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Theoretical Benefits (theoretical + benefit)
Selected AbstractsRenin Inhibitors in Chronic Heart Failure: The Aliskiren Observation of Heart Failure Treatment Study in ContextCLINICAL CARDIOLOGY, Issue 9 2010FESC, FRACP, Henry Krum PhD Renin-angiotensin aldosterone system (RAAS) activation is a key neurohormonal contributor to the progression of chronic heart failure. Strategies that block this activation have consistently demonstrated major beneficial impacts on morbidity and mortality in this setting. Direct renin inhibitors (DRIs) present a novel opportunity to block at an additional or alternative step in this pathway, that being conversion of angiotensinogen to angiotensin I. Theoretical benefits of blocking at the level of renin include: inhibition of the reflex activation of plasma renin activity induced by conventional downstream RAAS blockers. Minimization of angiotensin II and/or aldosterone escape and blocking upstream at the rate-limiting step of angiotensin I production. Preclinical and early-phase clinical studies have largely supported this hypothesis. In the Aliskiren Observation of Heart Failure Treatment study, patients with systolic chronic heart failure receiving background angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers and ,-blockers benefited from aliskiren in reduction vs placebo of plasma levels of brain natriuretic peptide, the primary efficacy endpoint of that study. Large-scale outcome trials are, however, required to definitively determine the benefits of a DRI strategy additional to, or as an alternative to, conventional approaches such as ACE inhibitors in the systolic chronic heart failure setting. Copyright © 2010 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose. [source] A retrospective analysis of two independent prospective cartilage repair studies: autogenous perichondrial grafting versus subchondral drilling 10 years post-surgeryJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2002Phianne S. J. M. Bouwmeester Background: Experimental data indicate that perichondrial grafting to restore articular cartilage defects will result in repair with hyaline-like cartilage. In contrast, debridement and drilling results in repair with fibro-cartilage. In this retrospective study the longterm clinical results of both procedures were compared to evaluate the theoretical benefit of repair with hyaline-like tissue. Methods: From two independent studies patients were selected with a cartilage defect in their knee. The selection was performed using strict inclusion criteria published elsewhere [Bouwmeester et al. Int. Orthop. 21 (1997) 313]. The patients were treated with either a perichondrium transplantation (PT group, n = 14) or with an ,open' debridement and drilling procedure (DD group, n = 11). The results of both procedures after 10,11 years were evaluated using the Hospital for Special Surgery Knee Score (HSSS), X-ray examination, clinical examination and visual analogue scales (VAS) for pain during walking and at rest. Results: Both procedures resulted in a general improvement compared to the situation before the operation. After an average of 10 years in the PT group there were three failures, in the DD group none, success rates were 78% and 100%, respectively. When comparing the successful PT patients with the DD patients, there were no differences in HSSS and VAS data. Both groups showed an equal number of irregular operation surface sites on X-ray (PT 9/11 versus DD 8/10). Conclusions: This study shows that clinically at 10 years follow-up no difference was observed between debridement and drilling and perichondrium transplantation for treatment of an isolated cartilage defect. This raises questions about ongoing research to develop methods in order to improve the results of debridement and drilling as therapy for an isolated cartilage defect in a young patient (, 40 years). © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] The paradoxes of legal paternalism and how to resolve them*LEGAL STUDIES, Issue 1 2010Anthony Ogus Legal paternalism occurs when the law forces individuals to avoid certain risks (,hard paternalism'), or, without coercion, nudges them away from such risks (,soft paternalism'), on the ground that otherwise they will make unwise decisions. The questions when and how such approaches should be taken are of fundamental importance in a society in which there are increasing risks to health and livelihood resulting from technological developments and greater freedom of choice. However, they are not openly addressed in policy-making circles and have also been neglected in the European legal literature. In this paper, I attempt to explain these paradoxes and to outline a theoretical benefit,cost framework for determining when and how legal paternalism might be considered appropriate. [source] Competency-Based Education and Assessment for the Accounting Profession: A Critical Review,ACCOUNTING PERSPECTIVES, Issue 1 2003J. EFRIM BORITZ ABSTRACT In recent years many professional accounting associations have become interested in establishing competency-based professional requirements and assessment methods for certifying accounting professionals. A competency-based approach to qualification specifies expectations in terms of outcomes, or what an individual can accomplish, rather than in terms of an individual's knowledge or capabilities. This idea has an obvious appeal to many practitioners and administrators of professional qualification programs. However, there is limited knowledge about competency-based approaches in the accounting profession and among accounting academics, which is constraining discussion about the value of these approaches and about the strengths and weaknesses of the different competency models that have sprung up in various jurisdictions. In this paper we review and synthesize the literature on competency-based approaches. We identify a number of theoretical benefits of competency-based approaches. However, we also find many alternative definitions and philosophies underlying competency-based approaches, and a variety of visions of how competencies should be determined and assessed. We note that there is limited evidence supporting many competency-based approaches and we identify 14 research questions that could be used to help policy makers to more effectively address policy matters related to competency-based education and assessment. [source] Evaluation of optimized inversion-recovery fat-suppression techniques for T2-weighted abdominal MR imagingJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2008Thomas C. Lauenstein MD Abstract Purpose To test the theoretical benefits of a spectral attenuated inversion-recovery (SPAIR) fat-suppression (FS) technique in clinical abdominal MRI by comparison to conventional inversion-recovery (IR) FS combined with T2-weighted (T2W) partial Fourier single shot fast spin echo (SSFSE). Materials and Methods 1.5T MRI studies of the abdomen were performed in 28 patients with liver lesions (hemangiomas n = 14; metastases n = 14). T2W sequences were acquired using IR and SPAIR SSFSE. Measurements included retroperitoneal and mesenteric fat signal-to-noise (SNR) to evaluate FS; liver lesion contrast-to-noise (CNR) to evaluate bulk water signal recovery effects; and bowel wall delineation to evaluate susceptibility and physiological motion effects. Results SPAIR-SSFSE images produce significantly improved FS and liver lesion CNR. The mean SNR of the retroperitoneal and mesenteric fat for SPAIR SSFSE was 20.5 ± 10.2 (±1 SD) and 12.7 ± 6.2, compared to 43.2 ± 24.1 (P = 0.000006) and 29.3 ± 16.8 (P = 0.0000005) for IR-SSFSE. SPAIR-SSFSE images produced higher CNR for both hemangiomas CNR = 164 ± 88 vs. 126 ± 83 (P = 0.00005) and metastases CNR = 75 ± 27 vs. 53 ± 19 (P = 0.007). Bowel wall visualization was significantly improved using SPAIR-SSFSE (P = 0.002). Conclusion The theoretical benefits of SPAIR over conventional IR FS translate into significant multiple improvements that can be measured on clinical abdominal MRI scans. J. Magn. Reson. Imaging 2008;27:1448,1454. © 2008 Wiley-Liss, Inc. [source] Validating the organizational climate measure: links to managerial practices, productivity and innovationJOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 4 2005Malcolm G. Patterson This paper describes the development and validation of a multidimensional measure of organizational climate, the Organizational Climate Measure (OCM), based upon Quinn and Rohrbaugh's Competing Values model. A sample of 6869 employees across 55 manufacturing organizations completed the questionnaire. The 17 scales contained within the measure had acceptable levels of reliability and were factorially distinct. Concurrent validity was measured by correlating employees' ratings with managers' and interviewers' descriptions of managerial practices and organizational characteristics. Predictive validity was established using measures of productivity and innovation. The OCM also discriminated effectively between organizations, demonstrating good discriminant validity. The measure offers researchers a relatively comprehensive and flexible approach to the assessment of organizational members' experience and promises applied and theoretical benefits. Copyright © 2005 John Wiley & Sons, Ltd. [source] Methods of gastric electrical stimulation and pacing: a review of their benefits and mechanisms of action in gastroparesis and obesityNEUROGASTROENTEROLOGY & MOTILITY, Issue 3 2009W. L. Hasler Abstract, Development of gastric electrical stimulation techniques for treatment of gastric dysmotility syndromes and obesity has been a long-standing goal of investigators and clinicians. Depending on stimulus parameters and sites of stimulation, such methods have a range of theoretical benefits including entrainment of intrinsic gastric electrical activity, eliciting propagating contractions and reducing symptomatology in patients with gastroparesis and reducing appetite and food intake in individuals with morbid obesity. Additionally, gastric stimulation parameters have extragastrointestinal effects including alteration of systemic hormonal and autonomic neural activity and modulation of afferent nerve pathways projecting to the central nervous system that may represent important mechanisms of action. Numerous case series and smaller numbers of controlled trials suggest clinical benefits in these two conditions, however better controlled trials are mandated to confirm their efficacy. Current research is focusing on novel stimulation methods to better control symptoms in gastroparesis and promote weight reduction in morbid obesity. [source] Developing a blueprint for conservation of the endangered longleaf pine ecosystem based on centers of Coastal Plain plant endemismAPPLIED VEGETATION SCIENCE, Issue 1 2006Bruce A. Sorrie Abstract Question: Can the geographic patterning of endemic plant species inform reserve selection in a region of high endemism? Location: The Southeastern Coastal Plain of North America, focusing primarily on the imperiled longleaf pine (Pinus palustris P. Miller) ecosystem. Methods: We documented the high level of plant endemism in the region, and characterized the endemic taxa into distributional subregions. Results: A total of 1630 plant taxa are endemic to the Coastal Plain, a large proportion of which are endemic to phytogeographical subregions within the Coastal Plain, with particularly large numbers of narrow endemics occurring in the East Gulf Coastal Plain and Florida Peninsula. Conclusions: This pattern of local endemism presents challenges in conserving the full biota of the region: a reserve system focusing on few and large conservation areas has theoretical benefits for long-term management and viability, but will fail to capture many local endemics. We propose that the dispersed distribution of endemic species will require a mixture of large core reserves and smaller satellite reserves. [source] Remifentanil in neonatal intensive care and anaesthesia practiceACTA PAEDIATRICA, Issue 10 2010Márcia Gomes Penido Abstract Remifentanil is a relatively new ultrashort action synthetic opioid. Studies on the use of remifentanil in neonatology have emerged demonstrating its effectiveness and safety in neonates. The present study describes the use of remifentanil in both full-term and premature newborns, highlighting the theoretical benefits for this population in terms of both neonatal intensive care and anaesthesia. A Medline search was undertaken of all reviews and reports about the use of remifentanil in neonates published between 1996 and 2009 using MeSH search terms ,remifentanil', ,analgesia', ,anaesthesia', ,newborn' and ,neonate'. The review points that remifentanil has been used with advantages in newborns including preterm neonates and even for foetal anaesthesia. It proved to be a good option to attenuate the hemodynamic/endocrine markers of stress related to surgery. Owing to its unique pharmacokinetic profile, shorter extubation times can be achieved what makes the drug also a good option for short duration invasive procedures in NICUs (InSurE). A concern on its use is that the hemodynamic response (hypotension) may become significant when the drug is associated to other drugs like sevoflurane. Conclusion:, Remifentanil seems to be an effective and safely used opioid for neonatal intensive care and anaesthesia practice. [source] | |||||||||||||