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Unique Challenges (unique + challenge)
Kinds of Unique Challenges Selected AbstractsAdopted Children: Core Issues and Unique ChallengesJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 4 2002Eileen M. Smit MSN TOPIC Psychological impact of adoption and resulting core issues for adopted children. PURPOSE To raise awareness of the psychological impact of adoption. SOURCES Published literature and personal observations. CONCLUSIONS Adoption raises unique issues and challenges for the child and adoptive parents. Resolving the issues of adoption is a lifelong process. Through an awareness of the issues inherent in adoption, nurses and parents can use strategies that will enhance childrens self-esteem and decrease their emotional vulnerability. [source] Illustrative Hybrid Visualization and Exploration of Anatomical and Functional Brain DataCOMPUTER GRAPHICS FORUM, Issue 3 2008W. M. Jainek Abstract Common practice in brain research and brain surgery involves the multi-modal acquisition of brain anatomy and brain activation data. These highly complex three-dimensional data have to be displayed simultaneously in order to convey spatial relationships. Unique challenges in information and interaction design have to be solved in order to keep the visualization sufficiently complete and uncluttered at the same time. The visualization method presented in this paper addresses these issues by using a hybrid combination of polygonal rendering of brain structures and direct volume rendering of activation data. Advanced rendering techniques including illustrative display styles and ambient occlusion calculations enhance the clarity of the visual output. The presented rendering pipeline produces real-time frame rates and offers a high degree of configurability. Newly designed interaction and measurement tools are provided, which enable the user to explore the data at large, but also to inspect specific features closely. We demonstrate the system in the context of a cognitive neurosciences dataset. An initial informal evaluation shows that our visualization method is deemed useful for clinical research. [source] Conducting suicide research in naturalistic clinical settings,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2009David A. Jobes Abstract Unique challenges arise for clinical researchers designing studies focused on suicidal behaviors due to the inherently high-risk nature of such research. Traditional approaches to clinical trial design are briefly discussed, highlighting the limitations and obstacles of these approaches when working with suicidal individuals. Using their own personal experiences and setbacks from an ongoing clinical suicidology research program, the authors argue for greater emphasis on effectiveness and translational research designs conducted in naturalistic clinical settings to test the practical utility of empirically-supported treatments for suicidal behaviors, to gain new perspectives on suicidal individuals, and to better understand the nature of suicidal risk. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,14, 2009. [source] Body Dysmorphic Disorder and the Liposuction PatientDERMATOLOGIC SURGERY, Issue 5 2005Dee Anna Glaser MD background. Body dysmorphic disorder (BDD) is an under-recognized disorder that affects a sizeable number of patients who seek cosmetic enhancement, in particular liposuction. Understanding and recognizing BDD can positively impact the care delivered to patients. objective. To familiarize physicians with the presenting signs of BDD and present strategies for caring for BDD patients in a liposuction and/or cosmetic surgery practice. methods. Review of currently available literature and diagnostic criteria. results. BDD affects approximately 1% of patients in the United States, but as many as 7 to 15% of patients seeking cosmetic surgery. Patients with BDD will usually demonstrate an obsession with the area they seek treatment of. In addition, patients with BDD present a unique challenge to the liposuction surgeon. conclusions. Physicians who care for patients seeking liposuction or other cosmetic procedures should learn to recognize those who have BDD. Proper recognition and counseling of BDD patients can have a significant positive impact on not only their care but also on the patient-physician relationship. Failure to recognize BDD can, and often does, lead to patient dissatisfaction, as well as difficult future interactions with the BDD patient. [source] Diagnostic evaluation of cystic pancreatic lesionsHPB, Issue 1 2008B. C. VISSER Abstract Background. Cystic pancreatic neoplasms (CPNs) present a unique challenge in preoperative diagnosis. We investigated the accuracy of diagnostic methods for CPN. Material and methods. This retrospective cases series includes 70 patients who underwent surgery at a university hospital for presumed CPNs between 1997 and 2003, and for whom a definitive diagnosis was established. Variables examined included symptoms, preoperative work-up (including endoscopic retrograde cholangiopancreatography (ERCP) in 22 cases and endoscopic ultrasound (EUS) in 12), and operative and pathological findings. Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans (n=50 patients; CT=48; MRI=13) were independently reviewed by two blinded GI radiologists. Results. The final histopathologic diagnoses were mucinous cystic neoplasm (n=13), mucinous cystadenocarcinoma (10), serous cystadenoma (11), IPMN (14), simple cyst (3), cystic neuroendocrine tumor (5), pseudocyst (4), and other (10). Overall, 25 of 70 were malignant (37%), 21 premalignant (30%), and 24 benign (34%). The attending surgeon's preoperative diagnosis was correct in 31% of cases, incorrect in 29%, non-specific "cystic tumor" in 27%, and "pseuodcyst vs. neoplasm" in 11%. Eight had been previously managed as pseudocysts, and 3 pseudocysts were excised as presumed CPN. In review of the CT and MRI, a multivariate analysis of the morphologic features did not identify predictors of specific pathologic diagnoses. Both radiologists were accurate with their preferred (no. 1) diagnosis in <50% of cases. MRI demonstrated no additional utility beyond CT. Conclusions. The diagnosis of CPN remains challenging. Cross-sectional imaging methods do not reliably give an accurate preoperative diagnosis. Surgeons should continue to err on the side of resection. [source] Reliability of capacitive RF MEMS switches at high and low temperaturesINTERNATIONAL JOURNAL OF RF AND MICROWAVE COMPUTER-AIDED ENGINEERING, Issue 4 2004Yong Zhu Abstract Some applications of RF MEMS switches, such as aircraft condition monitoring and distributed satellite communication, present a unique challenge for device design and reliability. This article examines these switches when operational temperatures in the range ,60°C to 100°C are envisioned. The basic operation of a capacitive MEMS switch is described and two tools for examining device reliability, modeling, and on-chip experimentation, are discussed in the case of capacitive MEMS switches. 1D, 2D, and 3D models are presented with emphasis on 3D coupled-field finite-element analysis, including temperature effects. Results and findings from the 3D simulations are reported. In particular, the advantages of employing corrugated membranes in the design of RF MEMS switches are assessed. Their performance in terms of reliability as a function of temperature is quantified. The effects of corrugation on the geometric parameters are discussed in the context of device-design optimization. In order to assess reliability experimentally, the M-test and the membrane deflection experiment (MDE) are reviewed due to their on-chip characteristic and simplicity. Ways in which these experimental/computational methodologies can be combined for identifying material properties and device performance is also highlighted. © 2004 Wiley Periodicals, Inc. Int J RF and Microwave CAE 14: 317,328, 2004. [source] Orthotopic, but Reversed Implantation of the Liver Allograft in Situs Inversus Totalis,A Simple New Approach to a Difficult ProblemAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2009S. C. Rayhill Situs inversus totalis is a rare congenital anomaly in which the heart and abdominal organs are oriented in a mirror image of normal. It provides a unique challenge as there is no established technique for liver transplantation in these patients. Employing two major alterations from our standard technique, a liver was transplanted in the left subphrenic space of a patient with situs inversus totalis. First, the liver was flipped 180° from right to left (facing backward). Second, a reversed cavaplasty (anterior, not posterior, donor suprahepatic caval incision) was performed. Otherwise, it was standard, with end-to-end anastomoses of the portal vein, hepatic artery and bile duct. Three years after the entirely uneventful transplant, the recipient continues to enjoy the benefits of a normally functioning liver. The described technique prevented torsion, kinking and tension on the anastomosed structures by allowing the liver to sit naturally in an anatomical position in the left hepatic fossa. As it required no special measurements or maneuvers, the technique was easy to execute and required no donor liver size restrictions. This novel technique, with a reversed cavaplasty and a 180° right-to-left flip of the liver into a left-sided hepatic fossa, may be ideal for situs inversus totalis. [source] Usage of white mineral trioxide aggregate in a non-vital primary molar with no permanent successorAUSTRALIAN DENTAL JOURNAL, Issue 1 2010E Sen Tunc Abstract The aim of this study was to present the treatment and long-term follow-up of a case in which white mineral trioxide aggregate (WMTA) was used in the pulpectomy of a non-vital primary molar with no permanent successor. The physiological, aesthetic and functional consequences of treating primary teeth without permanent successors makes this a unique challenge. In the present case, WMTA was used in the pulpectomy of a primary molar with no permanent successor in an 8-year-old child. The treatment was considered successful. Follow-up examinations showed that root resorption in the mesial root surface, with no infra-occlusion or ankylosis 36 months after treatment. WMTA may be considered as an alternative pulpectomy material for non-vital primary teeth with no permanent successors, although long-term clinical studies are still needed. [source] Evaluation and treatment of covert stereotypyBEHAVIORAL INTERVENTIONS, Issue 1 2002Joel E. Ringdahl The treatment of behavior maintained by automatic reinforcement (e.g. stereotypy) can present a unique challenge if practitioners cannot control delivery of the maintaining reinforcer. Further, some individuals might engage in stereotypy only when care providers are absent. In the current evaluation, an adolescent boy's hand flapping was demonstrated to occur in the absence of social contingencies and care providers. To reduce the behavior, two treatment strategies were assessed. In the first approach, verbal reminders to refrain from hand flapping were delivered on time-based schedules. In the second approach (differential reinforcement of other behavior, DRO), we provided access to a preferred item contingent on prespecified time lengths with no hand flapping when the participant was alone in a room. Results of the investigation indicated that the verbal reminders were unsuccessful, whereas the DRO program resulted in near-zero levels of stereotypy. Copyright © 2002 John Wiley & Sons, Ltd. [source] Rowing, the ultimate challenge to the human body , implications for physiological variablesCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 4 2009Stefanos Volianitis Summary Clinical diagnoses depend on a variety of physiological variables but the full range of these variables is seldom known. With the load placed on the human body during competitive rowing, the physiological range for several variables is illustrated. The extreme work produced during rowing is explained by the seated position and the associated ability to increase venous return and, thus, cardiac output. This review highlights experimental work on Olympic rowing that presents a unique challenge to the human capacities, including cerebral metabolism, to unprecedented limits, and provides a unique opportunity to reveal the extreme range of many physiological variables. [source] Pediatric psoriasis and psoriatic arthritisDERMATOLOGIC THERAPY, Issue 5 2004Debra Lewkowicz ABSTRACT:, Psoriasis and psoriatic arthritis (PsA) are not uncommon among the pediatric population. Recognizing and treating these chronic disorders in children present unique challenges for the dermatologist. Paucity of clinical trials and a dearth of available treatment modalities, many of which carry significant risk or adverse effects, can make treating pediatric psoriasis and PsA a daunting task. This review attempts to define and consolidate the current state of knowledge with regards to this disease spectrum. The need for further clinical trials to investigate treatment options in the pediatric population is also discussed. [source] POPULATION AGING AND INTERNATIONAL DEVELOPMENT: ADDRESSING COMPETING CLAIMS OF DISTRIBUTIVE JUSTICEDEVELOPING WORLD BIOETHICS, Issue 1 2007MICHAL ENGELMAN ABSTRACT To date, bioethics and health policy scholarship has given little consideration to questions of aging and intergenerational justice in the developing world. Demographic changes are precipitating rapid population aging in developing nations, however, and ethical issues regarding older people's claim to scarce healthcare resources must be addressed. This paper posits that the traditional arguments about generational justice and age-based rationing of healthcare resources, which were developed primarily in more industrialized nations, fail to adequately address the unique challenges facing older persons in developing nations. Existing philosophical approaches to age-based resource allocation underemphasize the importance of older persons for developing countries and fail to adequately consider the rights and interests of older persons in these settings. Ultimately, the paper concludes that the most appropriate framework for thinking about generational justice in developing nations is a rights-based approach that allows for the interests of all age groups, including the oldest, to be considered in the determination of health resource allocation. [source] Molecular mechanisms of early gut organogenesis: A primer on development of the digestive tractDEVELOPMENTAL DYNAMICS, Issue 2 2003Julie C. Kiefer Abstract Creating an organ poses unique challenges in embryogenesis, including establishing an organ primordium and coordinating development of different tissues in the organ. The digestive tract (gut) is a complex organ system, posing the interesting question of how the development of a series of organs is coordinated to establish an organ system with a common function. Although gut development has been the focus of much research, the molecular mechanisms that regulate these events are just beginning to be understood. This primer will first outline the basic anatomy of the digestive tract and then focus on molecular mechanisms that drive vertebrate gut organogenesis. Deciphering mechanisms underlying gut organogenesis also provides insights into understanding the development of other organs. Developmental Dynamics 228:287,291, 2003. © 2003 Wiley-Liss, Inc. [source] Anatomy of an Ambush: Security Risks Facing International Humanitarian AssistanceDISASTERS, Issue 1 2005Frederick M. Burkle Jr. MD The 2003 war with Iraq has generated security concerns that present unique challenges to the practice of providing international humanitarian assistance during war and conflict. Objective research studies on security management are lacking. However, case studies have proven to be an important education and training tool to advance situational awareness of security risks. These challenges are illustrated by an analysis of the events surrounding the first ambush of, and assassination attempt on, a senior US aid official in Baghdad. Before deployment to conflict areas, especially those characterised by insurgent activity, humanitarian providers must realistically assess the threats to life and to the mission. They must obtain pre-deployment situational awareness education, security training and optimal protective equipment and vehicles. [source] Identifying and managing inhibitor patients requiring orthopaedic surgery , the multidisciplinary team approachHAEMOPHILIA, Issue 2005C. LUDLAM Summary., Until recently, surgery in haemophilia patients with inhibitors was strongly contraindicated and was therefore often not even contemplated. Inhibitor patients entering the surgical arena face unique challenges; the most frequently encountered problem during surgical intervention is bleeding, and thrombosis is occasionally observed. The activated prothrombin complex concentrate, FEIBATM, and recombinant activated factor VII (rFVIIa) are available as haemostatic cover during surgery. The use of rFVIIa enables inhibitor patients to undergo orthopaedic surgery with an expectation of success, and results are generally good. An organized team approach is critical to this success. However, further information is required to enable different procedures to be optimized in terms of both outcome and safety. [source] Perspectives on ecological risk assessment of chiral compoundsINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 3 2009Jacob K Stanley Abstract Enantiomers of chiral contaminants can significantly differ in environmental fate as well as in effects. Despite this fact, such differences are often ignored in regulation and in practice, injecting uncertainty into the estimation of risk of chiral compounds. We review the unique challenges posed by stereochemistry to the ecological risk assessment of chiral contaminants and existing regulatory guidance for chiral pharmaceuticals and pesticides in the United States. We identify the advantages of obtaining data on fate and effects of each individual enantiomer of chiral contaminants that are either distributed as or may end up as enantiomer mixtures in the environment due to enantiomerization. Because enantiomers of the same compound are highly likely to coexist in the environment with each other and can result in nonadditive effects, we recommend treatment of enantiomers as components of a mixture using widely accepted mixture models from achiral risk assessment. We further propose the enantiomer hazard ratio for retrospectively characterizing relative enantiomer risk and examine uncertainty factor magnitudes for effects analysis. [source] Psychotherapy in Brunei DarussalamJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2007N. Kumaraswamy Clinical psychologists face unique challenges in developing Southeast Asian countries because mental health care has not received the kind of attention it deserves. In part, this has been the result of lack of knowledge or misunderstanding about mental health and adherence to various religious and traditional beliefs. In this article, the practice of psychotherapy in Brunei Darussalam is reviewed and then illustrated with a typical case, Mrs. A Asian psychotherapists need more comprehensive knowledge of prevailing cultural beliefs and religious practices among multiethnic population groups. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 735,744, 2007. [source] CITGO Petroleum Meeting the Challenge with ABMJOURNAL OF CORPORATE ACCOUNTING & FINANCE, Issue 3 2002Marlene B. Rodriguez Activity-based management (ABM) has helped process and energy industries cut costs and improve efficiencies, because it provides the baseline data needed for performance measurement, outsourcing, product costing, and capacity analysis. However, implementations of ABM have to be tailored to meet the unique challenges posed by Shared Services functions and operational units. This article outlines CITGO's implementation techniques for ABM and describes the company's results for its Shared Services and operations business units. © 2002 Wiley Periodicals, Inc. [source] Vision-only control and guidance for aircraftJOURNAL OF FIELD ROBOTICS (FORMERLY JOURNAL OF ROBOTIC SYSTEMS), Issue 10 2006Alison A. Proctor An unmanned aerial vehicle usually carries an array of sensors whose output is used to estimate vehicle attitude, velocity, and position. This paper details the development of guidance, navigation, and control strategies for a glider, which is capable of flying a terminal trajectory to a known fixed object using only a single vision sensor. Controlling an aircraft using only vision presents two unique challenges: First, absolute state measurements are not available from a single image; and second, the images must be collected and processed at a high rate to achieve the desired controller performance. The image processor utilizes an integral image representation and a rejective cascade filter to find and classify simple features in the images, reducing the image to the most probable pixel location of the destination object. Then, an extended Kalman filter uses measurements obtained from a single image to estimate the states that would otherwise be unobservable in a single image. In this research, the flights are constrained to keep the destination object in view. The approach is validated through simulation. Finally, experimental data from autonomous flights of a glider, instrumented only with a single nose-mounted camera, intercepting a target window during short low-level flights, are presented. © 2006 Wiley Periodicals, Inc. [source] Bioterrorism: Processing Contaminated Evidence, the Effects of Formaldehyde Gas on the Recovery of Latent Fingermarks,JOURNAL OF FORENSIC SCIENCES, Issue 5 2007Rebecca Hoile B.Sc. Abstract:, In the present age of heightened emphasis on counter terrorism, law enforcement and forensic science are constantly evolving and adapting to the motivations and capabilities of terrorist groups and individuals. The use of biological agents on a population, such as anthrax spores, presents unique challenges to the forensic investigator, and the processing of contaminated evidence. In this research, a number of porous and nonporous items were contaminated with viable anthrax spores and marked with latent fingermarks. The test samples were then subjected to a standard formulation of formaldehyde gas. Latent fingermarks were then recovered postdecontamination using a range of methods. Standard fumigation, while effective at destroying viable spores, contributed to the degradation of amino acids leading to loss of ridge detail. A new protocol for formaldehyde gas decontamination was developed which allows for the destruction of viable spores and the successful recovery of latent marks, all within a rapid response time of less than 1 h. [source] Development of fully functional proteins with novel glycosylation via enzymatic glycan trimmingJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 8 2009Melinda L. Toumi Abstract Recombinant glycoproteins present unique challenges to biopharmaceutical development, especially when efficacy is affected by glycosylation. In these cases, optimizing the protein's glycosylation is necessary, but difficult, since the glycan structures cannot be genetically encoded, and glycosylation in nonhuman cell lines can be very different from human glycosylation profiles. We are exploring a potential solution to this problem by designing enzymatic glycan optimization methods to produce proteins with useful glycan compositions. To demonstrate viability of this new approach to generating glycoprotein-based pharmaceuticals, the N -linked glycans of a model glycoprotein, ribonuclease B (RNase B), were modified using an ,-mannosidase to produce a new glycoprotein with different glycan structures. The secondary structure of the native and modified glycoproteins was retained, as monitored using circular dichroism. An assay was also developed using an RNA substrate to verify that RNase B had indeed retained its function after being subjected to the necessary glycan modification conditions. This is the first study that verifies both activity and secondary structure of a glycoprotein after enzymatic glycan trimming for use in biopharmaceutical development methods. The evidence of preserved structure and function for a modified glycoprotein indicates that extracellular enzymatic modification methods could be implemented in producing designer glycoproteins. © 2008 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:2581,2591, 2009 [source] The complex inter-relationships between protein flexibility and stabilityJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 9 2008Tim J. Kamerzell Abstract The ability to successfully formulate and manufacture therapeutic protein dosage forms requires a thorough understanding of their physico-chemical properties. Proteins are inherently dynamic molecules of marginal stability. These properties present unique challenges to the pharmaceutical scientist attempting to develop protein based therapeutics. The physicochemical stability and biological functions of proteins are thought to be intimately related to their global flexibility, intramolecular fluctuations and various other dynamic processes. Our understanding of these relationships, however, is incomplete but undeniably necessary for the development of efficacious therapies. Therefore, a better understanding of the complex inter-relationships between protein flexibility and stability should enable the rational design and optimization of protein formulation conditions based on protein dynamics. This review attempts to define protein dynamics and flexibility while summarizing a select number of studies of potential pharmaceutical interest that evaluate these relationships. © 2008 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 97:3494,3517, 2008 [source] Case-based pedagogy as a context for collaborative inquiry in the PhilippinesJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 5 2001Elvira L. Arellano The purpose of this study was to investigate the potential for using case-based pedagogy as a context for collaborative inquiry into the teaching and learning of elementary science. The context for this study was the elementary science teacher preparation program at West Visayas State University on the the island of Panay in Iloilo City, the Philippines. In this context, triple linguistic conventions involving the interactions of the local Ilonggo dialect, the national language of Philipino (predominantly Tagalog) and English create unique challenges for science teachers. Participants in the study included six elementary student teachers, their respective critic teachers and a research team composed of four Filipino and two U.S. science teacher educators. Two teacher-generated case narratives serve as the centerpiece for deliberation, around which we highlight key tensions that reflect both the struggles and positive aspects of teacher learning that took place. Theoretical perspectives drawn from assumptions underlying the use of case-based pedagogy and scholarship surrounding the community metaphor as a referent for science education curriculum inquiry influenced our understanding of tensions at the intersection of re-presentation of science, authority of knowledge, and professional practice, at the intersection of not shared language, explicit moral codes, and indigenization, and at the intersection of identity and dilemmas in science teaching. Implications of this study are discussed with respect to the building of science teacher learning communities in both local and global contexts of reform. © 2001 John Wiley & Sons, Inc. J Res Sci Teach 38: 502,528, 2001 [source] Beyond the "Model Minority" Stereotype: Trends in Health Risk Behaviors Among Asian/Pacific Islander High School StudentsJOURNAL OF SCHOOL HEALTH, Issue 8 2009Sung-Jae Lee PhD ABSTRACT BACKGROUND: Asian/Pacific Islander (API) students have been stereotyped as the "model minority." The objective of this study was to examine the trends in health risk behaviors among API students who participated in the San Diego City Schools Youth Risk Behavior Survey (YRBS) between 1993 and 2005. METHODS: High school students from the San Diego City School District completed the self-administered YRBS between 1993 and 2005. Among sexually active students, logistic regression for survey data was used to examine trends in health risk behaviors. RESULTS: From 1993 to 2005, condom use at last sexual intercourse was consistently lower among API students than their cross-ethnic peers. We observed a significant increasing trend in lifetime smoking, drinking, and marijuana use. Parental communications regarding human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) were significantly less frequent and decreased over time. CONCLUSIONS: Our findings challenge the notion of API youth being the "model minority." API students face unique challenges, including barriers to good communication about sex and lower rates of condom use. School-based prevention programs are needed for API students, including a focus on HIV communication with parents. [source] The REFLECT Statement: Methods and Processes of Creating Reporting Guidelines for Randomized Controlled Trials for Livestock and Food SafetyJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010A.M. O'Connor The conduct of randomized controlled trials in livestock with production, health, and food-safety outcomes presents unique challenges that might not be adequately reported in trial reports. The objective of this project was to modify the CONSORT (Consolidated Standards of Reporting Trials) statement to reflect the unique aspects of reporting these livestock trials. A 2-day consensus meeting was held on November 18,19, 2008 in Chicago, IL, to achieve the objective. Before the meeting, a Web-based survey was conducted to identify issues for discussion. The 24 attendees were biostatisticians, epidemiologists, food-safety researchers, livestock production specialists, journal editors, assistant editors, and associate editors. Before the meeting, the attendees completed a Web-based survey indicating which CONSORT statement items would need to be modified to address unique issues for livestock trials. The consensus meeting resulted in the production of the REFLECT (Reporting Guidelines for Randomized Control Trials) statement for livestock and food safety and 22-item checklist. Fourteen items were modified from the CONSORT checklist, and an additional subitem was proposed to address challenge trials. The REFLECT statement proposes new terminology, more consistent with common usage in livestock production, to describe study subjects. Evidence was not always available to support modification to or inclusion of an item. The use of the REFLECT statement, which addresses issues unique to livestock trials, should improve the quality of reporting and design for trials reporting production, health, and food-safety outcomes. [source] Time-domain integral-equation based analysis of scattering from conducting surfaces including the singular edge behaviorMICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 5 2002Yongxue Yu Abstract A method for modeling singular electric currents near conducting edges within marching-on-in-time (MOT) simulators is presented. The use of singular basis functions in MOT simulators presents unique challenges not encountered in frequency-domain implementations. Numerical results demonstrate that the proposed expansion results in accelerated convergence for scatterers with sharp features. © 2002 Wiley Periodicals, Inc. Microwave Opt Technol Lett 34: 327,332, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.10452 [source] Device Extraction in Adults with Congenital Heart DiseasePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2009DAVID CESARIO M.D., Ph.D. Background: Device extraction is a critical component in the treatment of patients with device-related infections. Due to complex anatomic considerations, device extraction in adults with congenital heart disease presents unique challenges to the electrophysiologist. Methods: Here, we present a series of device-extraction cases performed in patients with transposition of the great arteries status post either Mustard or Senning surgical procedures that subsequently had permanent pacemakers placed and ultimately developed device-related infections. Results: All of these patients eventually underwent successful laser extractions of their infected devices resulting in complete removal of all hardware and resolution of their infections. Conclusions: These cases illustrate that endovascular device extraction has been safely and effectively performed in adult patients with congenital heart disease, though further studies are needed to determine the procedural risks and success rates of this procedure in this patient population. [source] Assessment and Treatment of Pain Associated with Combat-Related PolytraumaPAIN MEDICINE, Issue 3 2009Michael E. Clark PhD ABSTRACT Due to the high rates of blast injuries sustained during operations in Iraq and Afghanistan, the number of soldiers returning with massive and multiple wounds is unprecedented. While casualty survival rates have improved dramatically, the extent and impact of these wounds on soldiers' functioning pose unique challenges for their rehabilitation. Pain is highly prevalent in these individuals with polytrauma injuries and is a source of suffering, as well as an impediment to rehabilitation. However, there are a number of obstacles to effective pain treatment in this group of war-injured, including their multiple and severe injuries, the high prevalence of brain injuries, cognitive impairments and emotional distress, the prolonged and intensive rehabilitation process, and the frequent need for repeated follow-up surgeries. As a result, we believe that a comprehensive, interdisciplinary approach to pain treatment is required. In this article we describe the model of pain care that has evolved at the Tampa Polytrauma Rehabilitation Center, which incorporates medical, rehabilitative, cognitive,behavioral, and interventional treatments targeting pain intensity as well as pain-related impairments and coping. We include a case study illustrating some key aspects of our approach. [source] The development of the RTS,S malaria vaccine candidate: challenges and lessonsPARASITE IMMUNOLOGY, Issue 9 2009W. R. BALLOU Summary RTS,S is the world's most advanced malaria vaccine candidate and is intended to protect infants and young children living in malaria endemic areas of sub-Saharan Africa against clinical disease caused by Plasmodium falciparum. Recently, a pivotal Phase III efficacy trial of RTS,S began in Africa. The goal of the programme has been to develop a vaccine that will be safe and effective when administered via the Expanded Program for Immunization (EPI) and significantly reduce the risk of clinically important malaria disease during the first years of life. If a similar reduction in the risk of severe malaria and other important co-morbidities associated with malaria infection can be achieved, then the vaccine could become a major new tool for reducing the burden of malaria in sub-Saharan Africa. Encouraging data from the ongoing phase II programme suggest that these goals may indeed be achievable. This review discusses some of the unique challenges that were faced during the development of this vaccine, highlights the complexity of developing new vaccine technologies and illustrates the power of partnerships in the ongoing fight against this killer disease. [source] Revising the Personality Disorder Diagnostic Criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): Consider the Later Life ContextAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2009Steve Balsis PhD The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications. [source] | |||||||||||||||||||||||||||||||||||||||||||