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Specific Criteria (specific + criterion)
Selected AbstractsFine-needle aspiration cytology of Hürthle cell carcinoma of the thyroidDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2008Howard Her-Juing Wu M.D. Abstract Specific criteria for the diagnosis of fine-needle aspiration (FNA) of Hürthle Cell Carcinoma (HCC) have rarely been discussed in the literature. A retrospective review of 35 FNA cases with the diagnosis of Hürthle cell lesion or Hürthle cell neoplasm was performed. In each case, there was a subsequent surgical excision. The FNA specimens were divided according to histologic diagnoses as HCC (12 cases), Hürthle cell adenoma (HCA) (14 cases), and benign nonneoplastic Hürthle cell lesions (BNHCL) (9 cases). Each case was examined using a semiquantitative scoring system for the following 11 features: presence or absence of colloid, lymphocytes, and transgressed blood vessels (each scored 0 or 1); the percentage of nuclear enlargement, small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion (each scored 0,3); and age, gender, and size of lesion. When diagnosed by FNA as either Hürthle cell neoplasm or Hürthle cell lesion, males were much more likely to have malignant tumors than females. Statistically significant cytologic features that favored malignant (HCC) over benign lesions (HCA and BNHCL) included small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion. The presence of colloid and lymphocytes favored a benign lesion. Nuclear enlargement and large tumor size are significantly more common in neoplasms than BNHCL. Diagn. Cytopathol. 2008;36:149,154. © 2008 Wiley-Liss, Inc. [source] Diagnostic criteria in patients with complex regional pain syndrome assessed in an out-patient clinicACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010E. A. M. VAN BODEGRAVEN HOF Background: Specific criteria have been described and accepted worldwide for diagnosing patients with complex regional pain syndrome (CRPS). Nevertheless, a clear-cut diagnosis cannot be confirmed in a number of cases. Aim: The objective of this study was to investigate the effectiveness of the described diagnostic criteria used by several clinical disciplines. Methods: We included 195 patients who were referred to our pain clinic within a period of 1 year. Data were collected on patient characteristics, signs, symptoms, disease-related medication, and the background of the referring clinicians. Results: The Harden and Bruehl criteria were confirmed in 95 patients (49%). These patients used a higher than average number of analgesics, opiates, and anti-oxidants, and frequently received prescriptions for benzodiazepines instead of anti-depressants. The mean disease duration was 29 ± 4.6 months and the mean visual analogue score for pain was 8.1 ± 0.19. A subgroup of patients had a colder temperature in the affected extremity compared with the unaffected extremity. This subgroup showed a longer disease duration and higher visual analogue scale pain. Conclusion: The diagnostic criteria used to determine CRPS should be further improved. A large number of referred patients experienced substantial pain, without receiving adequate medication. Disease-related medication is unrelated to CRPS-specific disease activity. Knowledge of underlying mechanisms is warranted before an adequate pharmaceutical intervention can be considered. [source] Association between pacifier use and breast-feeding, sudden infant death syndrome, infection and dental malocclusionINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 6 2005Ann Callaghan RN RM BNurs(Hons) Executive summary Objective, To critically review all literature related to pacifier use for full-term healthy infants and young children. The specific review questions addressed are: What is the evidence of adverse and/or positive outcomes of pacifier use in infancy and childhood in relation to each of the following subtopics: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Inclusion criteria, Specific criteria were used to determine which studies would be included in the review: (i) the types of participants; (ii) the types of research design; and (iii) the types of outcome measures. To be included a study has to meet all criteria. Types of participants,The participants included in the review were healthy term infants and healthy children up to the age of 16 years. Studies that focused on preterm infants, and infants and young children with serious illness or congenital malformations were excluded. However, some total population studies did include these children. Types of research design, It became evident early in the review process that very few randomised controlled trials had been conducted. A decision was made to include observational epidemiological designs, specifically prospective cohort studies and, in the case of sudden infant death syndrome research, case,control studies. Purely descriptive and cross-sectional studies were excluded, as were qualitative studies and all other forms of evidence. A number of criteria have been proposed to establish causation in the scientific and medical literature. These key criteria were applied in the review process and are described as follows: (i) consistency and unbiasedness of findings; (ii) strength of association; (iii) temporal sequence; (iv) dose,response relationship; (v) specificity; (vi) coherence with biological background and previous knowledge; (vii) biological plausibility; and (viii) experimental evidence. Studies that did not meet the requirement of appropriate temporal sequencing of events and studies that did not present an estimate of the strength of association were not included in the final review. Types of outcome measures,Our specific interest was pacifier use related to: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Studies that examined pacifier use related to procedural pain relief were excluded. Studies that examined the relationship between pacifier use and gastro-oesophageal reflux were also excluded as this information has been recently presented as a systematic review. Search strategy, The review comprised published and unpublished research literature. The search was restricted to reports published in English, Spanish and German. The time period covered research published from January 1960 to October 2003. A protocol developed by New Zealand Health Technology Assessment was used to guide the search process. The search comprised bibliographic databases, citation searching, other evidence-based and guidelines sites, government documents, books and reports, professional websites, national associations, hand search, contacting national/international experts and general internet searching. Assessment of quality, All studies identified during the database search were assessed for relevance to the review based on the information provided in the title, abstract and descriptor/MeSH terms, and a full report was retrieved for all studies that met the inclusion criteria. Studies identified from reference list searches were assessed for relevance based on the study title. Keywords included: dummy, dummies, pacifier(s), soother(s), comforter(s), non-nutritive sucking, infant, child, infant care. Initially, studies were reviewed for inclusion by pairs of principal investigators. Authorship of articles was not concealed from the reviewers. Next, the methodological quality of included articles was assessed independently by groups of three or more principal investigators and clinicians using a checklist. All 20 studies that were accepted met minimum set criteria, but few passed without some methodological concern. Data extraction, To meet the requirements of the Joanna Briggs Institute, reasons for acceptance and non-acceptance at each phase were clearly documented. An assessment protocol and report form was developed for each of the three phases of review. The first form was created to record investigators' evaluations of studies included in the initial review. Those studies that failed to meet strict inclusion criteria were excluded at this point. A second form was designed to facilitate an in-depth critique of epidemiological study methodology. The checklist was pilot tested and adjustments were made before reviewers were trained in its use. When reviewers could not agree on an assessment, it was passed to additional reviewers and discussed until a consensus was reached. At this stage, studies other than cohort, case,control and randomised controlled trials were excluded. Issues of clarification were also addressed at this point. The final phase was that of integration. This phase, undertaken by the principal investigators, was assisted by the production of data extraction tables. Through a process of trial and error, a framework was formulated that adequately summarised the key elements of the studies. This information was tabulated under the following headings: authors/setting, design, exposure/outcome, confounders controlled, analysis and main findings. Results, With regard to the breast-feeding outcome, 10 studies met the inclusion criteria, comprising two randomised controlled trials and eight cohort studies. The research was conducted between 1995 and 2003 in a wide variety of settings involving research participants from diverse socioeconomic and cultural backgrounds. Information regarding exposure and outcome status, and potential confounding factors was obtained from: antenatal and postnatal records; interviews before discharge from obstetric/midwifery care; post-discharge interviews; and post-discharge postal and telephone surveys. Both the level of contact and the frequency of contact with the informant, the child's mother, differed widely. Pacifier use was defined and measured inconsistently, possibly because few studies were initiated expressly to investigate its relationship with breast-feeding. Completeness of follow-up was addressed, but missing data were not uniformly identified and explained. When comparisons were made between participants and non-participants there was some evidence of differential loss and a bias towards families in higher socioeconomic groups. Multivariate analysis was undertaken in the majority of studies, with some including a large number of sociodemographic, obstetric and infant covariates and others including just maternal age and education. As might be expected given the inconsistency of definition and measurement, the relationship between pacifier use and breast-feeding was expressed in many different ways and a meta-analysis was not appropriate. In summary, only one study did not report a negative association between pacifier use and breast-feeding duration or exclusivity. Results indicate an increase in risk for a reduced overall duration of breast-feeding from 20% to almost threefold. The data suggest that very infrequent use may not have any overall negative impact on breast-feeding outcomes. Six sudden infant death syndrome case,control studies met the criteria for inclusion. The research was conducted with information gathered between 1984 and 1999 in Norway, UK, New Zealand, the Netherlands and USA. Exposure information was obtained from a variety of sources including: hospital and antenatal records, death scene investigation, and interview and questionnaire. Information for cases was sought within 2 days after death, within 2,4 weeks after death and in one study between 3 and 11 years after death. Information for controls was sought from as early as 4 days of a nominated sudden infant death syndrome case, to between 1 and 7 weeks from the case date, and again in one study some 3,11 years later. In the majority of the studies case ascertainment was determined by post-mortem. Pacifier use was again defined and measured somewhat inconsistently. All studies controlled for confounding factors by matching and/or using multivariate analysis. Generally, antenatal and postnatal factors, as well as infant care practices, and maternal, family and socioeconomic issues were considered. All five studies reporting multivariate results found significantly fewer sudden infant death syndrome cases used a pacifier compared with controls. That is, pacifier use was associated with a reduced incidence of sudden infant death syndrome. These results indicate that the risk of sudden infant death syndrome for infants who did not use a pacifier in the last or reference sleep was at least twice, and possibly five times, that of infants who did use a pacifier. Three studies reported a moderately sized positive association between pacifier use and a variety of infections. Conversely, one study found no positive association between pacifier use at 15 months of age and a range of infections experienced between the ages of 6 and 18 months. Given the limited number of studies available and the variability of results, no meaningful conclusions could be drawn. Five cohort studies and one case,control study focused on the relationship between pacifier use and dental malocclusion. Not one of these studies reported a measure of association, such as an estimate of relative risk. It was therefore not possible to include these studies in the final review. Implications for practice, It is intended that this review be used as the basis of a ,best practice guideline', to make health professionals aware of the research evidence concerning these health and developmental consequences of pacifier use, because parents need clear information on which they can base child care decisions. With regard to the association between pacifier use and infection and dental malocclusion it was found that, due to the paucity of epidemiological studies, no meaningful conclusion can be drawn. There is clearly a need for more epidemiological research with regard to these two outcomes. The evidence for a relationship between pacifier use and sudden infant death syndrome is consistent, while the exact mechanism of the effect is not well understood. As to breast-feeding, research evidence shows that pacifier use in infancy is associated with a shorter duration and non-exclusivity. It is plausible that pacifier use causes babies to breast-feed less, but a causal relationship has not been irrefutably proven. Because breast-feeding confers an important advantage on all children and the incidence of sudden infant death syndrome is very low, it is recommended that health professionals generally advise parents against pacifier use, while taking into account individual circumstances. [source] Clinical diagnostic criteria for dementia associated with Parkinson's diseaseMOVEMENT DISORDERS, Issue 12 2007Murat Emre MD Abstract Dementia has been increasingly more recognized to be a common feature in patients with Parkinson's disease (PD), especially in old age. Specific criteria for the clinical diagnosis of dementia associated with PD (PD-D), however, have been lacking. A Task Force, organized by the Movement Disorder Study, was charged with the development of clinical diagnostic criteria for PD-D. The Task Force members were assigned to sub-committees and performed a systematic review of the literature, based on pre-defined selection criteria, in order to identify the epidemiological, clinical, auxillary, and pathological features of PD-D. Clinical diagnostic criteria were then developed based on these findings and group consensus. The incidence of dementia in PD is increased up to six times, point-prevelance is close to 30%, older age and akinetic-rigid form are associated with higher risk. PD-D is characterized by impairment in attention, memory, executive and visuo-spatial functions, behavioral symptoms such as affective changes, hallucinations, and apathy are frequent. There are no specific ancillary investigations for the diagnosis; the main pathological correlate is Lewy body-type degeneration in cerebral cortex and limbic structures. Based on the characteristic features associated with this condition, clinical diagnostic criteria for probable and possible PD-D are proposed. © 2007 Movement Disorder Society [source] Nosocomial infection in a Danish Neonatal Intensive Care Unit: a prospective studyACTA PAEDIATRICA, Issue 8 2009Anne L Olsen Abstract Aim:, The aim of this study was to estimate the incidence and identify independent risk factors for nosocomial infections in a Danish Neonatal Intensive Care Unit and to compare these findings with international results. Methods:, The study was performed prospectively from January 1, 2005 to December 31, 2005 in the Neonatal Intensive Care Unit at Rigshospitalet, Copenhagen. Specific criteria for blood stream infection and respiratory tract infection adapted for neonates in our ward were worked out. Results:, Six hundred and eighty-three patients were included. The overall incidence of nosocomial infection was 8.8/1000 hospital days. Blood stream infection was the most frequent type of infection, with an incidence of 5.1/1000 hospital days. Multivariate analysis showed gestational age and heart disease to be significant independent risk factors for both first time blood stream infection and respiratory tract infection, and central venous catheter and parenteral nutrition risk factors for first time blood stream infection. Conclusion:, This first prospective study of nosocomial infection in a Danish Neonatal Intensive Care Unit found an overall incidence of 8.8/1000 hospital days, which is low or similar compared to other studies. Further Danish multicentre studies are needed, and we suggest that procedures related to central venous catheters should be a future focus area. [source] Agoraphobia: a review of the diagnostic classificatory position and criteria,,DEPRESSION AND ANXIETY, Issue 2 2010Hans-Ulrich Wittchen Ph.D. Abstract The status of agoraphobia (AG) as an independent diagnostic category is reviewed and preliminary options and recommendations for the fifth edition of The Diagnostic and Statistical Manual (DSM-V) are presented. The review concentrates on epidemiology, psychopathology, neurobiology, vulnerability and risk factors, clinical course and outcome, and correlates and consequences of AG since 1990. Differences and similarities across conventions and criteria of DSM and ICD-10 are considered. Three core questions are addressed. First, what is the evidence for AG as a diagnosis independent of panic disorder? Second, should AG be conceptualized as a subordinate form of panic disorder (PD) as currently stipulated in DSM-IV-TR? Third, is there evidence for modifying or changing the current diagnostic criteria? We come to the conclusion that AG should be conceptualized as an independent disorder with more specific criteria rather than a subordinate, residual form of PD as currently stipulated in DSM-IV-TR. Among other issues, this conclusion was based on psychometric evaluations of the construct, epidemiological investigations which show that AG can exist independently of panic disorder, and the impact of agoraphobic avoidance upon clinical course and outcome. However, evidence from basic and clinic validation studies remains incomplete and partly contradictory. The apparent advantages of a more straightforward, simpler classification without implicit hierarchies and insufficiently supported differential diagnostic considerations, plus the option for improved further research, led to favoring the separate diagnostic criteria for AG as a diagnosis independent of panic disorder. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Pulmonary neuroendocrine neoplasms: A review of clinicopathologic and cytologic featuresDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2010F.I.A.C., Momin T. Siddiqui M.D. Abstract Neuroendocrine tumors form a distinct group of lung neoplasms sharing characteristic cytohistologic, immunohistochemical, ultrastructural, and molecular features. The objective of this review article is to discuss the diagnostic classifications and the morphologic cytologic,histologic features for the different categories of neuroendocrine tumors of the lung. An accurate characterization of the neuroendocrine tumors of the lung requires knowledge of specific criteria separating the major categories, which is highly essential for determining prognosis and treatment options for these patients. Diagn. Cytopathol. 2010;38:607,617. 2009 Wiley-Liss, Inc. [source] Ecological niche modelling as a technique for assessing threats and setting conservation priorities for Asian slow lorises (Primates: Nycticebus)DIVERSITY AND DISTRIBUTIONS, Issue 2 2009J. S. Thorn ABSTRACT Aim, Data on geographical ranges are essential when defining the conservation status of a species, and in evaluating levels of human disturbance. Where locality data are deficient, presence-only ecological niche modelling (ENM) can provide insights into a species' potential distribution, and can aid in conservation planning. Presence-only ENM is especially important for rare, cryptic and nocturnal species, where absence is difficult to define. Here we applied ENM to carry out an anthropogenic risk assessment and set conservation priorities for three threatened species of Asian slow loris (Primates: Nycticebus). Location, Borneo, Java and Sumatra, Southeast Asia. Methods, Distribution models were built using maximum entropy (MaxEnt) ENM. We input 20 environmental variables comprising temperature, precipitation and altitude, along with species locality data. We clipped predicted distributions to forest cover and altitudinal data to generate remnant distributions. These were then applied to protected area (PA) and human land-use data, using specific criteria to define low-, medium- or high-risk areas. These data were analysed to pinpoint priority study sites, suitable reintroduction zones and protected area extensions. Results, A jackknife validation method indicated highly significant models for all three species with small sample sizes (n = 10 to 23 occurrences). The distribution models represented high habitat suitability within each species' geographical range. High-risk areas were most prevalent for the Javan slow loris (Nycticebus javanicus) on Java, with the highest proportion of low-risk areas for the Bornean slow loris (N. menagensis) on Borneo. Eighteen PA extensions and 23 priority survey sites were identified across the study region. Main conclusions, Discriminating areas of high habitat suitability lays the foundations for planning field studies and conservation initiatives. This study highlights potential reintroduction zones that will minimize anthropogenic threats to animals that are released. These data reiterate the conclusion of previous research, showing MaxEnt is a viable technique for modelling species distributions with small sample sizes. [source] Interpreting sustainable development and societal utility in Norwegian GMO assessmentsENVIRONMENTAL POLICY AND GOVERNANCE, Issue 4 2008G. Kristin Rosendal Abstract This article examines the process of assessing applications for genetically modified (GM) crops or plants for import or commercial planting in Norway. GMO legislation in Norway is closely linked to the EU through the Agreement on the European Economic Area (EEA), to which Norway is a party. A central difference with the EU processes emanates from specific clauses in the Norwegian Gene Technology Act on ,sustainable development' and ,societal utility', which provide a potentially wider leverage for Norwegian authorities to turn down the applications. Research material indicates evidence of an increasingly restrictive practice in the Norwegian evaluations, raising the question of how this can be explained in the face of increasing global acceptance of GMOs. A related question is to what extent and how this result is affected by the trends in the EU. An increasingly restrictive practice may be explained by changes in the access structure to the evaluating body, or it may be due to learning and a growing acceptance of the precautionary principle in this sector. Third, a higher number of rejections may largely be associated with the interest structure pertaining to GMOs in Norway. Final decisions are pending and there are uncertainties concerning how Norwegian authorities will apply the specific criteria of the Gene Technology Act. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [source] Identification of root canals in molars by tuned-aperture computed tomographyINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2000R. Nance Abstract Aim To compare the tuned-aperture computed tomography system of imaging to conventional D-speed film for their ability to identify root canals in extracted human molars. Methodology Thirteen maxillary and six mandibular human molars were mounted in acrylic blocks to simulate clinical conditions by surrounding the teeth with a radiodense structure. The teeth were then imaged with conventional D-speed film using a standard paralleling technique, and with a modified orthopantomograph OP100 machine using a Schick no. 2 size CCD sensor as the image receptor. The source images were registered and TACT slices were generated using TACT WorkbenchÔ Software. Three observers were asked to identify the number of canals in the conventional film group and the TACT image group using specific criteria. Ground truth was established by cross-sectioning the teeth at the coronal, middle, and apical thirds of the roots and directly visualizing the root canal morphology. Results TACT imaging detected 36% of 4th canals in maxillary molars and 80% of third canals in mandibular molars. Conventional film detected 0% of fourth canals in maxillary molars and 0% of third canals in mandibular molars. The differences in canal detection between the two techniques were statistically significant (Wilcoxon matched pair sign rank test, P = 0.001). Conclusions In this study, the TACT system of digital imaging was superior to conventional film in the detection of root canals in human molars and may be useful for the detection of root canals that will probably be missed upon conventional X-ray examination. [source] Estimating and eliminating redundant data transfers over the web: a fragment based approachINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 2 2005Christos Bouras Abstract Redundant data transfers over the Web, can be mainly attributed to the repeated transfers of unchanged data. Web caches and Web proxies are some of the solutions that have been proposed, to deal with the issue of redundant data transfers. In this paper we focus on the efficient estimation and reduction of redundant data transfers over the Web. We first prove that a vast amount of redundant data is transferred in Web pages that are considered to carry fresh data. We show this by following an approach based on Web page fragmentation and manipulation. Web pages are broken down to fragments, based on specific criteria. We then deal with these fragments as independent constructors of the Web page and study their change patterns independently and in the context of the whole Web page. After the fragmentation process, we propose solutions for dealing with redundant data transfers. This paper has been based on our previous work on ,Web Components' but also on related work by other researchers. It utilises a proxy based, client/server architecture, and imposes changes to the algorithms executed on the Proxy server and on clients. We show that our proposed solution can considerably reduce the amount of redundant data transferred on the Web. Copyright © 2004 John Wiley & Sons, Ltd. [source] Personality and Performance at the Beginning of the New Millennium: What Do We Know and Where Do We Go Next?INTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 1-2 2001Murray R. Barrick As we begin the new millennium, it is an appropriate time to examine what we have learned about personality-performance relationships over the past century and to embark on new directions for research. In this study we quantitatively summarize the results of 15 prior meta-analytic studies that have investigated the relationship between the Five Factor Model (FFM) personality traits and job performance. Results support the previous findings that conscientiousness is a valid predictor across performance measures in all occupations studied. Emotional stability was also found to be a generalizable predictor when overall work performance was the criterion, but its relationship to specific performance criteria and occupations was less consistent than was conscientiousness. Though the other three Big Five traits (extraversion, openness and agreeableness) did not predict overall work performance, they did predict success in specific occupations or relate to specific criteria. The studies upon which these results are based comprise most of the research that has been conducted on this topic in the past century. Consequently, we call for a moratorium on meta-analytic studies of the type reviewed in our study and recommend that researchers embark on a new research agenda designed to further our understanding of personality-performance linkages. [source] Control and legacy as functions of perceived criticality in major incidentsJOURNAL OF INVESTIGATIVE PSYCHOLOGY AND OFFENDER PROFILING, Issue 3 2004Jonathan Crego Abstract This paper outlines a model that captures the experiences of 28 Senior Officers who have managed some of the most significant police incidents in the UK in the past 5 years. The process for capturing the model rests on ,pragmatic psychology' (Fishman, 1999; Alison, West & Goodwill, 2003), a paradigm that recognizes practitioners' experiences as a central component of research and policy development. We utilized a set of connected electronic notebooks to enable each critical incident manager to log their experiences and views of the case that they managed. As each individual logs this information, it is simultaneously distributed to all participants. Thus, information is rapidly shared, stimulating further thought and discussion. Following the initial knowledge-sharing phase, participants reorder the material into themed categories that can then be scored against specific criteria (in this case ,impact' and ,ease'). This session revealed that senior officers consider a combination of two co-occurring issues as most significant in defining the ,criticality' of the incident: (i) how direct an impact the facet has on the enquiry at hand; and (ii) whether that issue will influence how the service will be judged (by the community, the victims and the media). These issues were perceived as the most complex and difficult to deal with. We argue that this perception is a joint function of perceived lack of control alongside the belief that judgment and blame regarding the incident will ultimately reside with them as managers. Copyright © 2004 John Wiley & Sons, Ltd. [source] The effect of home-use fluoride gels on glass,ionomer, compomer and composite resin restorationsJOURNAL OF ORAL REHABILITATION, Issue 7 2003P. Dionysopoulos summary The purpose of this study was to investigate the resistance to dissolution by two home-use fluoride gels on the surface integrity of glass,ionomer, resin modified glass,ionomer, compomer and composite resin restorations. Class V cavities prepared in extracted teeth were restored with a glass,ionomer (Fuji II), a resin modified glass,ionomer (Vitremenr), two compomers (Dyract and F-2000) and a composite resin (Z-100). Groups of five specimens of each material were treated for 24 h with one of the following: (i) distilled water, (ii) neutral fluoride gel and (iii) acidulated phosphate fluoride (APF) gel. Surface degradation of the restorations was studied using standard electron microscopy (SEM), rated according to specific criteria and statistically analysed by the Wilcoxon test (rank sums). Acidulated phosphate fluoride was found to have a significant effect on all examined materials, while minimal effects resulted from the neutral fluoride gel compared with the control group. The effect of home-use fluoride gels on glass,ionomer, compomer and composite resin restorations. [source] Patient Recall in Advanced Education in Prosthodontics Programs in the United StatesJOURNAL OF PROSTHODONTICS, Issue 4 2010Fatemeh S. Afshari DMD Abstract Purpose: This study surveyed program directors of Advanced Education Programs in Prosthodontics (AEPP) in the United States to determine the extent, type, incidence, and perceived effectiveness of implemented recall systems. Material and Methods: Surveys were sent to AEPP directors across the United States to assess their program's recall protocol. This survey first identified whether an active recall program existed. For programs with recall systems, rigor in promoting ongoing oral health was surveyed by focusing on recall frequency, patient tracking protocol, involved personnel, interaction with other university departments, provided clinical procedures, and therapy completion protocol. Whether the directors perceived that their recall system was successful was also investigated. Results: Thirty-three of 46 programs responded, giving a response rate of 72%. Of these 33 programs, only 21 (64%) had an active recall system, although 30 (91%) believed recall to be important. Twelve (57%) directors with recall programs considered their system to be effective. Conclusions: Prosthodontic program directors felt their program's recall effectiveness could be improved. Due to the numerous potential benefits of an active recall system, AEPPs should consider implementing or enhancing their recall programs. Further studies are indicated to determine specific criteria that describe an effective recall system for prosthodontic programs within the context of patient health promotion, program curriculum, and financial ramifications. [source] Crow,Fukase (POEMS) syndrome: a study of peripheral nerve biopsy in five new casesJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2003Claude Vital Abstract, The pathogenesis of Crow,Fukase (POEMS) syndrome is not well known, and in some cases, a definite diagnosis is difficult to establish. Nerve fibers have been studied in about 120 peripheral nerve biopsies (PNBs), and a mixture of axonal and demyelinating lesions were found in most of them. We report five new cases of Crow,Fukase (POEMS) syndrome with ultrastructural examination of their PNBs. In every case, there were features of axonal degeneration and primary demyelination. Interestingly, uncompacted myelin lamellae (UMLs) were present in every case at a percentage of 1,7. The association of UML and Crow,Fukase (POEMS) syndrome was described 20 years ago but was only reported in a few studies and found in 31 of 41 cases. In fact, this association is very significant because apart from Crow,Fukase (POEMS) syndrome, UMLs can only be found with such a frequency in rare cases of Charcot,Marie,Tooth disease type 1B. UML was also reported in acute and chronic inflammatory demyelinating polyneuropathies but at a much lower percentage. Moreover, in our five cases, UML was frequently associated with a decrease in the number of intra-axonal filaments, and this finding raises the problem of relationships between myelin formation and neurofilaments. So far, glomeruloid hemangiomas present in the dermis of some patients are considered as the only specific criteria of Crow,Fukase (POEMS) syndrome, but we think UML can also be regarded as highly suggestive of this entity on condition that a thorough ultrastructural examination of a PNB is performed. [source] Prospective study of presynaptic dopaminergic imaging in patients with mild parkinsonism and tremor disorders: Part 1.MOVEMENT DISORDERS, Issue 9 20033-month observations, Baseline Abstract To record prospectively, from early presentation, the clinical features of parkinsonism and tremor disorders, in relation to evidence of dopaminergic deficit shown with [123I]-FP-CIT (DaTSCAN, Amersham Health) single photon emission computerised tomography (SPECT). Clinical signs were recorded in 62 patients, of whom 24 failed standard Parkinson's disease (PD) and essential tremor criteria, and 38 fulfilled UK Brain Bank step 1 PD criteria. Striatal radioligand uptake was graded visually as normal or abnormal, and specific:nonspecific ratios were calculated. Bradykinesia and rigidity showed significant overall association with abnormal scans (P , 0.003), but rest tremor did not (P = NS). In the 24 patients not fulfilling specific criteria (mean age 63 [SD 9] years, disease duration 3 [SD 4] years), 10 (42%) had abnormal visual SPECT assessment and 14 (58%) had normal scans. Of 38 patients with early PD by clinical criteria (mean age 60 [SD 9] years, disease duration 3 [SD 1.7] years), 33 (87%) were visually abnormal. Baseline clinical diagnosis corresponded with SPECT imaging results in 51 of 62 cases (82%), which increased to 56 of 62 cases (90%) with amendment of seven clinical diagnoses at 3 months (blind to SPECT results). Akinetic,rigid cardinal diagnostic features of parkinsonism associate well with dopaminergic deficit in patients with early and mild clinical features. When these clinical features are uncertain, or the patient fails clinical diagnostic criteria, testing for dopaminergic deficit with [123I]-FP-CIT SPECT may assist the diagnostic process. © 2003 Movement Disorder Society [source] Comparison of ecological validity of learning disabilities diagnostic modelsPSYCHOLOGY IN THE SCHOOLS, Issue 2 2006Vincent J. Dean The purpose of this article is to examine models designed for the determination of a learning disability and compare them to specific criteria to determine whether the given diagnostic process is ecological in nature. The traditional child-centered deficit model (CCD), Relative Achievement Discrepancy model (RAD), and Responsiveness to Intervention model (RTI) were evaluated against the following three questions: (a) Does the environmental context of the assessment adequately represent the real-life situation? (b) Are the assessment stimuli relevant to the daily classroom activity? (c) Are the student behavior and/or required response natural and representative of the construct being assessed? The results of this examination suggested that the RTI has the most potential for ecological validity, but currently falls short. Suggestions for future research are included. © 2006 Wiley Periodicals, Inc. Psychol Schs 43: 157,168, 2006. [source] TOWARDS AN EXOGENOUS THEORY OF PUBLIC NETWORK PERFORMANCEPUBLIC ADMINISTRATION, Issue 3 2009PATRICK KENIS This article offers insights into the complexity of assessing the performance of public networks. We have identified three so-called exogenous factors: form of the network, type of inception,whether the network was initially formed as voluntary or mandated,and developmental stage of the network. We argue that where a network stands on each of these factors will determine the appropriateness of specific criteria for assessing the performance of the network. [source] Modern Concepts of Frontal Sinus SurgeryTHE LARYNGOSCOPE, Issue 1 2001Rainer Weber MD Abstract Objectives/Hypothesis To validate the endonasal surgical approach to frontal sinus in inflammatory sinus disease, trauma, and selective tumor surgery, and to define the role of external approaches to the frontal sinus. Endonasal frontal sinusotomy can range from endoscopic removal of obstructing frontal recess cells or uncinate process to the more complex unilateral or bilateral removal of the frontal sinus floor as described in the Draf II,III drainage procedures. In contrast, the osteoplastic frontal sinusotomy remains the "gold standard" for external approaches to frontal sinus disease. Methods A retrospective review of 1286 patients undergoing either endonasal or external frontal sinusotomy by the authors at four university teaching programs from 1977. Prior author reports were updated and previously unreported patient series were combined. Results Six hundred thirty-five patients underwent type I frontal sinusotomy, 312 type II sinusotomy, and 156 type III sinusotomy. A successful result was seen in these groups, 85.2% to 99.3%, 79% to 93.3%, and 91.5% to 95%, respectively. External frontal sinusotomy or osteoplastic frontal sinusotomy was successfully performed in 187 of 194 patients. Clinical symptoms, endoscopic findings, computed tomography, and magnetic resonance image scanning, and reoperation rate measured postoperative success. Conclusions A stepwise approach to the surgical treatment of frontal sinusitis, trauma, and selective benign tumors yields successful results as defined by specific criteria which vary from 79% to 97.8%. The details of specific techniques are discussed, essential points emphasized, and author variations noted. [source] Needlescopic versus laparoscopic cholecystectomy: a meta-analysisANZ JOURNAL OF SURGERY, Issue 6 2009Muhammad S. Sajid Abstract Background:, To systematically analyse clinical trials on needlescopic (NC) versus laparoscopic cholecystectomy (LC) that evaluated the effectiveness of both procedures for the management of cholelithiasis. Methods:, A systematic review of the literature was undertaken. Clinical trials on NC versus LC were selected according to specific criteria and analyzed to generate summative data expressed in standardized mean difference. Results:, Sixteen trials on NC versus LC encompassing 1549 patients were retrieved from electronic databases. Only six randomized controlled trials on 317 patients qualified for the meta-analysis according to inclusion criteria. NC was associated with longer operative time and higher conversion rate as compared with LC. There was statistically significant heterogeneity among trials. Intraoperative complications, postoperative complications and total stay in hospital were not significantly different. NC was superior to LC in terms of less post-operative pain and better cosmetic outcomes. Conclusion:, NC is a safe and effective procedure for the management of gallstone disease. NC is as effective as LC for perioperative complications and total stay in hospital. NC is superior to LC for less post-operative pain and better cosmetic results. NC is associated with longer operative time and higher conversion rate. [source] Automated Assessment of Early Concept DesignsARCHITECTURAL DESIGN, Issue 2 2009Chuck Eastman Abstract Building information modelling (BIM) is a powerful tool for clients and architects alike, particularly when clients have ongoing complex programmatic requirements. Chuck Eastman describes how with his team* at the AEC Integration Laboratory at the College of Architecture at the Georgia Institute of Technology he was commissioned by the US federal government's General Service Administration (GSA) to automate the design guidelines for all US courthouses in such a way that preliminary designs by architects could be assessed and checked against specific criteria. Copyright © 2009 John Wiley & Sons, Ltd. [source] The diagnosis of polycystic ovary syndrome: the criteria are insufficiently robust for clinical researchCLINICAL ENDOCRINOLOGY, Issue 6 2007Julian H. Barth Summary Polycystic ovary syndrome (PCOS) is a common disorder but has considerable phenotypic variability and this has led to controversy over its exact definition and diagnosis. The objective of this study was to review the recently proposed diagnostic criteria to determine whether they were sufficiently robust for clinical and research practise. We have reviewed the literature pertaining to clinical measurement and quality of laboratory analysis in relation to clinical and biochemical hyperandrogenism. The recently published statements regarding the diagnosis of PCOS assume that the clinical, laboratory and imaging studies are dichotomous variables, without considering the effect of observer subjectivity or measurement variability on the outcome. The data suggest that there is considerable uncertainty of all measurements and lack of clarity of the definition of the term ,hyperandrogenaemia' which can lead to misdiagnosis. The current diagnostic strategies for PCOS are defined too vaguely to ascertain that individuals fit the definition of the syndrome. A pragmatic approach may be taken in the management of an individual depending upon her particular symptoms and needs. However, research into the epidemiology, pathophysiology and treatment of PCOS will require the production of robust definitions of the diagnostic criteria. We propose specific criteria that would answer the criticisms that we have raised. [source] Innovations in the Development and Application of Edible Coatings for Fresh and Minimally Processed Fruits and VegetablesCOMPREHENSIVE REVIEWS IN FOOD SCIENCE AND FOOD SAFETY, Issue 3 2007Daniel Lin ABSTRACT:, One of the major growth segments in the food retail industry is fresh and minimally processed fruits and vegetables. This new market trend has thus increased the demands to the food industry for seeking new strategies to increase storability and shelf life and to enhance microbial safety of fresh produce. The technology of edible coatings has been considered as one of the potential approaches for meeting this demand. Edible coatings from renewable sources, including lipids, polysaccharides, and proteins, can function as barriers to water vapor, gases, and other solutes and also as carriers of many functional ingredients, such as antimicrobial and antioxidant agents, thus enhancing quality and extending shelf life of fresh and minimally processed fruits and vegetables. This review discusses the rationale of using edible coatings on fresh and minimally processed produce, the challenges in developing effective coatings that meet the specific criteria of fruits and vegetables, the recent advances in the development of coating technology, the analytical techniques for measuring some important coating functionalities, and future research needs for supporting a broad range of commercial applications. [source] | ||||||||||||||||||||||