differ among some tree species. In some trees, infestation of bacteria in decaying heartwood may provide a TCE dechlorination mechanism within the trunk. [source] Practical questions in liver metastases of colorectal cancer: general principles of treatmentHPB, Issue 4 2007Héctor Daniel González Abstract Liver metastases of colorectal cancer are currently treated by multidisciplinary teams using strategies that combine chemotherapy, surgery and ablative techniques. Many patients classically considered non-resectable can now be rescued by neoadjuvant chemotherapy followed by liver resection, with similar results to those obtained in initial resections. While many of those patients will recur, repeat resection is a feasible and safe approach if the recurrence is confined to the liver. Several factors that until recently were considered contraindications are now recognized only as adverse prognostic factors and no longer as contraindications for surgery. The current evaluation process to select patients for surgery is no longer focused on what is to be removed but rather on what will remain. The single most important objective is to achieve a complete (R0) resection within the limits of safety in terms of quantity and quality of the remaining liver. An increasing number of patients with synchronous liver metastases are treated by simultaneous resection of the primary and the liver metastatic tumours. Multilobar disease can also be approached by staged procedures that combine neoadjuvant chemotherapy, limited resections in one lobe, embolization or ligation of the contralateral portal vein and a major resection in a second procedure. Extrahepatic disease is no longer a contraindication for surgery provided that an R0 resection can be achieved. A reverse surgical staged approach (liver metastases first, primary second) is another strategy that has appeared recently. Provided that a careful selection is made, elderly patients can also benefit from surgical treatment of liver metastases. [source] Rates of adherence to pharmacological treatment among children and adolescents with attention deficit hyperactivity disorderHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 5 2002El Sheikh R. Ibrahim Abstract Pharmacological intervention, mainly with psychostimulants, alone or with psychotherapy or behavioural modification, was found to be effective in increasing sustained attention span, improving concentration, reducing hyperactive behaviour and improving areas of academic deficits in children and adolescents with the diagnosis of attention deficit-hyperactivity disorder (ADHD). Despite their proven efficacy, noncompliance of the children and adolescents to the prescribed medication presents serious problems to patients and health care providers alike. Objective To investigate the rate of adherence to prescribed medication in a clinically referred sample of children and adolescents diagnosed as having ADHD. In addition, the stability of reports of adherence over a 3 month period was explored. Method Fifty-one children and adolescents (males: n,=,42; females: n,=,9) between the age of 7 years and 16.6 years diagnosed with ADHD and their parents were administered a children behaviour checklist, a teacher report form scale and a compliance with treatement opinion and attitude scale. Results There were very high reports of adherence by children to prescribed medications for ADHD with rates of compliance greater than 70%. Correlation between the children and adolescents' reports and the parents' reports revealed high agreement both at the end of week 1 and at the end of the study (week 12). There were also findings of stability of adherence reports over a 3 month period. Conclusion The results of this study documented high rates of adherence to medication prescribed for symptoms of attention deficit hyperactivity disorder in a sample of children and adolescents. Their reports of adherence were well correlated with parents' reports. Several factors were found to be related to the high level of adherence. Copyright © 2002 John Wiley & Sons, Ltd. [source] Caspases and T lymphocytes: a flip of the coin?IMMUNOLOGICAL REVIEWS, Issue 1 2003Saquib Lakhani Summary:, In this review, we consider the role caspases play in cell death downstream of death receptors and cell intrinsic death mechanisms. In particular, we focus on these mechanisms in antigen-induced cell death, a mechanism which regulates the number of surviving T cells at the end of an immune response. The relative role of the apoptosome as an amplifier rather than an initiator of apoptosis is considered. Several factors that regulate the susceptibility to activation-induced cell death are considered. These factors emanate from the stimulation of the T-cell receptors and include multiple pathways. Recent work has shown that death receptor signaling can play an interesting role in cell proliferation in both humans and animals. These recent findings are discussed in the light of models of death receptor signaling. [source] Russia's non-strategic nuclear forcesINTERNATIONAL AFFAIRS, Issue 3 2001David S. Yost Several factors explain the high level of support for non-strategic nuclear forces(NSNF) in Russia and the correspondingly limited interest in NSNF arms control. These include Russia's conventional military weakness, NATO's conventional military superiority, political assessments that portray NATO as threatening to Russia, and the several important functions assigned to Russia's nuclear weapons and to NSNF in particular by Russian military doctrine and policy. The Russians have made it clear that they attach great importance to NSNF in a number of ways: in their preoccupations during the NATO-Russia Founding Act negotiations in 1996-7; in their recent military exercises; in their decisions regarding NSNF modernization; in their lack of transparency in implementing their 1991-2 commitments to reduce and eliminate certain types of NSNF; and in their discussions about possibly abandoning certain nuclear arms control commitments. Russian interests in using NSNF to deter powers other than NATO (such as China), to substitute for advanced non-nuclear precision-strike systems, and to ,de-escalate' regional conflicts (among other functions attributed to NSNF) would not be modified by the course of action some observers have advocated,a unilateral withdrawal of US NSNF from Europe. Such a withdrawal would, however, damage the Western alliance's security interests. NATO has adopted the most practical objective currently available: pursuing greater transparency regarding NSNF in the NATO-Russia Permanent Joint Council. [source] Computability in non-linear solid mechanicsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 1-2 2001T. Belytschko Abstract The computability of non-linear problems in solid and structural mechanics problems is examined. Several factors which contribute to the level of difficulty of a simulation are discussed: the smoothness and stability of the response, the required resolution, the uncertainties in the load, boundary conditions and initial conditions and inadequacies and uncertainties in the constitutive equation. An abstract measure of the level of difficulty is proposed, and some examples of typical engineering simulations are classified by this measure. We have put particular emphasis on engineering calculations, where many of the factors that diminish computability play a prominent role. Copyright © 2001 John Wiley & Sons, Ltd. [source] Conceptualization of mild cognitive impairment: a reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2004Heather S. Davis Abstract Background Several factors have prompted renewed interest in the concept of declines in cognitive function that occur in association with aging, in particular the area between normal cognition and dementia. We review the changing conceptualization of what has come to be known as mild cognitive impairment (MCI) in an effort to identify recent developments and highlight areas of controversy. Methods Standard MEDLINE search for relevant English-language publications on mild cognitive impairment and its associated terms, supplemented by hand searches of pertinent reference lists. Results Many conditions cause cognitive impairment which does not meet current criteria for dementia. Within this heterogenous group, termed ,Cognitive Impairment, No Dementia' (CIND), there are disorders associated with an increased risk of progression to dementia. Still, the conceptualization of these latter disorders remains in flux, with variability around assumptions about aging, the relationship between impairment and disease, and how concomitant functional impairment is classified. Amongst patients with MCI, especially its amnestic form, many will progress to Alzheimer's disease (AD). In contrast with clinic-based studies, where progression is more uniform, population-based studies suggest that the MCI classification is unstable in that context. In addition to Amnestic Mild Cognitive Impairment (AMCI), other syndromes exist and can progress to dementia. For example, an identifiable group with vascular cognitive impairment without dementia shows a higher risk of progression to vascular dementia, Alzheimer's disease and mixed dementia. Conclusions Recent attempts to profile patients at an increased risk of dementia suggest that this can be done in skilled hands, especially in people whose symptoms prompt them to seek medical attention. Whether these people actually have early AD remains to be determined. The more narrowly defined MCI profiles need to be understood in a population context of CIND. Copyright © 2004 John Wiley & Sons, Ltd. [source] Predictors of gambling problems among male adolescentsINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 3 2003Arne Gerdner The study concerns prediction of gambling problems in 178 male adolescents (aged 16 and 18 years) who completed a questionnaire, which included the South Oaks Gambling Screen (SOGS), a version of the Temperament and Character Inventory and a number of questions concerning social background, emotional and life-style factors. About 27% of the boys gamble at least weekly. As many as 16% qualify as probable pathological gamblers according to the SOGS. Another 7% are at risk. None of the social background factors are related to severity of gambling problems. The only significant family factor is parental substance misuse. The optimal multivariate model predicts about 30% of the variance in gambling problems. The strongest factor is frequency of alcohol drinking. Several factors indicate a personality with problems in relations to others. Another factor indicates a dreamy personality. Unexpectedly, impulsiveness is not related to gambling. In conclusion, problem gambling among male adolescents is related to life-style and personality, especially in relation to others, but not to usual social background factors. Gamblers are asocial rather than impulsive. The nature of this finding should be further explored, since an asocial personality may point at genetics as well as to early social influences, as may the finding on the relation between gambling and parental drinking. [source] Differences in End-of-Life Preferences Between Congestive Heart Failure and Dementia in a Medical House Calls ProgramJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2004Ziad R. Haydar MD Objectives: To compare end-of-life preferences in elderly individuals with dementia and congestive heart failure (CHF). Design: Retrospective case-control study. Setting: Geriatrician-led interdisciplinary house-call program using an electronic medical record. Participants: Homebound individuals who died while under the care of the house-call program from October 1996 to April 2001. Measurements: Medical records review for demographics, functional status, advance medical planning, hospice use, and place of death. Results: Of 172 patients who died in the program, 29 had CHF, 79 had dementia, 34 had both, and 30 had neither. Patients with CHF were younger (82.6 vs 87.0, P=.011) and less functionally dependent (activities of daily living score 9.1 vs 11.5, P=.001). Time from enrollment to death was not significantly different (mean±standard deviation=444±375 days for CHF vs 325±330 days for dementia, P=.113). A do-not-resuscitate (DNR) directive was given in 62% of patients with CHF and 91% with dementia (P<.001). Advance medical planning discussions were not significantly different (2.10 in CHF vs 1.65 in dementia, P=.100). More patients with CHF participated in their advance medical planning than those with dementia (86% vs 17%, P<.001). Hospice was used in 24% of CHF and 61% of dementia cases (P<.001). Finally, 45% of patients with CHF and 18% of patients with dementia died in the acute hospital (P=.006). Multivariate analysis showed that the fact that more patients with CHF were involved in their medical planning was not significant in predicting end-of-life preferences. Alternatively, Caucasian ethnicity was an independent predictor of having a documented DNR and death outside of the acute hospital. Conclusion: In the months before death, patients with CHF were more likely to have care plans directed at disease modification and treatment, whereas dementia patients were more likely to have care plans that focused on symptom relief and anticipation of dying. Several factors may contribute to this difference. [source] Epidemiology of Anemia in the Elderly: Information on Diagnostic EvaluationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3s 2003Lodovico Balducci MD A rise in the aging population has been predicted, and, as a result, it is expected that the incidence of age-related health conditions will also increase. Although common in the elderly, anemia is often mild and asymptomatic and rarely requires hospitalization. However, untreated anemia can be detrimental, because it is associated with increased mortality, poor health, fatigue, and functional dependence and can lead to cardiovascular and neurological complications. Several factors have been suggested to cause anemia in this population, for example, blood loss or chronic disease. In some cases, the cause is unknown. It has been suggested that this is a result of the presence of comorbid conditions that can mask the symptoms of anemia. Therefore, appropriate diagnosis and management strategies of anemia in the elderly need to be identified, particularly because anemia may indicate the presence of other serious diseases. [source] Shorebird predation of horseshoe crab eggs in Delaware Bay: species contrasts and availability constraintsJOURNAL OF ANIMAL ECOLOGY, Issue 3 2007S. GILLINGS Summary 1Functional responses , the relationship between resource intake rate and resource abundance , are widely used in explaining predator,prey interactions yet many studies indicate that resource availability is crucial in dictating intake rates. 2For time-stressed migrant birds refuelling at passage sites, correct decisions concerning patch use are crucial as they determine fattening rates and an individual's future survival and reproduction. Measuring availability alongside abundance is essential if spatial and temporal patterns of foraging are to be explained. 3A suite of shorebird species stage in Delaware Bay where they consume horseshoe crab Limulus polyphemus eggs. Several factors including spawning activity and weather give rise to marked spatial and temporal variation in the abundance and availability of eggs. We undertook field experiments to determine and contrast the intake rates of shorebird species pecking for surface and probing for buried eggs. 4Whether eggs were presented on the sand surface or buried, we demonstrate strong aggregative responses and rapid depletion (up to 80%). Depletion was greater at deeper depths when more eggs were present. No consistent give-up densities were found. Type II functional responses were found for surface eggs and buried eggs, with peck success twice as high in the former. Maximum intake rates of surface eggs were up to 83% higher than those of buried eggs. 5Caution is needed when applying functional responses predicted on the basis of morphology. Our expectation of a positive relationship between body size and intake rate was not fully supported. The smallest species, semipalmated sandpiper, had the lowest intake rate but the largest species, red knot, achieved only the same intake rate as the mid-sized dunlin. 6These functional responses indicate that probing is rarely more profitable than pecking. Currently, few beaches provide egg densities sufficient for efficient probing. Areas where eggs are deposited on the sand surface are critical for successful foraging and ongoing migration. This may be especially true for red knot, which have higher energetic demands owing to their larger body size yet appear to have depressed intake rates because they consume smaller prey than their body size should permit. [source] The influence of patient acuity on satisfaction with emergency care: perspectives of family, friends and carersJOURNAL OF CLINICAL NURSING, Issue 6 2008Anna Ekwall PhD Aims and objectives., To investigate the factors that influence satisfaction with emergency care among individuals accompanying patients to the emergency department and explore agreement between the triage nurse and accompanying person regarding urgency. Background., Many patients seeking treatment in hospital are escorted by an accompanying person, who may be a friend, family member or carer. Several factors influence patient satisfaction with emergency care, including waiting time and time to treatment. It is also influenced by provision of information and interpersonal relations between staff and patients. Research on satisfaction has focused on the patient perspective; however, individuals who accompany patients are potential consumers. Knowledge about the ways accompanying persons perceive the patient's medical condition and level of urgency will identify areas for improved patient outcomes. Design and methods., A prospective cross-sectional survey with a consecutive sample (n = 128 response rate 83·7%) was undertaken. Data were collected in an Australian metropolitan teaching hospital with about 32,000 visits to the emergency department each year. The Consumer Emergency Satisfaction Scale was used to measure satisfaction with nursing care. Results., Significant differences in perceptions of patient urgency between accompanying persons and nurses were found. Those people accompanying patients of a higher urgency were significantly more satisfied than those accompanying patients of a lower urgency. These results were independent of real waiting time or the accompanying person's knowledge of the patients' triage status. In addition, older accompanying persons were more satisfied with emergency care than younger accompanying persons. Discussion., Little attention has been paid to the social interactions that occur between nurses and patients at triage and the ways in which these interactions might impact satisfaction with emergency care. Relevance to clinical practice., Good interpersonal relationships can positively influence satisfaction with the emergency visit. This relationship can contribute to improved patient care and health outcomes. [source] Role of executive dysfunction in predicting frequency and severity of violenceAGGRESSIVE BEHAVIOR, Issue 5 2010Megan Hancock Abstract The adverse consequences of violence on society are tremendous. The proportion of offenders incarcerated for violent offenses is large, and the cost of keeping these offenders incarcerated is startling. Understanding and treating the causal underpinnings of violent crime is of utmost importance for individuals and society as a whole. Several factors have been identified as potential contributors to violent crime, including cognitive deficits in executive functioning [Hoaken et al., 2007]. To investigate this further, 77 offenders from Fenbrook Institution, a federal facility, were tested on a battery of executive functioning measures. Offenders were found to have broad and pervasive dysfunction in their executive abilities. In addition, specific scores from the battery were found using regression techniques, to predict the frequency and severity of past violent offending but not nonviolent offending. This speaks of the possibility of a new type of correctional rehabilitation program, one that focuses on the rehabilitation of basic executive functions. Aggr. Behav. 36:338,349, 2010. © 2010 Wiley-Liss, Inc. [source] What determines the management of anxiety disorders and its improvement?JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2008Mirrian Smolders MSc Introduction, Although anxiety disorders are highly prevalent, lack of correct diagnosis and related concerns about treatment are serious clinical problems. Several factors affect, positively or negatively, management of anxiety and its improvement. A literature review and thematic analysis was executed to obtain an overview of the types of determinants of anxiety care and its improvement. Methods, Literature was identified from electronic database searching (January 1995,March 2006), contact with authors of studies, and searching of websites of organizations concerned with mental health. By using a template analysis approach, a set of strong themes relating to determinants of anxiety care and its improvement was identified. Results, The 15 eligible studies identified 43 factors that impeded or facilitated optimal anxiety care and its improvement. Individual characteristics of both patients (n = 13) and professionals (n = 6) were most frequently reported as determinants of anxiety care and its improvement. A considerable number of factors were related to the organizational context (n = 12), such as practice type and location. Some factors related to the social context (n = 4), the economic context (n = 2), or to the innovation itself (n = 6) were identified. Conclusion, The findings show that there is a multitude of barriers and facilitators to optimal anxiety care and its improvement. Some determinants are modifiable, and thus responsive to interventions. Examples are collaboration within and between organizations, financial resources and assignment of both an opinion leader and responsible staff. The quality of anxiety care can be improved by systematically designing innovation strategies which are tailored to a selection of the determinants identified in this study. [source] Food consumption in the European Union: Main determinants and country differencesAGRIBUSINESS : AN INTERNATIONAL JOURNAL, Issue 4 2001A. Gracia Consumers in the European Union are involved in integration processes that head towards homogenization of food consumption patterns. Several factors are encouraging these homogenization trends based on consumers' similarities and corporate activities. In this article a review of the food consumption structure, across European Union countries, is undertaken. First, food consumption trends in different countries are described and, second, factors, which determine consumer choices, are presented. Despite the fact that European consumers face more homogeneous food market conditions, food consumption differences exist because preferences and food habits are still different among European consumers, and the market is fragmented (EconLit: L660). © 2001 John Wiley & Sons, Inc. [source] Forensic Dental Training in the Dental School CurriculumJOURNAL OF FORENSIC SCIENCES, Issue 3 2007Daniel C. Stoeckel D.D.S. ABSTRACT: This article reviews the literature regarding forensic education in the dental school curriculum and describes an exercise in forensic identification of victims of a mass casualty. Radiographs were made of dentate human cadavers in the gross anatomy laboratory at the Southern Illinois School of Dental Medicine. The jaws were then removed to provide "wet specimens" for the exercise. Several restorations were performed on the cadaver teeth, after which radiographs of the dissected jaws were made. One author wrote up mock dental records for each of the victims. These records included the first set or "premortem" radiographs. Students participating in the exercise were provided with a plane crash scenario, the dental records of the passengers on the manifest, the dissected jaws, and the second set or "postmortem" radiographs. Students were expected to form three teams. The first two teams evaluated the ante-mortem and postmortem dental records. The third team compared the ante-mortem and postmortem records to arrive at identification. The purpose of the exercise was twofold. It introduced dental students to forensic dentistry and emphasized the need for complete and accurate record keeping in the dental office. Several factors lessened the realism of the exercise and made it difficult to reproduce in the future. These included the uniformity of the dental records and the destruction of cadaver material following the exercise. [source] Sindbis viruses and other alphaviruses as cause of human arthritic diseaseJOURNAL OF INTERNAL MEDICINE, Issue 6 2004M. Laine Abstract. Amongst the arthritis-causing arboviruses, i.e. those spread by insects, the alphavirus group is of special interest. These viruses occasionally cause vast outbreaks, such as O'nyong-nyong in Africa in 1959. In Fennoscandia, Sindbis-related Ockelbo, Pogosta, or Karelian fever viruses have been found to cause significant morbidity. The major symptoms in addition to joint inflammation are fever, fatigue, headache and rash. The joint symptoms may persist for weeks, even months. The diagnosis is based on the clinical picture and serology. The causative viruses are closely related but not identical. It appears that at least in Finland the Pogosta disease is more common than thought, and the symptoms may often be overlooked. Several factors related to the viruses, their hosts, and global environmental changes may affect the spread of these viruses. All over the world arbovirus-caused diseases have increased, because of global changes. [source] Effect of cooling procedure on final denture base adaptationJOURNAL OF ORAL REHABILITATION, Issue 8 2002S. M. Ganzarolli Summary Well-fitted dentures prevent hyperplasic lesions, provide chewing efficiency and promote patient's comfort. Several factors may affect final adaptation of dentures, as the type of the acrylic resin, the flask cooling procedure and the water uptake. This investigation evaluated the effect of water storage and two different cooling procedures [bench cooling (BC) for 2 h; running water (RW) at 20 °C for 45 min] on the final adaptation of denture bases. A heat-cured acrylic resin (CL, Clássico, Clássico Artigos Odontológicos) and two microwave-cured acrylic resins [Acron MC, (AC) GC Dent. Ind. Corp.; Onda Cryl (OC), Clássico Artigos Odontológicos] were used to make the bases. Adaptation was assessed by measuring the weight of an intervening layer of silicone impression material between the base and the master die. Data was submitted to ANOVA and Tukey's test (0·05). The following means were found: (BC) CL=0·72 ± 0·03 a; AC=0·70 ± 0·03 b; OC=0·76 ± 0·04 c//(RW) CL= 1·00 ± 0·11 a; AC=1·00 ± 0·12 a; OC=0·95 ± 0·10 a. Different labels join groups that are not statistically different (P > 0·05). Comparisons are made among groups submitted to the same cooling procedure (BC or RW). The conclusions are: interaction of type of material and cooling procedure had a statistically significant effect on the final adaptation of the denture bases (P < 0·05); water storage was not detected as a source of variance (P > 0·05) on the final adaptation. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||