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Significant Growth (significant + growth)

Distribution by Scientific Domains

Medical Sciences	40%
Life Sciences	31%
Business, Economics, Finance and Accounting	22%

Terms modified by Significant Growth

significant growth inhibition

Selected Abstracts

Whither Latin America? trends and challenges of science in Latin America

IUBMB LIFE, Issue 4-5 2007
Marcelo Hermes-Lima
Abstract Science in Latin America has experienced vigorous growth in the past decade, as demonstrated by the fact that the Latin American share of the world's scientific publications increased from 1.8% in 1991 - 1995 to 3.4% in 1999 - 2003. Significant growth has also taken place in the numbers of PhDs in science and engineering (S&E) awarded in Latin American countries in recent years, including those in the natural sciences. Importantly, albeit at different rates, growth has been verified in almost all countries in the region, indicating a general effort to promote the development of S&E. In most research fields, however, the recognition or relative impact of Latin American science, as measured by the average number of citations received by published articles (CpP), is still below world averages and much lower than in developed nations. We show that average CpP values for a set of 34 representative developing and developed countries correlate significantly with gross expenditure in research and development (GERD), with gross domestic product (GDP) per capita and with the number of researchers per million inhabitants (RpM). Among those countries, Latin American nations present some of the lowest average values of CpP (<6), GERD (,1% of GDP) and RpM (<2,000). We also examined recent trends in scientific activity in Latin America, with focus on the natural sciences and on biochemistry and molecular biology (BMB). In terms of citation scores, publications in BMB compare favorably to those in other research fields within Latin America. At the same time, however, Latin American BMB is one of the areas for which relative impact - compared to developed nations or normalized to world averages - is lowest. These observations clearly indicate the need to establish effective policies to increase competitiveness in terms of the quality and international recognition of Latin American natural sciences in general, and BMB in particular, as opposed to merely increasing the absolute numbers of publications or the numbers of PhDs awarded in the region. IUBMB Life, 59: 199-210, 2007 [source]

Utilization of oligo- and polysaccharides at microgram-per-litre levels in freshwater by Flavobacterium johnsoniae

JOURNAL OF APPLIED MICROBIOLOGY, Issue 4 2010
E.L.W. Sack
Abstract Aims:, To obtain a bacterial strain that can be used to quantify biodegradable polysaccharides at concentrations of a few micrograms per litre in freshwater. Methods and Results:,Flavobacterium johnsoniae strain A3 was isolated from tap water supplemented with laminarin, pectin or amylopectin at 100 ,g C l,1 and river Rhine water. The organism utilized 14 of 23 oligo- and polysaccharides, and 1 of 9 monosaccharides, but none of the sugar acids, sugar alcohols, carboxylic acids or aromatic acids tested at 10 ,g C l,1. Amino acids promoted growth of strain A3, but not in coculture with assimilable organic carbon (AOC) test strain Pseudomonas fluorescens P17, which utilized these compounds more rapidly than strain A3. Compounds released by strain P17 and AOC test strain Spirillum sp. NOX grown on acetate promoted the growth of strain A3 at Nmax values of , 2 × 105 CFU ml,1 of strain P17 and , 5 × 105 CFU ml,1 of strain NOX. Significant growth of strain A3 was observed in surface water and in tap water in the presence of strain P17 (Nmax P17 < 2 × 105 CFU ml,1). Conclusions:, Strain A3 utilizes oligo- and polysaccharides at microgram-per-litre levels. In surface water and in tap water, the organism was able to utilize compounds that were not utilized by strain P17. These compounds may include oligo- and/or polysaccharides. Significance and Impact of the Study:, Phytoplanktonic and bacterial polysaccharides can constitute an important biodegradable fraction of natural organic matter in water and may promote growth of heterotrophic bacteria during water treatment and drinking water distribution. Strain A3 can be used to quantify a group of compounds that includes oligo- and polysaccharides at microgram-per-litre levels in freshwater. [source]

Aid to Agriculture, Growth and Poverty Reduction

EUROCHOICES, Issue 1 2006
Peter Hazell
Agriculture and rural growth promotion show a recent ,comeback' in development cooperation, but action on the ground so far is not sufficient. After years of neglect, policy makers have recognized that poverty reduction in many low income countries can only be achieved if development efforts are clearly focused on the sector which employs most of the poor, and the space where most of the poor live. The importance of agricultural growth was amply demonstrated during the economic transformation of Asia. Forty years ago, Asia was a continent of widespread poverty. Today, most Asian countries are experiencing significant growth and poverty reduction. Rapid growth in productivity in the small-farm sector helped drive this process. Sub-Saharan Africa, however, failed to achieve rapid agricultural growth and remains mired in poverty and hunger. If Africa is to halve poverty by 2015 in accordance with the Millennium Development Goals (MDG), agriculture will need to maintain an annual growth rate of 6 per cent between 2000 and 2015. China's experience from 1978 to 1984 shows such growth is possible. Achieving the desired rapid rates of growth in Africa will require coherent policies by governments and donors, a substantial investment of public resources in rural infrastructure and access to agricultural technology, and significant improvement in national governance. Dans les milieux de la coopération et de l'aide au développement, même si les actions sur le terrain sont encore insuffisantes, on assiste depuis peu au retour en scène de l'agriculture et du monde rural. Après s'en être désintéressés pendant des années, les décideurs politiques finissent par admettre que, dans beaucoup de pays a faible revenu, il ne sera pas possible de réduire la pauvreté sans focaliser les efforts de développement sur les secteurs qui emploient le plus de pauvres et les zones dans lesquelles ils vivent pour la plupart. Les transformations économiques de l'Asie montrent bien l'importance de la croissance agricole. Il y a quarante ans, l'Asie étaient le continent de la pauvreté généralisée. Aujourd'hui, la plupart des pays d'Asie connaissent une croissance très significative et la pauvreté s'y réduit. L'augmentation de la productivité dans le secteur des petites exploitations a contribuéà la mise en ,uvre de ce processus. L'Afrique sub-saharienne, au contraire, n'a pas réussi à développer une croissance agricole rapide, ce qui la fait s'embourber dans la faim et la pauvreté. Si l'Afrique doit réduire de moitié la pauvreté d'ici 2015 comme l'y invitent les objectifs millénaires du développement (MDG), il faudra y maintenir un taux de croissance annuel de 6% pour l'agriculture entre 2000 et 2015. L'expérience de la Chine entre 1978 et 1984 montre que c'est possible. Mais pour obtenir en Afrique le taux de croissance élevé qui est souhaité, il faudra de la cohérence dans les politiques entre les gouvernements et des donneurs, un investissement public substantiel dans les infrastructures rurales et les moyens d'accès aux techniques modernes, enfin, des modes de gestion publique significativement améliorés Die Förderung der Landwirtschaft und des Wachstums im ländlichen Raum erfreut sich seit kurzem erneuter Beliebtheit in der Entwicklungszusammenar beit; die bisher ergriffenen Maßnahmen sind jedoch noch nicht ausreichend. Nachdem dieses Thema jahrelang vernachlässigt wurde, haben die Politikakteure festgestellt, dass die Armutsbekämpfung in zahlreichen Ländern mit geringem Einkommen nur dann erfolgreich durchgeführt werden kann, wenn die Bemühungen zur Entwicklung deutlich auf den Sektor ausgerichtet werden, in welchem die meisten Armen beschäftigt sind, und auf die Räume, in welchen die meisten Armen leben. Bei der wirtschaftlichen Transformation in Asien wurde sehr deutlich, wie wichtig das landwirtschaftliche Wachstum ist. Vor 40 Jahren war Armut in Asien weit verbreitet. Heute zeichnen die meisten asiatischen Länder durch signifikantes Wachstum und durch Armutsverringerung aus. Ein schneller Anstieg der Produktivität bei den kleineren landwirtschaftlichen Betrieben half dabei, diese Entwicklung voran zu treiben. In den afrikanischen Ländern unterhalb der Sahara (Sub-Sahara-Afrika) konnte schnelles landwirtschaftliches Wachstum jedoch nicht erreicht werden, dort dominieren weiterhin Armut und Hunger. Wenn Afrika gemäß der Millenniumsentwicklungsziele (Millennium Development Goals, MDG) die Armut bis zum Jahr 2015 halbieren soll, muss die Landwirtschaft eine jährliche Wachstumsrate von sechs Prozent zwischen den Jahren 2000 und 2015 aufrecht erhalten. Die Erfahrungen aus China aus den Jahren 1978 bis 1984 belegen, dass ein solches Wachstum möglich ist. Damit die gewünschten hohen Wachstumsraten in Afrika erzielt werden können, sind kohärente Politikmaßnahmen seitens der Regierungen und der Geldgeber, erhebliche Investitionen von öffentlichen Ressourcen in die ländliche Infrastruktur und in den Zugang zur Agrartechnologie sowie eine signifikante Verbesserung der nationalen Governance erforderlich. [source]

Reversible transition between active and dormant microbial states in soil

FEMS MICROBIOLOGY ECOLOGY, Issue 2-3 2001
John Stenström
Abstract The rate of respiration obtained in the substrate-induced respiration (SIR) method can be divided into the respiration rate of growing (r) and non-growing (K) microorganisms. The fraction of r is generally small (5,20%) in soils with no recent addition of substrates, but can be 100% in soils with high substrate availability. This suggests that substrate availability determines the proportion of biomass between these groups, and implies that transitions between them can take place reversibly. These hypotheses were tested by adding three different amounts of glucose which induced first-order, zero-order, and growth-associated respiration kinetics to three soils at four pre-incubation times (4, 12, 27, and 46 days) before the SIR measurement. An abiotic flush of CO2 in the SIR measurement was detected and corrected for before data analysis. Accumulated CO2 -C over 4 days after glucose addition, corrected for the respiration in unamended controls, corresponded to 41,50% mineralization of the glucose-C, and the relative amount mineralized by each soil was independent of the glucose amount added. The high glucose concentration gave an increased SIR, which reverted to the initial value within 27,46 days. In a specific sample, the maximum respiration rate induced during the pre-incubation, and the amount of organisms transformed from the K to the r state, as quantified in respiration rate units in the SIR measurement, were identical to each other, and these parameters were also highly correlated to the initial glucose concentration. The K,r transition was very fast, probably concurrent with the instantaneous increase in the respiration rate obtained by the glucose amendment. Thereafter, a slow first-order back-transition from the r to the K state ensued, with half-lives of 12, 23, and 70 days for the three soils. The results suggest the existence of community-level controls by which growth within or of the whole biomass is inhibited until it has been completely transformed into the r state. The data also suggest that the microbial specific activity is not related to the availability of exogenous substrate in a continuous fashion, rather it responds as a sharp transition between dormant and fully active. Furthermore, the inherent physiological state of the microbial biomass is strongly related to its history. It is proposed that the normal dynamics of the soil microbial biomass is an oscillation between active and dormant physiological states, while significant growth occurs only at substantial substrate amendment. [source]

Impact of nutritional supplements and monosaccharides on growth, oxalate accumulation, and culture pH by Sclerotinia sclerotiorum

FEMS MICROBIOLOGY LETTERS, Issue 1 2007
Bryan J. Culbertson
Abstract Sclerotinia sclerotiorum D-E7 was studied to determine the impact of nutritional supplements and monosaccharides on growth, oxalate accumulation, and culture pH in broth media (initial pH c. 5). Cultures with 0.1% nutritional supplement (tryptone, yeast extract, or soytone) yielded minimal growth, 2,3 mM oxalate, and a final culture pH of 4.2,4.8. In contrast, cultures with 0.1% nutritional supplement and 25 mM glucose yielded significant growth, minimal oxalate (<1 mM), and a final culture pH of 2.8,3.7. Similar trends were observed when glucose in 0.1% soytone cultures was replaced with 25 mM d -mannose, l -arabinose, or d -xylose. With 1% soytone-25 mM glucose cultures, growth and oxalate accumulation (,21 mM) occurred with little change in initial pH. This was not the case with 1% soytone-250 mM glucose cultures; increased glucose levels resulted in a decrease in oxalate accumulation (,7 mM) and in final culture pH (3.4). Time-course studies with these cultures revealed that oxalate accumulation was suppressed during growth when the culture pH dropped to <4. Overall, these results indicate that (1) the decrease in external pH (i.e. acidification) was independent of oxalate accumulation and (2) acidification coupled to glucose-dependent growth regulated oxalate accumulation by Sclerotinia sclerotiorum. [source]

Climate for Scandal: Corporate Environments that Contribute to Accounting Fraud

FINANCIAL REVIEW, Issue 1 2007
Claire E. Crutchley
G34; G38; K22 Abstract We examine the governance characteristics, earnings quality, growth rates, dividend policy, and compensation structure of 97 firms recently under investigation by the Securities and Exchange Commission (SEC) for accounting fraud. Our results show that the corporate environment most likely to lead to an accounting scandal manifests significant growth and accounting practices that are already pushing the envelope of earnings smoothing. Firms operating in this environment seem more likely to tip over the edge into fraud if there are fewer outsiders on the audit committee and outside directors appear overcommitted. [source]

Who Benefits from the Reform of Pension Taxation in Germany?,

FISCAL STUDIES, Issue 1 2007
Hans Fehr
The present paper quantifies the revenue, distributional and efficiency effects of the recent reform of pension taxation in Germany. The starting point is the new legislation, which has introduced a switch to the deferred taxation of retirement benefits starting in 2005. We compare this reform with an alternative transition proposed by the Federation of German Pension Insurance Institutes (VDR), where double taxation is avoided at the cost of higher revenue losses. Our simulations indicate significant growth and efficiency gains from the new tax legislation. Winners from the reform are mainly younger workers, while older workers, civil servants and the self-employed will lose. The VDR proposal would have resulted in higher efficiency gains, but also in stronger distributional consequences. [source]

Inequality and two decades of British tax and benefit reforms

FISCAL STUDIES, Issue 2 2004
Tom Clark
Abstract Microsimulation methods are used to identify the contribution of tax and benefit reforms to the significant growth in UK income inequality since 1979. The total effect turns out to depend crucially on the counterfactual against which the reforms are assessed: compared with the alternative of pure price-indexation, the total effect of reform is small; by contrast, compared with a counterfactual in which benefits rose in line with national income (historically the case before 1979), the effect is substantial , approximately half the total rise in income inequality is explained. The impact of reforms on inequality has varied significantly over time: income tax cuts in the late 1970s and late 1980s increased inequality; direct tax rises in the early 1980s and 1990s, together with increases in means-tested benefits in the late 1990s, reduced it. The robustness of the results to sampling variation and to the measure of inequality used is also investigated. [source]

The level of Internet access and ICT training for health information professionals in sub-Saharan Africa

HEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2008
Grace Ada Ajuwon
Background:,, Information and Communication Technologies (ICTs) are important tools for development. Despite its significant growth on a global scale, Internet access is limited in sub-Saharan Africa (SSA). Few studies have explored Internet access, use of electronic resources and ICT training among health information professionals in Africa. Objective:, The study assessed Internet access, use of electronic resources and ICT training among health information professionals in SSA. Methods:, A 26-item self-administered questionnaire in English and French was used for data collection. The questionnaire was completed by health information professionals from five Listservs and delegates at the 10th biannual Congress of the Association of Health Information and Libraries in Africa (AHILA). Results:, A total of 121 respondents participated in the study and, of those, 68% lived in their countries' capital. The majority (85.1%) had Internet access at work and 40.8% used cybercafes as alternative access points. Slightly less than two-thirds (61.2%) first learned to use ICT through self-teaching, whilst 70.2% had not received any formal training in the previous year. Eighty-eight per cent of respondents required further ICT training. Conclusions and recommendations:, In SSA, freely available digital information resources are underutilized by health information professionals. ICT training is recommended to optimize use of digital resources. To harness these resources, intergovernmental and non-governmental organizations must play a key role. [source]

Widening the appeal of charity

INTERNATIONAL JOURNAL OF NONPROFIT & VOLUNTARY SECTOR MARKETING, Issue 4 2000
Adrian Sargeant
In the UK there is a contracting donor pool, but a significant growth in registered charities. This paper discusses the impact of individual, organisational and environmental factors on giving, and also distinguishes characteristics of givers and non-givers. The focus of the paper is on the long-term solution to the problem of recruitment of donors, by expanding the current supporter base for the charity sector. Copyright © 2000 Henry Stewart Publications. [source]

Global Regime Formation or Complex Institution Building?

INTERNATIONAL STUDIES QUARTERLY, Issue 2 2006
The Principled Content of International River Agreements
This paper analyzes the principled content of 62 international river agreements for the period 1980,2000. We ask two questions: whether governments are converging on common principles for governing shared river basins and whether the effort to create a global normative framework for shared rivers has shaped the principled content of basin-level international accords. The data reveal a complex process of normative development. A few core principles emanating from global legal efforts have shown significant growth, diffusion and deepening at the basin-specific level. Others are common in basin agreements but show no diffusion or deepening. Still others are weakly represented in the data. If joint articulation of common principles is necessary for regime formation, then there is only weak evidence for a global rivers regime. But the data also reveal normative developments not captured by a regime-theoretic lens: a backlash reinforcing sovereign rights, the emergence of two seemingly conflicting clusters of principles, and an ambiguous relationship between some principles typically thought to be mutually reinforcing. The results show the need to treat principled content as an important dependent variable in the study of cooperation and to view institution building as a dynamic, multi-dimensional and multi-level process. [source]

Demographic models and the management of endangered species: a case study of the critically endangered Seychelles magpie robin

JOURNAL OF APPLIED ECOLOGY, Issue 5 2003
Ken Norris
Summary 1Demographic models are assuming an important role in management decisions for endangered species. Elasticity analysis and scope for management analysis are two such applications. Elasticity analysis determines the vital rates that have the greatest impact on population growth. Scope for management analysis examines the effects that feasible management might have on vital rates and population growth. Both methods target management in an attempt to maximize population growth. 2The Seychelles magpie robin Copsychus sechellarum is a critically endangered island endemic, the population of which underwent significant growth in the early 1990s following the implementation of a recovery programme. We examined how the formal use of elasticity and scope for management analyses might have shaped management in the recovery programme, and assessed their effectiveness by comparison with the actual population growth achieved. 3The magpie robin population doubled from about 25 birds in 1990 to more than 50 by 1995. A simple two-stage demographic model showed that this growth was driven primarily by a significant increase in the annual survival probability of first-year birds and an increase in the birth rate. Neither the annual survival probability of adults nor the probability of a female breeding at age 1 changed significantly over time. 4Elasticity analysis showed that the annual survival probability of adults had the greatest impact on population growth. There was some scope to use management to increase survival, but because survival rates were already high (> 0·9) this had a negligible effect on population growth. Scope for management analysis showed that significant population growth could have been achieved by targeting management measures at the birth rate and survival probability of first-year birds, although predicted growth rates were lower than those achieved by the recovery programme when all management measures were in place (i.e. 1992,95). 5Synthesis and applications. We argue that scope for management analysis can provide a useful basis for management but will inevitably be limited to some extent by a lack of data, as our study shows. This means that identifying perceived ecological problems and designing management to alleviate them must be an important component of endangered species management. The corollary of this is that it will not be possible or wise to consider only management options for which there is a demonstrable ecological benefit. Given these constraints, we see little role for elasticity analysis because, when data are available, a scope for management analysis will always be of greater practical value and, when data are lacking, precautionary management demands that as many perceived ecological problems as possible are tackled. [source]

Core competencies in hospital medicine: Development and methodology

JOURNAL OF HOSPITAL MEDICINE, Issue S1 2006
Daniel D. Dressler MD
Abstract BACKGROUND The hospitalist model of inpatient care has been rapidly expanding over the last decade, with significant growth related to the quality and efficiency of care provision. This growth and development have stimulated a need to better define and characterize the field of hospital medicine. Training and developing curricula specific to hospital medicine are the next step in the evolution of the field. METHODS The Core Competencies in Hospital Medicine: A Framework for Curriculum Development (the Core Competencies), by the Society of Hospital Medicine, introduces the expectations of hospitalists and provides an initial structural framework to guide medical educators in developing curricula that incorporate these competencies into the training and evaluation of students, clinicians-in-training, and practicing hospitalists. This article outlines the process that was undertaken to develop the Core Competencies, which included formation of a task force and editorial board, development of a topic list, the solicitation for and writing of chapters, and the execution of multiple reviews by the editorial board and both internal and external reviewers. RESULTS This process culminated in the Core Competencies document, which is divided into three sections: Clinical Conditions, Procedures, and Healthcare Systems. The chapters in each section delineate the core knowledge, skills, and attitudes necessary for effective inpatient practice while also incorporating a systems organization and improvement approach to care coordination and optimization. CONCLUSIONS These competencies should be a common reference and foundation for the creation of hospital medicine curricula and serve to standardize and improve inpatient training practices. Journal of Hospital Medicine 2006;1:48,56. © 2006 Society of Hospital Medicine. [source]

In vitro Selection for Fusarium Wilt Resistance in Gladiolus

JOURNAL OF INTEGRATIVE PLANT BIOLOGY, Issue 5 2008
Idrees Ahmad Nasir
Abstract Cormels pieces of four Fusarium susceptible Gladiolus cultivars (Friendship, Peter Pears, Victor Borge and Novalux) formed friable calli when cultured in vitro on Murashige and Skoog basal medium containing various concentrations of auxin and cytokinin. The friable calli established cell suspensions. Plantlet regeneration was obtained from the control callus, control cell suspension derived callus and in vitro selected Fusarium oxysporum Schlecht. resistant cell-lines of Friendship. The in vitro cormlets showed 85,95% germination after breaking dormancy of 8 weeks at 4 °C. Cell suspensions of all four Gladiolus cultivars were found to be highly sensitive to fusaric acid. Gradual increase in fusaric acid concentrations to the cell-suspension cultures decreased cell growth considerably. One albino plant was found from the second generation of the in vitro selected cell line of Friendship. The albino plant was found to be highly susceptible to F. oxysporum. The cormlets of all in vitro selected cell lines of Friendship were inoculated with a conidial suspension of the F. oxysporum before planting and were also sprayed with the same spore suspension for further characterization when the height of plants was about 6 cm. The four selected cell lines showed the same response whether or not they were inoculated with conidia of the F. oxysporum. Plantlets of all of the selected cell lines exhibited significant growth as compared with the control after application of conidia of the F. oxysporum. [source]

Fetal Alcohol Spectrum Disorders in Children Residing in Russian Orphanages: A Phenotypic Survey

ALCOHOLISM, Issue 3 2006
Laurie C. Miller
Background: Alcohol use in Russia is among the highest in the world. Over 600,000 children reside in institutional care in Russia, most of them in baby homes and orphanages. The actual prevalence of fetal alcohol spectrum disorders (FASD) among these children is unknown. Therefore, we performed a systematic survey of phenotypic features associated with prenatal alcohol exposure among institutionalized Russian children and related these findings to their growth, development, medical, and social histories. Methods: Phenotypic screening was conducted of all 234 baby home residents in the Murmansk region of Russia (mean age 21+12.6 months). Phenotypic expression scores were devised based on facial dysmorphology and other readily observable physical findings. Growth measurements from birth, time of placement in the baby home, and at present were analyzed. In addition, the charts of 64% of the children were randomly selected for retrospective review. Information collected included maternal, medical, developmental, and social histories. Results: Thirteen percent of children had facial phenotype scores highly compatible with prenatal alcohol exposure and 45% had intermediate facial phenotype scores. These scores correlated with maternal gravidity and age. At least 40% of mothers in whom history was available ingested alcohol during pregnancy; some also used illicit drugs and tobacco. Z scores for growth measurements corresponded to phenotypic score, as did the degree of developmental delay. Children with no or mild delay had significantly lower phenotypic scores than those with moderate or severe delay (p=0.04); more than 70% of children with high phenotypic scores were moderately or severely delayed. Conclusions: More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers. [source]

Is a repeat urine culture useful during antibiotic therapy for febrile urinary tract infection?

NEPHROLOGY, Issue 7 2009
NATTACHAI ANANTASIT
SUMMARY: Aim: To evaluate the cost-effectiveness of a repeat urine culture after a few days of antibiotic therapy in childhood urinary tract infection (UTI) in southern Thailand. Methods: A retrospective review of the medical record of children diagnosed with UTI aged less than 15 years in Songklanagarind Hospital from January 1995 to December 2004 was performed. Patient demographics were collected. The results of repeat urine culture after starting antibiotic were evaluated. The risk factors that indicated positive repeat urine culture were determined. Results: Four hundred and forty-nine patients (245 boys and 204 girls) with 533 UTI episodes were analyzed, of which 49 (9.2%) had a repeat urine culture with significant growth. Multivariate analysis showed that age less than 1 year, aetiological agents Enterococci spp., fever of more than 72 h, inappropriate antibiotics and kidney, ureter and bladder anomalies were the most significant risk factors for a positive repeat culture, while sex, vesicoureteral reflux and recurrent UTI episodes were not significant risk factors. If the treatment protocol during the study period had indicated that children with at least one of the above risk factors should receive a repeat urine culture, then only 356 cases (66.8% ± 2.0%) would have received a repeat test and $US 655 would have been saved, while five positive repeat urine cultures would have been missed. Conclusion: The present study in a group of Thai children indicates that a repeat urine culture during antibiotic therapy should still be recommended. [source]

High risk studies and developmental antecedents of anxiety disorders,

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 2 2008
Dina R. Hirshfeld-Becker
Abstract The past two decades have witnessed significant growth in our understanding of the developmental antecedents of anxiety disorders. In this article, we review studies of offspring at risk for anxiety disorders, longitudinal studies of the course of anxiety disorders in clinical, epidemiologic, and at-risk samples, studies of hypothesized temperamental risk factors for anxiety, and give a brief overview of the literature on environmental risk factors. Clear developmental antecedents to anxiety disorders identified include (1) childhood anxiety disorders [in particular, separation anxiety and overanxious disorder/general anxiety disorder (GAD)], (2) behavioral inhibition which predicts later social phobia, (3) anxiety sensitivity which predicts later panic disorder, and (4) negative affectivity, which predicts a spectrum of psychopathology including anxiety disorders. Further prospective studies are needed to examine the roles of environmental factors such as parenting practices, peer influences, stressful life events, and perinatal stressors. Future studies could benefit from (1) beginning earlier in development and following individuals into adulthood, (2) assessing the overlap between multiple temperamental constructs, (3) greater use of observational measures of temperament and of parent,child and peer interactions, (4) greater attention to parental psychopathology which may confound associations noted, (5) exploration of other features of anxiety disorders (neurofunctional correlates, cognitive features, other aspects of emotional regulation) as potential precursors, and (6) intervention studies exploring whether modifying developmental antecedents can alter the course of anxiety disorders. © 2008 Wiley-Liss, Inc. [source]

Long-Term Performance of Clarion 1.0 Cochlear Implant Users,

THE LARYNGOSCOPE, Issue 7 2007
Chad V. Ruffin BS
Abstract Objective/Hypothesis: To evaluate the long-term performance of adult Clarion 1.0 cochlear implant users. Study Design: This was a retrospective, longitudinal study evaluating word discrimination in quiet for 31 adult cochlear implant patients with preimplantation sentence scores of less than 10%. Methods: The length of the study was 135 months with a mean follow-up length of 93 (median, 96) months. For the duration of the study, all subjects used the Clarion 1.0 cochlear implant with speech processors programmed for the use of the continuous interleaved sampling strategy. Results: There was no significant growth or decline in speech perception after 24 months postimplantation unless adverse medical events were experienced. Age at implantation was significantly and substantially negatively correlated (,11% word score per decade, r = 0.68) with most recent score, maximum score, time to maximum score, range of performance, 24- to 130-month mean score, and for any longitudinal data point tested: 3 to 6 months, 6 months, 1 year, 2 years, 5 years, and 10 years. There were no age-related declines in performance. There were no observed correlations between duration of deafness and any of the variables listed above. Conclusions: The lack of correlation between duration of deafness and performance in a cohort without residual hearing suggests the presence of a strong correlation between age and speech performance with a cochlear implant. That the cochlear implant is a safe therapy for the treatment of profound deafness is supported by the stability of scores through the 10-year study period as well as a zero rate of device failures or explantation. [source]

Consequences to Hearing During the Conservative Management of Vestibular Schwannomas,

THE LARYNGOSCOPE, Issue 2 2000
FRCS(ORL), Rory M. Walsh MA
Abstract Objective: To estimate the risk of loss of serviceable hearing during the conservative management of vestibular schwannomas. Study Design: Retrospective case review. Methods: Twenty-five patients with a radiological diagnosis of unilateral vestibular schwannoma were managed conservatively for a mean duration of 43.8 months (range, 12,194 mo). The pure-tone average (PTA) (0.5, 1, 2, and 3 kHz) and speech discrimination scores (SDS) were measured at regular intervals throughout the entire duration of follow-up. Serviceable hearing was defined using two criteria: 70% SDS/30 dB PTA (the 70/30 rule) and 50% SDS/50 dB PTA (the 50/50 rule). The size and growth rate of tumors were determined according to the American Academy of Otolaryngology,Head and Neck Surgery guidelines (1995). Intervention was recommended if there was evidence of continuous or rapid radiological tumor growth, and/or increasing symptoms or signs suggestive of tumor growth. Results: The risk of loss of serviceable hearing for the total group was 43% using the 70/30 rule and 42% using the 50/50 rule. Tumor growth was considered significant (> 1 mm) in 8 tumors (32%) and nonsignificant in 17 (68%). The risk of loss of serviceable hearing for the tumor-growth group was 67% using the 70/30 rule and 80% using the 50/50 rule. In contrast, the risk of loss of serviceable hearing for the no tumor,growth group was 25% using the 70/30 rule and 14% using the 50/50 rule. No audiological factors predictive of tumor growth were identified. Conclusions: There is a significant risk of loss of serviceable hearing during the conservative management of vestibular schwannomas. This risk appears to be greater in tumors that demonstrate significant growth. [source]

Nothing to sneeze at!

ANZ JOURNAL OF SURGERY, Issue 12 2009
A study into intra-operative contamination
Abstract Purpose:, We performed a prospective study of sneezes from orthopaedic registrars to assess the potential for intra-operative contamination from a masked surgeon, and to determine if head position can alter the potential for contamination. Type of Study:, Prospective controlled trial. Methods:, Four orthopaedic registrars from the Gold Coast Hospital each inhaled pepper to precipitate a sneeze. Cultures were taken with and without standard Smith & NephewÔ surgical masks, in positions directly in front and to the sides of a masked registrar. The process was repeated three times for each registrar. A control plate was left exposed to the atmosphere. A control plate and sneeze plate was cultured on blood agar. Three masks were subsequently swabbed to exclude contamination from the masks. Results:, 2/24 (8.33%) of the side with mask cultures returned significant bacterial growths. Also, 1/12 (8.33%) of the front with mask cultures returned significant growths. In addition, 9/12 (75%) of the direct sneezes resulted in significant bacterial counts. The control plate failed to return any growth. Subsequent culture of the exterior of three surgical masks failed to yield significant growth. There was a statistically significant odds ratio of 0.03 comparing the front and side group with the unmasked direct group. There was no statistically significant difference comparing front and side sneeze growth. Conclusions:, While the use of surgical face masks significantly reduces bacterial counts following a sneeze, it fails to eliminate the potential for surgical field contamination completely. The fact that significant bacterial counts can be returned from direct culture through a mask and to the sides of a mask suggests that head position is irrelevant and contamination is possible in any direction. It is, therefore, suggested that, if possible, a sneezing surgeon distances himself/herself as much as possible from the sterile field. We also recommend following a sneeze; surgeons should re-gown and glove, given the risk of contamination of the sterile field. Level of evidence:, Level II. [source]

Optimizing antibiotic therapy,the Aberdeen experience

CLINICAL MICROBIOLOGY AND INFECTION, Issue 5 2003
Y. Kumarasamy
Objective To study the quality and continuity of treatment in the Acute Medicines Assessment Unit (AMAU) with regard to empirical prescription of antibiotics, mode of administration, adherence to ward antibiotic policy, as well as collection, awareness and utilization of microbiological investigations. Methods A prospective study over a 3-month period at the AMAU, Aberdeen Royal Infirmary (ARI), a teaching hospital in north-eastern Scotland, was performed. The study included all patients started on empirical antibiotics on admission to the AMAU and followed up until their discharge. Results Of 1303 patients admitted, 221 (17%) were started on empirical antibiotics. This was in accordance with hospital antibiotic policy in 52% of cases. Appropriate specimens were taken from 77% of patients. Culture results showed that 29% (n = 65) of the patients had clinically significant growth of organisms. Of the 65 patients with clinically significant culture results, 49% (n = 32) were on an inappropriate empirical regimen. In 55%, the medication was not changed to a more appropriate antibiotic. In 72% of the patients with a negative culture, the culture report had no obvious effect on the duration or type of antibiotic being administered. Intravenous antibiotics were used in 60% of patients. Conclusion This study demonstrates a significant overuse of antibiotics, especially intravenous forms, despite a paucity of positive sepsis parameters and chest X-ray findings in these patients The duration of treatment could be shortened and an early switch policy introduced if culture results and sepsis profiles were taken into consideration, as there was a large number of unproven infections. Suggestions are made about how these improvements in prescribing could be made within the current administrative set-up of AMAUs. [source]