Distribution by Scientific Domains
Distribution within Medical Sciences

Terms modified by Sure

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  • Selected Abstracts

    Business Optimism for Small, Medium and Large Firms: Does It Explain Investment?,

    FISCAL STUDIES, Issue 2 2007
    Ciaran Driver
    We use UK survey data on variation in business optimism by manufacturing size group to estimate the determinants of optimism using OLS and SURE. There are similarities across the size groups but also some differences: the medium-size group seems to have been unusually affected by real interest rates in recent years. We also model investment authorisations, conditional on business optimism. Again, there are similarities across the size groups. However, the largest-size group, and possibly also the medium-size group, seem to be investing less in recent years in relation to reported optimism. By contrast, capital investment by smaller-sized firms has been stable in relation to business optimism. Some tentative explanations for these findings are explored. [source]

    Disaggregate Wealth and Aggregate Consumption: an Investigation of Empirical Relationships for the G7*

    Joseph P. Byrne
    To date, studies of wealth effects on consumption have mainly used aggregate wealth definitions on a single-country basis. This study seeks to break new ground by analysing disaggregated financial wealth in consumption functions for G7 countries. Contrary to earlier empirical work, we find that illiquid financial wealth (i.e. securities, pensions and mortgage debt) tends to be a more important long-run determinant of consumption than liquid financial wealth. These results imply potential instability in consumption functions employing aggregate wealth. Our results are robust using SURE; when testing with a nested specification; and when using a linear model. [source]

    Efficacy and Safety of Two Dosing Regimens of Tadalafil and Patterns of Sexual Activity in Men with Diabetes Mellitus and Erectile Dysfunction: Scheduled Use vs.

    On-Demand Regimen Evaluation (SURE) Study in 14 European Countries
    ABSTRACT Aim., The aim of this article is to evaluate the efficacy and safety of 20-mg tadalafil taken on demand or three times per week and its effect on the sexual activity of patients with diabetes mellitus and erectile dysfunction (ED). Methods., The scheduled use vs. on-demand regimen evaluation (SURE) was a randomized, crossover, open-label study with 4,262 patients in 14 European countries. The efficacy measures for the 762 patients with diabetes and ED included changes from baseline in the erectile function (EF) domain of the International Index of Erectile Function (IIEF), and the proportion of "yes" responses to patient Sexual Encounter Profile (SEP) questions 2 (SEP2) and 3 (SEP3). The treatment satisfaction was measured with responses to SEP question 4 (SEP4) and SEP question 5 (SEP5), and sexual attempts data were collected. Patient preference for either regimen was determined by the treatment preference question (TPQ). Results., At end point on both regimens, the mean IIEF EF domain score was 22, and >40% of the patients had a normal EF domain score (,26). The proportion of "yes" responses was ,73% for SEP2 (penetration), ,58% for SEP3 (successful intercourse), >46% for SEP4 (hardness of erection), and ,45% for SEP5 (overall satisfaction). Efficacy was maintained up to 36 hours post-dosing. More than 70% of sexual attempts while on the three-times-per-week regimen and approximately 50% of the attempts on the on-demand treatment occurred >4 hours post-dosing. Tadalafil was well tolerated, with dyspepsia and headache as the most frequent adverse events reported. Treatment preference was 57.2% for on demand and 42.8% for three times per week. Conclusions., Tadalafil, when taken on demand or three times per week, is efficacious and safe in men with diabetes and ED. Buvat J, van Ahlen H, Schmitt H, Chan M, Kuepfer C, and Varanese L. Efficacy and safety of two dosing regimens of tadalafil and patterns of sexual activity in men with diabetes mellitus and erectile dysfunction: Scheduled use vs. on-demand regimen evaluation (SURE) study in 14 European countries. J Sex Med 2006;3:512,520. [source]

    Identification of a novel cis -acting element conferring sulfur deficiency response in Arabidopsis roots

    THE PLANT JOURNAL, Issue 3 2005
    Akiko Maruyama-Nakashita
    Summary SULTR1;1 high-affinity sulfate transporter is highly regulated in the epidermis and cortex of Arabidopsis roots responding to sulfur deficiency (,S). We identified a novel cis -acting element involved in the ,S-inducible expression of sulfur-responsive genes in Arabidopsis. The promoter region of SULTR1;1 was dissected for deletion and gain-of-function analysis using luciferase (LUC) reporter gene in transgenic Arabidopsis. The 16-bp sulfur-responsive element (SURE) from ,2777 to ,2762 of SULTR1;1 promoter was sufficient and necessary for the ,S-responsive expression, which was reversed when supplied with cysteine and glutathione (GSH). The SURE sequence contained an auxin response factor (ARF) binding sequence (GAGACA). However, SURE was not responsive to naphthalene acetic acid, indicating its specific function in the sulfur response. The base substitution analysis indicated the significance of a 5-bp sequence (GAGAC) within the conserved ARF binding site as a core element for the ,S response. Microarray analysis of early ,S response in Arabidopsis roots indicated the presence of SURE core sequences in the promoter regions of ,S-inducible genes on a full genome GeneChip array. It is suggested that SURE core sequences may commonly regulate the expression of a gene set required for adaptation to the ,S environment. [source]

    Structure of SurE protein from Aquifex aeolicus VF5 at 1.5, resolution

    Svetlana V. Antonyuk
    SurE is a stationary-phase survival protein found in bacteria, eukaryotes and archaea that exhibits a divalent-metal-ion-dependent phosphatase activity and acts as a nucleotidase and polyphosphate phosphohydrolase. The structure of the SurE protein from the hyperthermophile Aquifex aeolicus has been solved at 1.5, resolution using molecular replacement with one dimer in the asymmetric unit and refined to an R factor of 15.6%. The crystal packing reveals that two dimers assemble to form a tetramer, although gel-filtration chromatography showed the presence of only a dimer in solution. The phosphatase active-site pocket was occupied by sulfate ions from the crystallization medium. [source]

    How to Make Sure a Brand Behaves Itself

    Mark Churchman Senior Global Creative Director
    First page of article [source]

    There May Be No Room in the Inn, but the Innkeepers Sure Are Happy

    Peter Viccellio MD
    No abstract is available for this article. [source]

    Automatic Light Source Placement for Maximum Visual Information Recovery

    P.-P. Vzquez
    Abstract The automatic selection of good viewing parameters is a very complex problem. In most cases, the notion of good strongly depends on the concrete application. Moreover, when an intuitive definition of good view is available, it is often difficult to establish a measure that brings it to the practice. Commonly, two kinds of viewing parameters must be set: camera parameters (position and orientation) and lighting parameters (number of light sources, its position and eventually the orientation of the spot). The first parameters will determine how much of the geometry can be captured and the latter will influence on how much of it is revealed (i.e., illuminated) to the user. Unfortunately, ensuring that certain parts of a scene are lit does not make sure that the details will be communicated to the user, as the amount of illumination might be too small or too high. In this paper we define a metric to calculate the amount of information relative to an object that is effectively communicated to the user given a fixed camera position. This measure is based on an information-based concept, the Shannon entropy, and will be applied to the problem of automatic selection of light positions in order to adequately illuminate an object. In order to validate the results, we have carried out an experiment on users, this experiment helped us to explore other related measures. [source]

    Security in distributed metadata catalogues

    Nuno Santos
    Abstract Catalogue services provide the discovery and location mechanisms that allow users and applications to locate data on Grids. Replication is a highly desirable feature in these services, since it provides the scalability and reliability required on large data Grids and is the basis for federating catalogues from different organizations. Grid catalogues are often used to store sensitive data and must have access control mechanisms to protect their data. Replication has to take this security policy into account, making sure that replicated information cannot be abused but allowing some flexibility such as selective replication for the sites depending on the level of trust in them. In this paper we discuss the security requirements and implications of several replication scenarios for Grid catalogues based on experiences gained within the EGEE project. Using the security infrastructure of the EGEE Grid as a basis, we then propose a security architecture for replicated Grid catalogues, which, among other features, supports partial and total replication of the security mechanisms on the master. The implementation of this architecture in the AMGA metadata catalogue of the EGEE project is then described including the application to a complex scenario in a biomedical application. Copyright 2008 John Wiley & Sons, Ltd. [source]

    Screening for the 21st century: learning from the past

    CYTOPATHOLOGY, Issue 1 2000
    A. E. Raffle
    Introduction In 1986 I took on the public health responsibility for the cervical screening service in Avon. Like many others, I understood screening to be a simple, highly effective, and inexpensive way of stopping people getting cancer. The only problem so far as I was aware was in making sure those most at risk took up the opportunity to be screened. The more involved I became with screening, however, the more I was obliged to modify this view. In summary, I was confronted with two problems. The Avon cervical screening service,thanks to contributions from many individuals over the previous two decades,was already well organized and population coverage was already high. Why then were women still dying from cancer of the cervix? Why also was there a substantial and rising number of women requiring colposcopic investigation for screen-detected abnormality when, according to screening theory, the ,prevalence' pool should have been cleared and the rate of newly detected ,incident' abnormalities should equate to the incidence of serious disease? [source]

    Dental therapists' experience in the immediate management of traumatized teeth

    Teresa Loh
    Abstract,,, The optimal immediate management of traumatized teeth is known to be important for long-term success. One hundred and sixty-seven school dental therapists with General Certificate of Education ,Ordinary' (GCE ,O') level qualification were surveyed on their knowledge and experience on immediate management of dental trauma. The results showed only 41.2% felt comfortable with their present knowledge on the subject. A high proportion of the respondents (94.6%) indicated a need for more knowledge. All therapists concurred on the need to replant a permanent tooth and most (85.1%) agreed that this should be done within 30 min. More than half (54.8%) were not sure of the optimal storage medium for avulsed teeth. Their attitude towards acquiring knowledge in this aspect was good (80.5%) and all would take immediate action to settle appointments for trauma cases. [source]

    Optimal eradication: when to stop looking for an invasive plant

    ECOLOGY LETTERS, Issue 7 2006
    Tracey J. Regan
    Abstract The notion of being sure that you have completely eradicated an invasive species is fanciful because of imperfect detection and persistent seed banks. Eradication is commonly declared either on an ad hoc basis, on notions of seed bank longevity, or on setting arbitrary thresholds of 1% or 5% confidence that the species is not present. Rather than declaring eradication at some arbitrary level of confidence, we take an economic approach in which we stop looking when the expected costs outweigh the expected benefits. We develop theory that determines the number of years of absent surveys required to minimize the net expected cost. Given detection of a species is imperfect, the optimal stopping time is a trade-off between the cost of continued surveying and the cost of escape and damage if eradication is declared too soon. A simple rule of thumb compares well to the exact optimal solution using stochastic dynamic programming. Application of the approach to the eradication programme of Helenium amarum reveals that the actual stopping time was a precautionary one given the ranges for each parameter. [source]

    Texas Nameplate Company: A Profile of Environmental Success

    Kirsten Koepsel
    An initially ignored customer request started a small Texas company on the road to environmental excellence. Ten years later, it offers an example of solid accomplishment,with more achievements sure to come. 2001 John Wiley & Sons, Inc. [source]

    Statistical tests and power analysis for three in-vivo bioassays to determine the quality of marine sediments

    ENVIRONMETRICS, Issue 3 2002
    Nelly van der Hoeven
    Abstract Statistical tests are recommended for three marine sediment in-vivo bioassays. In two bioassays (Corophium volutator and Echinocardium cordatum), the mortality in the sediment is compared with that in a control. An unconditional 2,,2 test is recommended. For one bioassay (Rotoxkit MTM with Brachionus plicatilis), mortality in a dilution series of pore water is compared with the mortality in a control. The Williams test for trends is recommended. For each of these tests the power to assess an effect has been calculated. The number of replicates recommended in the standardized test protocol only allows large effects to be observed in almost all (95 per cent) of the experiments. Given the control mortality rates estimated from a large set of controls, a power of 95 per cent will only be reached if the mortality rate in the tested sediment is over 30 per cent for C. volutator and almost 60 per cent for E. cordatum. To reach this power for bioassays with B. plicatilis, where five concentrations are compared with a control, the mortality rate in the lowest effect concentration should be about 35 per cent. As an alternative to no effect testing, it is suggested that whether the effect of a treatment remains below some chosen minimal relevant effect (MRE) should be tested. Given an MRE at a fixed mortality rate of 25 per cent and ,,=,0.05, at least 55 individuals are necessary to be reasonably sure (95 per cent) that a mortality of 10 per cent will not be declared toxic incorrectly. The tests for mortality are based on the assumption that the survival probabilities of individuals within a test vessel are independent. We have described a method to test this assumption and applied it to the data on C. volutator. Copyright 2002 John Wiley & Sons, Ltd. [source]

    Mepivacaine local anaesthetic duration in equine palmar digital nerve blocks

    Summary Reasons for performing study: Perineural analgesics are used for lameness diagnosis but the duration of effect, knowledge of which would provide valuable information when performing subsequent blocks, is unknown. Objective: To evaluate the duration of a palmar digital nerve block using force plate measurements. Methods: Ten horses diagnosed with unilateral navicular syndrome were trotted at range of 3 0.15 m/sec over a force plate to record ground reaction forces for 5 trials of each forelimb. Data were recorded before nerve block, and then at 15 mins, 1, 2 and 24 h post nerve block. Results: Before nerve block, peak vertical force (mean s.e.) was significantly higher in the contralateral forelimb (CL = 5345 188 N) than in the lame forelimb (L = 4256 204 N; P<0.05). At 15 mins post nerve block there was no significant difference between the 2 forelimbs (CL = 5140 184 N; L = 5126 129 N), and this remained the case for 1 h. By 2 h, the mean score for the lame leg had decreased (L = 4642 182 N) but was still greater than preblock. By 24 h, vertical forces had returned to preblock values. Conclusions: The palmar digital nerve block was fully effective between 15 mins and 1 h. The analgesic effect began to subside between 1 and 2 h but sufficient analgesia persisted to affect gait characteristics beyond 2 h. Potential relevance: When using a palmar digital nerve block, it is important to perform lameness evaluations between 15 mins and 1 h to be sure of effective nerve blockade. [source]

    From European Integration to European Integrity: Should European Law Speak with Just One Voice?

    EUROPEAN LAW JOURNAL, Issue 3 2004
    Samantha Besson
    According to the European integrity principle, all national and European authorities should make sure their decisions cohere with the past decisions of other European and national authorities that create and implement the law of a complex but single European legal order. Only by doing so, it is argued, can the European political and legal community gain true authority and legitimacy in the eyes of the European citizens to whom all these decisions apply. Although European integrity is primarily a product of European integration, it has gradually become one of the requirements of further integration. The article suggests that the principle of European integrity would help dealing with the growing pressure for common European solutions under conditions of increasing diversity. It places disagreement at the centre of European politics, as both an incentive and a means of integration by way of comparison and self-reflectivity. It constitutes therefore the ideal instrument for a pluralist and flexible further constitutionalisation of the European Union. [source]

    The Langerhans' cell-like cell lines XS52 and XS106 express mRNA for ciliary neurotrophic factor and neurotrophic factor 4/5

    K. Seiffert
    Neurotrophins are responsible for the survival and outgrowth of nerves within the peripheral and central nervous systems. These factors include brain-derived neurotrophic factor (BDNF), CNTF, NT 3, and NT4/5. We have previously shown that LCs lie in close proximity to nerves and that several neuropeptides regulate LC function, implying that nerves send regulatory signals to LCs. To evaluate the possibility that LC signal nerves by release of neurotrophins, we examined LC expression of neurotrophins by RT-PCR. To eliminate the possibility of contaminating keratinocytes in highly enriched LC preparations, we utilized the LC-like cell lines XS52 (BALB/c derived) and XS106 (A/J derived) for initial experiments. The RNA obtained was digested with DNase to ensure complete absence of genomic DNA. Several independent RT-PCRs revealed expression of bands of the expected size for CTNF and NT4/5, but not for BDNF and NT3 in XS106 and XS52 cells. In contrast, the transformed keratinocyte cell line PAM212 expressed BDNF, as well as CTNF and NT4/5. Preliminary experiments with purified LC confirm the expression of CTNF and NT4/5 and also show the expression of BDNF. However, we cannot be sure that BDNF expression is not due to keratinocyte contamination. We conclude that LCs may regulate nerve cells by the release of neurotrophic factors. [source]

    Non-medical palliative care and education to improve end-of-life care at geriatric health services facilities: A nationwide questionnaire survey of chief nurses

    Yoshihisa Hirakawa
    Background: Geriatric health services facilities (GHSF) are expected to assume a growing role in caring for the dying elderly. However, research in this area has so far been scant. The purpose of the present study is to reveal the status of non-medical palliative care and staff education aiming at improving and enhancing end-of-life care at GHSF. Methods: The subjects were 2876 chief nurses of GHSF. Data was collected through a mailed questionnaire in 2003. The questionnaire covered the following: (i) staff perception of end-of-life care policies; (ii) staff education; and (iii) available non-medical care. To evaluate the factors correlated with end-of-life care policies at GHSF, we divided the facilities into two groups. Results: We analyzed the answers collected from 313 facilities with a progressive policy toward end-of-life care (PP group) and 818 with a regressive policy toward it (RP group). It was found that staff training was conducted more frequently among PP facilities. Generally, nurses in the PP facilities were more confident that they could provide comprehensive on-site end-of-life care and grieving support, but did not feel so sure about their ability to provide better end-of-life environments for dying residents and family by organizing outside support from voluntary and/or governmental organizations and religious organization for healing and to pursue appropriately a written follow-up communication with the bereaved family. Conclusions: Our results suggest that providing GHSF staff with education about end-of-life issues or setting up collaboration with the outside is an important factor to enhance overall end-of-life care at these facilities. [source]

    Efficacy of Eletriptan in Migraine-Related Functional Impairment: Functional and Work Productivity Outcomes

    HEADACHE, Issue 5 2007
    Stephen D. Silberstein MD
    Objective.,To provide a multidimensional assessment of the extent of functional impairment during an acute migraine attack, and of the improvement in functioning in response to treatment, using 4 concurrently administered scales: the 7-item work productivity questionnaire (PQ-7), the functional assessment in migraine (FAIM) activities and participation (FAIM-A&P) subscale, the FAIM-impact of migraine on mental functioning (FAIM-IMMF) subscale, and the traditional 4-point global functional impairment scale (FIS). Methods.,Outpatients with an International Classification of Headache Disorders diagnosis of migraine were randomized to double-blind treatment of a single attack with either oral eletriptan 20 mg (n = 192) once-daily, eletriptan 40 mg (N = 213) once-daily, or placebo (n = 208). Patients were encouraged to take study medication as soon as they were sure they were experiencing a typical migraine headache, after the aura phase (if present) had ended. Patients with moderate-to-severe functional impairment were identified on each of the 4 disability scales, and 2-hour functional response was compared between treatments. Results.,At baseline, the PQ-7 and FAIM-IMMF items that assessed ability to perform tasks requiring concentration, sustained work or attention, and ability to think quickly or spontaneously, were especially sensitive to the effects of mild headache pain, with 27% to 48% of patients (n = 92-112) reporting moderate-to-severe impairment. Only 11.3% of patients (n = 112) reported this level of impairment due to mild pain on the FIS. Functional response at 2 hours was significantly higher on eletriptan 40 mg versus placebo on the FAIM-A&P (63% vs 36%; n = 218; P < .0001); on the PQ-7 (56% vs 34%; n = 116; P= .0052); and on the FAIM-IMMF (50% vs 34%; n = 215; P= .017). These rates were all lower than the functional response rates on the FIS for eletriptan 40 mg (75%) and eletriptan 20 mg (70%) versus placebo (45%; P < .001). Conclusions.,In this exploratory analysis, use of multidimensional scales was found to provide a sensitive measure of headache-related functional impairment, especially for detecting clinically meaningful cognitive effects, and for detecting drug versus placebo differences. [source]

    High sensitivity of chemiluminescent methodology for detection of clonal CDR3 sequences in patients with acute lymphoblastic leukemia

    E. Leal
    Abstract Detection of minimal residual disease (MRD) in patients with B-cell acute lymphoblastic leukemia (B-ALL) has been achieved using several radioactive labelling methodologies; however, limited information exists about the use of chemiluminescent labelling. Although many malignant disorders are related to cytogenetic alterations, there is not a consistent chromosomal translocation that could serve as a tumour marker for the monitoring of MRD. ALL are derived from B-lymphocytes in 80% of cases. In the early stages of their maturation, the immunoglobulin heavy chain genes (IgH) undergo rearrangements among their V, D, and J segments, giving rise to the Complementary Determining Regions (CDR). Among these, CDR3 is considered unique for each lymphocyte and used as a tumour-specific marker in B-ALL patients. In this study, the CDR3 was labelled with digoxigenin and used as a patient-specific probe to test its sensitivity for further detection of MRD. Fourteen pretreatment samples of bone marrow (BM) or peripheral blood (PB) from B-ALL patients were included. Tumour-specific probes were designed from each clonal product by elimination of the consensus sequences. Ten digoxigenin-labelled probes were hybridized with a mixture of their respective clonal DNA and the polyclonal product from a normal healthy donor, in serial dilutions from 1:1 up to 1:107. A sensitivity range of 1:103,1:106 was obtained, with an average of 1:105. Crossed tests performed in four patients, showed right probe specificity in all cases. We propose that the design of allele-specific probes with chemiluminescent labelling, represents a reliable, sure and sensitive alternative methodology for MRD detection in patients with B-cell lymphoproliferative disorders. Copyright 2004 John Wiley & Sons, Ltd. [source]

    Steady and unsteady incompressible flow in a double driven cavity using the artificial compressibility (AC)-based characteristic-based split (CBS) scheme

    P. Nithiarasu
    Abstract In this paper, the explicit characteristic-based split (CBS) scheme has been employed to solve both steady and unsteady flows inside a non-rectangular double driven cavity. This problem is recently suggested as a benchmark problem for incompressible flows. Both unstructured and structured meshes have been employed in the present study to make sure that the predicted results are as close to reality as possible. The results obtained show the existence of steady state at lower Reynolds numbers (,1000) and transient states at higher Reynolds numbers. The flow approaches a turbulent state as the Reynolds number is increased to 10 000. Copyright 2005 John Wiley & Sons, Ltd. [source]

    Simple efficient algorithm (SEA) for shallow flows with shock wave on dry and irregular beds

    Alireza Zia
    Abstract An explicit Godunov-type solution algorithm called SEA (simple efficient algorithm) has been introduced for the shallow water equations. The algorithm is based on finite volume conservative discretisation method. It can deal with wet/dry and irregular beds. Second-order accuracy, in both time and space, is achieved using prediction and correction steps. A very simple and efficient flux limiting technique is used to equip the algorithm with total variation dimensioning property for shock capturing purposes. In order to make sure about the balance between the flux gradient and the bed slope, treatment of the source term has been done using a new procedure inspired mainly by the physical rather than mathematical consideration. SEA has been applied to one-dimensional problems, although it can equally be applied to multi-dimensional problems. In order to assess the capability of proposed algorithm in dealing with practical applications, several test cases have been examined. Copyright 2007 John Wiley & Sons, Ltd. [source]

    Are you sure , the importance of "reasonable doubts"

    Graham Jackson
    No abstract is available for this article. [source]

    Beliefs and perceptions of Arab vitiligo patients regarding their condition

    Khalid M. AlGhamdi MD
    Background, Patients' beliefs about their illness can result in positive and/or negative implications for the management of their disease. To examine the beliefs held by vitiligo patients about their condition and to explore the potential factors that might influence such beliefs. Methods, The illness perception questionnaire (IPQ) was translated into the particular regional language (Arabic) and administered to adult vitiligo patients visiting our Dermatology Department, from 2006 to 2008. Demographic and illness details were obtained. Results, We recruited 164 vitiligo patients (91 male subjects). The mean age was 27 years (SD = 13, range 15,57 years). It was believed that stress, altered immunity, and heredity were the cause of vitiligo by 33%, 26%, and 24% of the respondents respectively. Eighty-four percent and 28% believed in fate and evil eye as a cause of their illness respectively. Forty-two percent believed that their illness had a major effect on their lives and 44% believed that vitiligo had strongly affected the way others see them. For both beliefs, this was independent of the gender. Thirty-seven percent reported that they do not understand their illness. Six percent believed that their disease was contagious while 12% were not sure. Fifty-four and 57% reported feeling depressed and anxious respectively, because of their disease. This was more common in female patients (P = 0.019 and 0.031 respectively). Conclusion, Misconceptions and negative attitudes are widespread among vitiligo patients. The lack of disease-related understanding and the existence of anxiety and depression require targeted health education and psychosocial support. [source]

    The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patients

    Martin Smalbrugge
    Abstract The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home population of attributing somatic symptoms of depression and anxiety to either somatic or psychiatric disorder. Symptoms of major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD) were measured using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Somatic symptoms of MD, GAD and PD were attributed to somatic causes when the interviewer was not sure about a psychiatric cause. To analyse the effect of this attribution on the prevalence rate of MD, GAD and PD, a sensitivity analysis was undertaken in which symptoms that were attributed to somatic causes were recoded as symptoms attributed to psychiatric disorder. Prevalence rates of MD, GAD and PD were calculated before and after recoding. The prevalence of MD after recoding rose from 7.5% to 8.1%. The prevalence of GAD did not change. The prevalence of PD rose from 1.5% to 1.8%. Attribution of somatic symptoms to either somatic or psychiatric disorder when the interviewer was not sure about a psychiatric cause of the somatic symptoms had only a very modest effect on the prevalence rate of major depression, generalized anxiety disorder and panic disorder in a nursing home population. Copyright 2005 John Wiley & Sons, Ltd. [source]

    Nurses' perceptions of care and caring

    BA(Hons), Chris Bassett RN
    Care and caring have been identified as inherently difficult concepts to define, but many authors believe that care is the central and unifying core of nursing. It is vital that nurses understand what care is, with the current issues about measuring and justifying exactly what they do for patients in order to be clear about what good care is. If nurses are to constantly improve the care they give, they need to be clearer about how to care for patients. Nurses need to make sure that they are giving the patients what they want and not what the nurses want. This review of the literature explores nurses' perceptions of care and compares it with what patients want in terms of care. It also highlights some important and interesting differences between what patients and nurses perceive as good care. [source]

    Established ways to keep donor's interest alive

    J. Ringwald
    Background, The future demographic changes will be associated with an enhancement of the worldwide shortage of blood. The ageing of the population in developed countries is associated with a decrease in young individuals being potentially eligible to donate blood and an increase in older individuals who might be in the need of blood transfusion. Therefore, the retention of active blood donors (BD) is becoming more important. A substantial increase in blood donations could be achieved by a relatively small increase in BD return. It is the task of blood donation services (BDSs) to elaborate specific and adequate measures to increase the BD's likelihood to return. Successful BD retention programmes are viable to ensure a sufficient supply with blood and blood components at present and the upcoming years. Aims, To give recommendations for BD retention strategies based on a survey of potential and established measures how BD's interest could be kept alive. Methods, With focus on the last decade, literature about internal and external influences on BD's intention to regular blood donation and their actual return behaviour was reviewed. Furthermore, a special aspect was drawn on published articles about established or potential measures to increase BD's return-rate. Based on this information, different ways how BD's interest could be kept alive were suggested. Results, Overall, individuals of younger age (< 30,40 years), women, those with a lower education level are less likely to return to blood donation. External influences of friends, family or co-workers are import for starting a BD career. To become a committed BD, however, a high level of intrinsic motivation is needed. To keep BD's interest alive for a long time, BDSs should focus on the following to increase the satisfaction of the BD: Make blood donation a good experience and as convenient as possible, reduce adverse events and anxiety, and train and motivate your staff. This could be further supported by an intensive and active communication with the BDs right from the start, the application of loyalty builders to establish BD identity, and the appropriate use of incentives. Finally, temporarily deferred BDs should ask to return personally and advertisement programmes for repeat BDs should appeal on personal motivation and moral norms. However, BDS should always try to adapt their measures on their target population considering that people are different all around the world. Moreover, some promotion programmes should be even tailored for distinct subgroups of BDs to have a successful outcome. Conclusions, There is quite a number of ways to keep BDs interest alive and to start a career as a regular and committed BD. In this context, the self-identification as a BD is definitely of major importance. BDSs are challenged to support this developmental process. They have to make sure that blood donation is associated with a good experience for the BD, making him or her feeling good and happy. [source]

    Life-Sustaining Treatments: What Do Physicians Want and Do They Express Their Wishes to Others?

    Joseph J. Gallo MD
    OBJECTIVES: To assess whether older physicians have discussed their preferences for medical care at the end of life with their physicians, whether they have established an advance directive, and what life-sustaining treatment they wish in the event of incapacity to make these decisions for themselves. DESIGN: Mailed survey to a cohort of physicians. SETTING: Physicians who were medical students at the Johns Hopkins University in graduating classes from 1946 to 1964. PARTICIPANTS: Physicians who completed the advance directive questionnaire (mean age 68). MEASUREMENTS: Questionnaires were sent out to known surviving physicians of the Precursors Study, an on-going study that began in 1946, asking physicians about their preferences for life-sustaining treatments. RESULTS: Of 999 physicians who were sent the survey, 765 (77%) responded. Forty-six percent of the physicians felt that their own doctors were unaware of their treatment preferences or were not sure, and of these respondents, 59% had no intention of discussing their wishes with their doctors within the next year. In contrast, 89% thought their families were probably or definitely aware of their preferences. Sixty-four percent reported that they had established an advance directive. Compared with physicians without advance directives, physicians who established an advance directive were more likely to believe that their doctors (odds ratio (OR) = 3.42, 95% confidence interval (CI) = 2.49,4.69) or family members (OR = 9.58, 95% CI = 5.33,17.23) were aware of their preferences for end-of-life care and were more likely to refuse treatments than those without advance directives. CONCLUSION: This survey of physicians calls attention to the gap between preferences for medical care at the end of life and expressing wishes to others through discussion and advance directives, even among physicians. [source]

    It Ain't Broke: The Past, Present, and Future of Venture Capital

    Steven N. Kaplan
    This article presents a selective history of the U.S. venture capital (VC) industry, a discussion of the current state of the market, and some predictions about where the market is going. There is no doubt that the U.S. venture capital industry has been very successful. The VC model has provided an efficient solution to a difficult problem,that of enabling people with promising ideas but often limited track records to raise capital from outside investors. A large fraction of IPOs, including many of the most successful, have been funded by venture capitalists, and the U.S. VC model has been copied around the world. Armed with this historical perspective, the authors view with skepticism the recent claims that the VC model is broken. In the past, VC investments in companies have represented a remarkably constant 0.15% of the total value of the stock market; and commitments to VC funds, while more variable, have been consistently in the 0.10% to 0.20% range. Both of these percentages have continued to hold in recent years. And despite the relatively low number of IPOs, the returns to VC funds this decade have largely maintained their historical relationship to the overall stock market. To be sure, VC investment and returns continue to be subject to boom-and-bust cycles. But if the recent period has most of the features of a bust, the authors view today's historically low level of commitments to U.S. VC funds as a fairly reliable indicator of relatively high expected returns for the 2009 and (probably) 2010 vintage years. Perhaps the most promising future role for venture capital, as the authors suggest in closing, is to increase the productivity of the corporate research and development function through various kinds of partnerships and outsourcing arrangements. [source]

    Developmental insights into experience-based decision making

    Tim Rakow
    Abstract In three experiments involving children and adults (N,=,324), option payoffs for sure versus risky choices were either described or experienced via observation of 20 outcomes. Choices revealed a description-experience gap for payoffs with rare events, implying greater impact of small probabilities (,.2) for described than for experienced choices. The size of this effect was independent of participant age. Therefore, the role of cognitive limitations in the description-experience distinction remains unclear, as the age groups would have differed in cognitive capacity. Age-related differences in ,sampling style' in decisions from experience were observed. Pre-choice data acquisition changed markedly with age: From frequent alternation between options towards separate systematic exploration of options with increasing age. A fourth experiment, that manipulated sampling style, failed to demonstrate its link to other age-related features of choice (e.g. risk preferences). Our studies illustrate the value of developmental research for testing theoretical claims and revealing novel phenomena in decision research. Copyright 2009 John Wiley & Sons, Ltd. [source]