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Beneficial
Kinds of Beneficial Terms modified by Beneficial Selected AbstractsProviding Nutrition Supplements to Institutionalized Seniors with Probable Alzheimer's Disease Is Least Beneficial to Those with Low Body Weight StatusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Karen W. H. Young MSc Objectives: To examine whether providing a midmorning nutrition supplement increases habitual energy intake in seniors with probable Alzheimer's disease (AD) and to investigate the effects of body weight status and cognitive and behavioral function on the response to the intervention. Design: Randomized, crossover, nonblinded clinical trial. Setting: A fully accredited geriatric teaching facility affiliated with the University of Toronto's Medical School with a home for the aged. Participants: Thirty-four institutionalized seniors with probable AD who ate independently. Intervention: Nutrition supplements were provided between breakfast and lunch for 21 consecutive days and compared with 21 consecutive days of habitual intake. Measurements: Investigator-weighed food intake, body weight, cognitive function (Severe Impairment Battery and Global Deterioration Scale), behavioral disturbances (Neuropsychiatric Inventory,Nursing Home Version), and behavioral function (London Psychogeriatric Rating Scale). Results: Relative to habitual intake, group mean analyses showed increased 24-hour energy, protein, and carbohydrate intake during the supplement phase, but five of 31 subjects who finished all study phases completely compensated for the energy provided by the supplement by reducing lunch intake, and 24-hour energy intake was enhanced in only 21 of 31 subjects. Compensation at lunch was more likely in subjects with lower body mass indices, increased aberrant motor behavior, poorer attention, and increased mental disorganization/confusion. Conclusion: Nutrition supplements were least likely to enhance habitual energy intake in subjects who would normally be targeted for nutrition intervention,those with low body weight status. Those likely to benefit include those with higher body mass indices, less aberrant motor problems, less mental disorganization, and increased attention. [source] Increases in Serum Non-High-Density Lipoprotein Cholesterol May Be Beneficial in Some High-Functioning Older Adults: MacArthur Studies of Successful AgingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2004Arun S. Karlamangla PhD Objectives: To examine the association between changes in serum non-high-density lipoprotein cholesterol (non-HDL-C) over a 2.5-year period and risk of adverse health outcomes in the following 4.5 years in high-functioning older adults. Design: Prospective cohort, established in 1988, with a follow-up in 1991 and 1995. Setting:, Population-based, community-dwelling men and women. Participants: A random sample (n=267) from the MacArthur cohort (N=1,189). The cohort represented the highest-functioning tertile of 4,030 screened candidates aged 70 to 79. Measurements:, Change in non-HDL-C between 1988 and 1991 was measured as a predictor of health outcomes between 1991 and 1995, including all-cause mortality, and among survivors, incident heart attack or stroke, development of new disability in basic activities of daily living, and decline in performance on the Short Portable Mental Status Questionnaire. Results: More-positive change in non-HDL-C between 1988 and 1991 was associated with fewer adverse outcomes between 1991 and 1995. In individuals whose total cholesterol at baseline was in the middle two quartiles (195,244 mg/dL), each 10-mg/dL increase in the 1988-to-1991 change in non-HDL-C was associated with an adjusted mortality odds ratio (OR) of 0.67 (95% confidence interval (CI)=0.51,0.88). In individuals without cardiovascular disease at baseline, the adjusted OR for new physical disability was 0.79 (95% CI=0.65,0.95) and for cognitive decline was 0.81 (95% CI=0.67,0.98). Conclusion: Increases in cholesterol over time have beneficial associations in some older adults. The role of cholesterol changes in the health of older individuals needs further exploration. [source] A Case Study of the Beneficial Reuse of Treated GroundwaterREMEDIATION, Issue 3 2001Andrew Curtis Elmore The future disposal of treated groundwater at the former Nebraska Ordnance Plant (NOP) Superfund site has been a topic of interest to the local property owners, the U.S. Army Corps of Engineers, and the local regulatory agencies. The Record of Decision for the site includes the extraction, treatment, and disposal of almost 3,000 gpm of groundwater with an estimated restoration time period exceeding 100 years. Interest from property owners and the Nebraska agency charged with regulating groundwater supply prompted the Corps of Engineers to consider several strategies for beneficially reusing the treated water. Alternatives included the establishment of a rural water district or local distribution system; delivery of the water to the municipal supply system of Lincoln, Nebraska, andsol;or other nearby municipalities; and consideration of innovative remedial technologies to reduce the quantity of treated water requiring disposal. The selected disposal plan consists of providing treated groundwater to interested parties for agricultural use with excess treated groundwater discharged to two streams. Multiple feasibility studies were generated, public input was solicited, and interagency agreements were executed during the course of the project. The remediation project is currently being constructed, and at least one property owner has constructed a new center-pivot irrigation system to use the treated groundwater. © 2001 John Wiley & Sons. [source] In Vitro Compaction of Germinal Vesicle Chromatin is Beneficial to Survival of Vitrified Cat OocytesREPRODUCTION IN DOMESTIC ANIMALS, Issue 2009P Comizzoli Contents The immature cat oocyte contains a large-sized germinal vesicle (GV) with decondensed chromatin that is highly susceptible to cryo-damage. The aim of the study was to explore an alternative to conventional cryopreservation by examining the influence of GV chromatin compaction using resveratrol (Res) exposure (a histone deacetylase enhancer) on oocyte survival during vitrification. In Experiment 1, denuded oocytes were exposed to 0, 0.5, 1.0 or 1.5 mmol/l Res for 1.5 h and then evaluated for chromatin structure or cultured to assess oocyte meiotic and developmental competence in vitro. Exposure to 1.0 or 1.5 mmol/l Res induced complete GV chromatin deacetylation and the most significant compaction. Compared to other treatments, the 1.5 mmol/l Res concentration compromised the oocyte ability to achieve metaphase II (MII) or to form a blastocyst. In Experiment 2, denuded oocytes were exposed to Res as in Experiment 1 and cultured in vitro either directly (fresh) or after vitrification. Both oocyte types then were assessed for meiotic competence, fertilizability and ability to form embryos. Vitrification exerted an overall negative influence on oocyte meiotic and developmental competence. However, ability to reach MII, achieve early first cleavage, and develop to an advanced embryo stage (8,16 cells) was improved in vitrified oocytes previously exposed to 1.0 mmol/l Res compared to all counterpart treatments. In summary, results reveal that transient epigenetic modifications associated with GV chromatin compaction induced by Res is fully reversible and beneficial to oocyte survival during vitrification. This approach has allowed the production of the first cat embryos from vitrified immature oocytes. [source] Host responses to a versatile commensal: PAMPs and PRRs interplay leading to tolerance or infection by Candida albicansCELLULAR MICROBIOLOGY, Issue 7 2009Thierry Jouault Summary The molecular interactions between commensal microorganisms and their host are basically different from those triggered by pathogens since they involve tolerance. When the commensal is genetically equipped to become an opportunistic pathogen, as is the case with Candida albicans, the picture becomes more complex. In this case, the balance between protection and invasion depends on host reactivity to altered microbial expression of ligands interacting with innate immune sensors. Based on experimental evidence obtained with C. albicans, we discuss the different molecular processes involved in the sensing of this important opportunistic human pathogen by a panel of pattern recognition receptors (PRRs) according to the numerous pathogen-associated molecular patterns (PAMPs) that can be exposed at its surface. Beneficial or deleterious immune responses that either maintain a commensal state or favour damage by the yeast result from this dynamic interplay. [source] Rapid Human-Assisted Creation of Bounding Models for Obstacle Avoidance in ConstructionCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 1 2004J. McLaughlin A practical, interactive method for doing so is described here. The method: (1) exploits a human operator's ability to quickly recognize significant objects or clusters of objects in a scene, (2) exploits the operator's ability to acquire sparse range point clouds of the objects quickly, and then (3) renders models, such as planes, boxes, and generalized convex hulls, to be displayed graphically as visual feedback during equipment operation and/or for making proximity calculations in an obstacle detection system. Experiments were performed in which test subjects were asked to model objects of varying complexity and clutter. These models were then compared to control models using a ray-tracing algorithm to determine the operator's ability to create conservative models that are critical to construction operations. To demonstrate the applicability of the modeling method to obstacle avoidance, a scripted motion robot simulation was conducted using an artificial potential formulation that monitors position (closest point on manipulator link to nearest obstacle) as well as velocity (link inertia). Experimental results indicate that bounding models can be created rapidly and with sufficient accuracy for obstacle avoidance with the aid of human intelligence and that human-assisted modeling can be very beneficial for real-time construction equipment control. [source] Network-aware selective job checkpoint and migration to enhance co-allocation in multi-cluster systems,CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 13 2009William M. Jones Abstract Multi-site parallel job schedulers can improve average job turn-around time by making use of fragmented node resources available throughout the grid. By mapping jobs across potentially many clusters, jobs that would otherwise wait in the queue for local resources can begin execution much earlier; thereby improving system utilization and reducing average queue waiting time. Recent research in this area of scheduling leverages user-provided estimates of job communication characteristics to more effectively partition the job across system resources. In this paper, we address the impact of inaccuracies in these estimates on system performance and show that multi-site scheduling techniques benefit from these estimates, even in the presence of considerable inaccuracy. While these results are encouraging, there are instances where these errors result in poor job scheduling decisions that cause network over-subscription. This situation can lead to significantly degraded application performance and turnaround time. Consequently, we explore the use of job checkpointing, termination, migration, and restart (CTMR) to selectively stop offending jobs to alleviate network congestion and subsequently restart them when (and where) sufficient network resources are available. We then characterize the conditions and the extent to which the process of CTMR improves overall performance. We demonstrate that this technique is beneficial even when the overhead of doing so is costly. Copyright © 2009 John Wiley & Sons, Ltd. [source] Lessons from brief therapy?CONFLICT RESOLUTION QUARTERLY, Issue 3 2002Some interactional suggestions for family mediators One continuing issue in mediation is the degree to which mediation and therapy can and should overlap. This article, which draws upon the empirical work of Dingwall and colleagues, looks at an area in which overlap may be beneficial. The authors review the concept and techniques of brief therapy and indicate appropriateness for family mediation. [source] Conservation of the Biodiversity of Brazil's Inland WatersCONSERVATION BIOLOGY, Issue 3 2005ANGELO A. AGOSTINHO Threatened freshwater species include 44 species of invertebrates (mostly Porifera) and 134 fishes (mostly Cyprinodontiformes, Rivulidae), primarily distributed in south and southeastern Brazil. Reasons for the declines in biodiversity in Brazilian inland waters include pollution and eutrophication, siltation, impoundments and flood control, fisheries, and species introductions. These problems are more conspicuous in the more-developed regions. The majority of protected areas in Brazil have been created for terrestrial fauna and flora, but they also protect significant water bodies and wetlands. As a result, although very poorly documented, these areas are of great importance for aquatic species. A major and pressing challenge is the assessment of the freshwater biodiversity in protected areas and surveys to better understand the diversity and geography of freshwater species in Brazil. The concept of umbrella species (e.g., certain migratory fishes) would be beneficial for the protection of aquatic biodiversity and habitats. The conservation and improved management of river corridors and associated floodplains and the maintenance of their hydrological integrity is fundamental to preserving Brazil's freshwater biodiversity and the health of its aquatic resources. Resumen:,En términos de biodiversidad, las aguas interiores de Brasil son de enorme importancia global para Algae (25% de las especies del mundo), Porifera (Demospongiae, 33%), Rotifera (25%), Cladocera (Branchiopoda, 20%) y peces (21%). Las especies dulceacuícolas amenazadas incluyen a 44 especies de invertebrados (la mayoría Porifera) y 134 de peces (en su mayor parte Cyprinodontiformes, Rivulidae), distribuidos principalmente en el sur y sureste de Brasil. Las razones de la declinación en la biodiversidad de aguas interiores de Brasil incluyen contaminación y eutrofización, sedimentación, represas y control de inundaciones, pesquerías e introducción de especies. Estos problemas son más conspicuos en las regiones más desarrolladas. La mayoría de las áreas protegidas en Brasil han sido creadas para fauna y flora terrestres, pero también protegen a considerable número de cuerpos de agua y humedales y, aunque muy deficientemente documentado, como tales son de gran importancia para las especies acuáticas. La evaluación de la biodiversidad dulceacuícola en áreas protegidas y muestreos para un mejor entendimiento de la diversidad y geografía de especies dulceacuícolas de Brasil son un reto mayor y apremiante. El concepto de especies sombrilla (e.g., ciertos peces migratorios) sería benéfico para la protección de biodiversidad y hábitats acuáticos. La conservación y perfeccionamiento de la gestión de corredores fluviales y las llanuras de inundación asociadas y el mantenimiento de su integridad hidrológica son fundamentales para preservar la biodiversidad dulceacuícola de Brasil y la salud de sus recursos acuáticos. [source] Enhancement of Farmland Biodiversity within Set-Aside LandCONSERVATION BIOLOGY, Issue 4 2004JOSH VAN BUSKIRK agricultura; biodiversidad; conservación; terrenos de reserva Abstract:,The efficacy of agricultural set-aside policies for protecting farmland biodiversity is widely debated. Based on a meta-analysis of 127 published studies, we found that land withdrawn from conventional production unequivocally enhances biodiversity in North America and Europe. The number of species of birds, insects, spiders, and plants is 1,1.5 standard deviation units higher on set-aside land, and population densities increase by 0.5,1 standard deviation units. Set-aside land may be especially beneficial for desirable taxa because North American bird species that have exhibited population declines react most positively to set-aside agricultural land. Larger and older plots protect more species and higher densities, and set-aside land is more effective in countries with less-intensive agricultural practices and higher fractions of land removed from production. Although policies specifically designed to protect biodiversity might work even better, current incentives clearly improve the standing of plants and animals in farmland. Resumen:,La eficiencia de las políticas de reservas agrícolas para la protección de la biodiversidad en tierras cultivadas esta ámpliamente debatida. Con base en un meta-análisis de 127 estudios publicados, encontramos que terrenos retirados de la producción convencional inequívocamente mejoran la biodiversidad en Norte América y Europa. El número de especies de aves, insectos, arañas y plantas es 1-1.5 unidades de desviación estándar más alto en terrenos de reserva, y las densidades de población incrementan en 0.5-1 unidades de desviación estándar. Los terrenos de reserva pueden ser especialmente benéficos para taxones deseables porque especies de aves norteamericanas que han presentado una declinación poblacional reaccionan positivamente a terrenos agrícolas de reserva. Parcelas más grandes y viejas protegen a más especies y tienen mayores densidades, y los terrenos de reserva son más efectivos en países con prácticas agrícolas menos intensivas y con mayores fracciones de tierras removidas de la producción. Aunque las políticas diseñadas específicamente para proteger la biodiversidad pueden ser mejores aún, los incentivos actuales claramente mejoran la situación de plantas y animales en tierras agrícolas. [source] FC03.1 Experience from joint occupational health/dermatology clinicsCONTACT DERMATITIS, Issue 3 2004Yat Wing Wong Background:, A monthly consultant led occupational health/dermatology clinic was started in 1999 providing rapid access to staff with suspected occupational skin disease including natural rubber latex (NRL) allergy and teaching for the occupational health staff. Objectives:, To evaluate the characteristics and outcome of staff attending this clinic and to assess patient satisfaction. Methods:, A retrospective case note survey was performed from staff attending the clinic from 1999 to 2002. A questionnaire was sent to them >3 months following consultation. Results:, A total of 116 patients were identified (12 male, 104 female), and 85 (73%) were nurses. 77 (66%) patients were referred with hand eczema (HE). Of the 45 patients referred with adverse reactions or exacerbation of hand dermatitis following the use of latex gloves, only 4 had positive prick tests and were considered to have NRL allergy. Patients with significant HE or occupational exacerbation of HE were referred for patch testing (n = 36). Of the remainder, most could be discharged after a single visit. 49/95 (52%) questionnaires were returned, 34/45 (76%) patients found the consultation useful. As a separate study, the data recorded within the patch test clinic looking at health care workers (HCW) referred both from this clinic and from other sources was analysed. This showed relevant positive patch tests in 16/49 (33%) patients. In 55/99 (56%), an occupational cause was likely. Conclusion:, Occupational skin disease in HCW is common, attendance at the clinic was beneficial and a single visit was sufficient in most cases. [source] An audit of the value of patch testing and its effect on quality of lifeCONTACT DERMATITIS, Issue 5 2003P. N. Woo We have assessed the value of patch testing from the patient's perspective and examined the impact of patch testing on their quality of life (QoL). 140 patients were recruited over 5 months. 2 questionnaires were designed to investigate the patient's views on patch testing. The 1st questionnaire was completed at the final visit to the clinic and the 2nd was posted 6 weeks later. The Dermatology Life Quality Index (DLQI) questionnaire was completed on both occasions. There was a significant improvement of the DLQI score in all patch-tested subjects (P = 0·003). Patients with involvement of the trunk had worse QoL. At the 4-day visit, 77 patients (55%) expressed the opinion that patch testing had been helpful. 6 weeks later, 71 patients replied. 47 patients were diagnosed as having allergic contact dermatitis: 87% of them found that patch testing had been useful, 91% were able to avoid the allergen(s) and 57% reported improvement/clearing in their skin condition. 58% of the 24 patients with negative results also found that patch testing had been beneficial. Overall, patient perception was that they understood verbal information (92%) better than written information (76%). Patch testing is beneficial to patients, leading to improved QoL. Patient perception was that they understood verbal advice better than written information. [source] What Do Shareholders' Coalitions Really Want?CORPORATE GOVERNANCE, Issue 2 2007Evidence from Italian voting trusts This paper studies the effects of having multiple large shareholders who share the control of firms, by analysing a unique dataset of Italian shareholders' agreements (voting trusts). We investigate the separation between ownership and control granted by such agreements, showing that, on average, a voting trust owning 52 per cent of the total company's cash-flow rights is able to exercise up to 87 per cent of the total board rights; the wedge is particularly beneficial to the largest shareholder within the voting trust who is able to get the majority of board rights despite owning only a minority fraction of the company's cash-flow rights. Then, an event-study analysis of a sample of voting trusts' announcements is performed. The results support the "entrenchment effects" hypothesis (Stulz, 1988) linking the ownership structure and the firm value, and are consistent with the view that, in Italy, voting trust agreements are mainly aimed at both protecting controlling shareholders from hostile takeovers and entrenching incumbent management. [source] Androgen replacement therapy improves function in male rat muscles independently of hypertrophy and activation of the Akt/mTOR pathwayACTA PHYSIOLOGICA, Issue 4 2009C. Hourdé Abstract Aim:, We analysed the effect of physiological doses of androgens following orchidectomy on skeletal muscle and bone of male rats, as well as the relationships between muscle performance, hypertrophy and the Akt/mammalian target of rapamycin (mTOR) signalling pathway involved in the control of anabolic and catabolic muscle metabolism. Methods:, We studied the soleus muscle and tibia from intact rats (SHAM), orchidectomized rats treated for 3 months with vehicle (ORX), nandrolone decanoate (NAN) or dihydrotestosterone (DHT). Results:, Orchidectomy had very little effect on the soleus muscle. However, maximal force production by soleus muscle (+69%) and fatigue resistance (+35%) in NAN rats were both increased when compared with ORX rats. In contrast, DHT treatment did not improve muscle function. The relative number of muscle fibres expressing slow myosin heavy chain and citrate synthase activity were not different in NAN and ORX rats. Moreover, NAN and DHT treatments did not modify muscle weights and cross-sectional area of muscle fibres. Furthermore, phosphorylation levels of downstream targets of the Akt/mTOR signalling pathway, Akt, ribosomal protein S6 and eukaryotic initiation factor 4E-binding protein 1 were similar in muscles of NAN, DHT and ORX rats. In addition, trabecular tibia from NAN and DHT rats displayed higher bone mineral density and bone volume when compared with ORX rats. Only in NAN rats was this associated with increased bone resistance to fracture. Conclusion:, Physiological doses of androgens are beneficial to muscle performance in orchidectomized rats without relationship to muscle and fibre hypertrophy and activation of the Akt/mTOR signalling pathway. Taken together our data clearly indicate that the activity of androgens on muscle and bone could participate in the global improvement of musculoskeletal status in the context of androgen deprivation induced by ageing. [source] Examining the role of the forest industry in collaborative ecosystem management: implications for corporate strategyCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 1 2005Jennifer Dyke Abstract The North American timber industry owns or controls a substantial amount of commercial timberland, and it is within this privately held acreage that major portions of critical natural habitat and areas of biodiversity are found. Because significant ecosystem components and processes lie within the ownership of forestry operations, industry participation in collaborative ecosystem management initiatives is vital to protect the integrity of ecological units at the landscape scale. This article analyzes and identifies the role of industry in ecosystem management projects, industry's willingness to participate in collaborative ecosystem management and the motivations behind company participation. Companies indicated active involvement in collaborative ecosystem management as both project initiators and collaborators. Motivations for participating in collaborative ecosystem management initiatives include the desires to decrease governmental regulations, collect data, develop relationships and improve current practices. Many companies also feel that participation is financially beneficial because it positively impacts corporate public relations. We discuss the implications of these results for developing an effective corporate environmental strategy associated with resource-based industries. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment. [source] RIGHT-TO-CARRY CONCEALED HANDGUNS AND VIOLENT CRIME: CRIME CONTROL THROUGH GUN DECONTROL?,CRIMINOLOGY AND PUBLIC POLICY, Issue 3 2003TOMISLAV V. KOVANDZIC Research Summary: "Right-to-Carry" (RTC) concealed-handgun laws mandate that authorities issue concealed handgun permits to qualified applicants. The supposition by those supporting the laws is that allowing private citizens to carry concealed handguns in public can reduce violent crime by deterring prospective criminals afraid of encountering armed civilians. Critics of the laws argue that violent altercations are more likely to turn deadly when more people carry guns. Whether the laws cause violent crime to increase or to decrease has become an important public policy question, as most states have now adopted such legislation. The present study evaluates Florida's 1987 RTC law, which prior research suggests plays a key role in the RTC debate. Specifically, we use panel data for 58 Florida counties from 1980 to 2000 to examine the effects on violent crime from increases in the number of people with concealed-carry permits, rather than before-after dummy and time-trend variables used in prior research. We also address many of the methodological problems encountered in earlier RTC studies. We present numerous model specifications, and we find little evidence that increases in the number of citizens with concealed-handgun permits reduce or increase rates of violent crime. Policy Implications: The main policy implication of this research is that there appears to be little gained in the way of crime prevention by converting restrictive gun carrying laws to "shall-issue" laws, although the laws might still prove beneficial by (1) eliminating arbitrary decisions on gun permit applications, (2) encouraging gun safety, (3) making permit holders feel safer when out in public, (4) providing permit holders with a more effective means of self-defense, and (5) reducing the costs to police departments of enforcing laws prohibiting unlicensed gun carrying. [source] CPA assessment , the regional assessors' experienceCYTOPATHOLOGY, Issue 2007E. Welsh Many individuals within Laboratory Medicine will be unaware that CPA conducts assessments to two different sets of CPA Standards. There are the Standards for the Medical Laboratory and the Standards for EQA Schemes in Laboratory Medicine. The style and format of both sets of standards is very similar with each being presented in eight sections A , H. The EQA standards are almost identical to the laboratory standards with the exception of the E.F and G standards which are specific to EQA schemes. There are approximately 40 EQA Schemes registered with CPA compared with almost 2 500 laboratories. These EQA schemes vary from very large national/international schemes with numerous analytes to small interpretive schemes run by one individual with a personal interest in that specific subject. The large schemes usually come under the UKNEQAS consortia banner and due to their size and configuration do not present undue problems in the assessment process. Smaller interpretive EQA schemes present a challenge both for the scheme and CPA in gaining accreditation. These schemes are usually within the discipline of Histopathology and are regarded as educational rather than proficiency testing schemes. Very frequently, the scheme is organized by a single individual with a collection of microscope slides, storage facilities for the slides and a computer. This presents the Scheme Organizer with great difficulty in complying with the Quality Management System requirements of the CPA Standards. There are a number of models which can be applied in order to satisfy the requirement of the Quality Management System, but ultimately it must be recognized that in some circumstances it is not possible to accredit these small schemes. The NHSCSP Gynae Cytology EQA Scheme is probably the largest EQA scheme within the UK, in respect of the number of participants and the number of staff supporting the scheme. Scheme Management decided that all nine regions of England would apply for accreditation under one CPA Reference Number. This process meant that the scheme would be assessed as a Managed Pathology Network. This is unique in terms of EQA schemes and presented a number of problems not previously encountered in EQA scheme accreditation. This decision meant that all nine regions must comply with a single Quality Management System and other CPA standards whilst allowing flexibility within the system for each region to facilitate the assessment process specific to their user's requirements. The process worked in a satisfactory manner and the overall outcome was not dissimilar to that of other large EQA schemes. The assessment to the current EQA Standards only commenced in April 2006 whilst the Standards for Medical Laboratories commenced in 2003, and it is perhaps not surprising to find that the principal non-conformities are related to the Quality Management System. This parallels the findings encountered in laboratory accreditation. There is an ongoing educational process for Scheme Management and the Facilitators in each region in how to comply fully with the standards and a commitment to quality improvement which ultimately is beneficial to the participant's of the scheme and to patient safety. [source] Multiple Conceptualizations of Small Business Web Use and Benefit*DECISION SCIENCES, Issue 3 2003Kurt A. Pflughoeft ABSTRACT Small businesses play an important role in the U.S. economy and there is anecdotal evidence that use of the Web is beneficial to such businesses. There is, however, little systematic analysis of the conditions that lead to successful use of and thereby benefits from the Web for small businesses. Based on the innovation adoption, organizations, and information systems (IS) implementation literature, we identify a set of variables that are related to adoption, use, and benefits of information technology (IT), with particular emphasis on small businesses. These variables are reflective of an organization's contextual characteristics, its IT infrastructure, Web use, and Web benefits. Since the extant research does not suggest a single theoretical model for Web use and benefits in the context of small businesses, we adopt a modeling approach and explore the relationships between "context-IT-use-benefit" (CIUB) through three models,partial-mediator, reduced partial-mediator, and mediator. These models posit that the extent of Web use by small businesses and the associated benefits are driven by organizations' contextual characteristics and their IT infrastructure. They differ in the endogeneity/exogeneity of the extent of IT sophistication, and in the direct/mediated effects of organizational context. We examine whether the relationships between variables identified in the literature hold within the context of these models using two samples of small businesses with national coverage, including various sizes, and representing several industry sectors. The results show that the evidence for patterns of relationships is similar across the two independent samples for two of these models. We highlight the relationships within the reduced partial-mediator and mediator models for which conclusive evidence are given by both samples. Implications for small business managers and providers of Web-based technologies are discussed. [source] The Value of Production Schedule Integration in Supply ChainsDECISION SCIENCES, Issue 4 2001Lee Krajewski Abstract This study explores the value of integrated production schedules for reducing the negative effects of schedule revisions in supply chains involving buyer and supplier firms. A stochastic cost model is developed to evaluate the total supply chain cost with integrated purchasing and scheduling policies. The model minimizes the costs associated with assembly rate adjustment, safety stock, and schedule changes for all supply chain members. Through experimentation, the paper examines the impact of several environmental factors on the value of schedule integration. This study finds that schedule integration can lead to overall cost savings in a supply chain, but some firms may have to absorb costs in excess of those they would incur with independent scheduling. Environments with high inventory holding costs and long supplier lead times may not find it beneficial to adopt an integrated schedule. Forecast effectiveness plays a critical role in realizing the benefits of schedule integration. The paper concludes with suggestions for future research. [source] Behavioral and cardiovascular effects of 7.5% CO2 in human volunteersDEPRESSION AND ANXIETY, Issue 1 2005Jayne E. Bailey M.Sc. Abstract The study of carbon dioxide (CO2) inhalation in psychiatry has a long and varied history, with recent interest in using inhaled CO2 as an experimental tool to explore the neurobiology and treatment of panic disorder. As a consequence, many studies have examined the panic-like response to the gas either using the single or double breath 35% CO2 inhalation or 5,7% CO2 inhaled for 15,20 min, or rebreathing 5% CO2 for a shorter time. However, this lower dose regime produces little physiological or psychological effects in normal volunteers. For this reason we have studied the effects of a higher concentration of CO2, 7.5%, given over 20 min. Twenty healthy volunteers were recruited to a double blind, placebo-controlled study where air and 7.5% CO2 were inhaled for 20 min. Cardiovascular measures and subjective ratings were obtained. When compared to air, inhaling 7.5% CO2 for 20 min increases systolic blood pressure and heart rate, indicating increased autonomic arousal. It also increases ratings of anxiety and fear and other subjective symptoms associated with an anxiety state. The inhalation of 7.5% CO2 for 20 min is safe for use in healthy volunteers and produces robust subjective and objective effects. It seems promising as an anxiety provocation test that could be beneficial in the study of the effects of anxiety on sustained performance, the discovery of novel anxiolytic agents, and the study of brain circuits and mechanisms of anxiety. Depression and Anxiety 00:000,000, 2005. © 2005 Wiley-Liss, Inc. [source] Photodynamic Therapy for the Treatment of Cutaneous Neoplasia, Inflammatory Disorders, and PhotoagingDERMATOLOGIC SURGERY, Issue 5 2009EMILY TIERNEY MD BACKGROUND Photodynamic therapy (PDT) has demonstrated high efficacy, minimal side effects, and improved cosmetic outcome when used for the treatment of actinic keratoses (AK), basal cell carcinoma (BCC), squamous cell carcinoma, and photoaging. METHODS To review the literature on the use of PDT in dermatologic surgery using MEDLINE. RESULTS Published clinical studies using PDT in the treatment of AKs yield overall efficacy rates ranging from 50% to 71% with one treatment to as high as 88% to 90% with two or more treatments. For superficial BCC, initial clearance rates were 76% to 97%, and for Bowen's disease, initial clearance rates ranged from 72% to 94% overall. The use of PDT for photorejuvenation is a relatively new application of this technology, which has shown promise in improving the appearance of fine lines, pigmentary variation, and telangiectasias. CONCLUSIONS The advantages of photodynamic therapy include the capacity for noninvasive targeted therapy through topical application of aminolevulinic acid and methyl aminolevulinic acid, with outstanding cosmetic results. Although the theory behind the use of chemical photosensitizers and ultraviolet light to treat a wide variety of skin disorders is straightforward, the practical application of this technology is evolving. Additional research into the precise mechanisms of action for specific photosensitizers and optimal light sources will be highly beneficial to the advancement of this technology. [source] Surgical Monotherapy Versus Surgery Plus Adjuvant Radiotherapy in High-Risk Cutaneous Squamous Cell Carcinoma: A Systematic Review of OutcomesDERMATOLOGIC SURGERY, Issue 4 2009ANOKHI Jambusaria-PAHLAJANI MD BACKGROUND Adjuvant radiotherapy (ART) has been recommended for squamous cell carcinoma (SCC) with a high risk of recurrence, particularly perineurally invasive disease. The utility of ART is unknown. This study compares reported outcomes of high-risk SCC treated with surgical monotherapy (SM) with those of surgery plus ART (S+ART). METHODS The Medline database was searched for reports of high-risk SCC treated with SM or S+ART that reported outcomes of interest: local recurrence, regional or distant metastasis, or disease-specific death. RESULTS There were no controlled trials. Of the 2,449 cases of high-risk SCC included, 91 were treated with S+ART. Tumor stage and surgical margin status before ART were generally unreported. In 74 cases of perineural invasion (PNI), outcomes were statistically similar between SM and S+ART. In 943 high-risk SCC cases in which clear surgical margins were explicitly documented, risks of local recurrence, regional metastasis, distant metastasis, and disease-specific death were 5%, 5%, 1%, and 1%, respectively. CONCLUSIONS High cure rates are achieved in high-risk cutaneous SCC when clear surgical margins are obtained. Current data are insufficient to identify high-risk features in which ART may be beneficial. In cases of PNI, the extent of nerve involvement appears to affect outcomes, with involvement of larger nerves imparting a worse prognosis. [source] High-Risk Cutaneous Squamous Cell Carcinoma without Palpable Lymphadenopathy: Is There a Therapeutic Role for Elective Neck Dissection?DERMATOLOGIC SURGERY, Issue 4 2007JUAN-CARLOS MARTINEZ MD PURPOSE The beneficial role of elective neck dissection (END) in the management of high-risk cutaneous squamous cell carcinoma (CSCC) of the head and neck remains unproven. Some surgical specialists suggest that END may be beneficial for patients with clinically node-negative (N0) high-risk CSCC, but there are few data to support this claim. We reviewed the available literature regarding the use of END in the management of both CSCC and head and neck SCC (HNSCC). METHODOLOGY The available medical literature pertaining to END in both CSCC and HNSCC was reviewed using PubMed and Ovid Medline searches. RESULTS Many surgical specialists recommend that END be routinely performed in patients with N0 HNSCC when the risk of occult metastases is estimated to exceed 20%; however, patients who undergo END have no proven survival benefit over those who are initially staged as N0 and undergo therapeutic neck dissection (TND) after the development of apparent regional disease. There is a lack of data regarding the proper management of regional nodal basins in patients with N0 CSCC. In the absence of evidence-based data, the cutaneous surgeon must rely on clinical judgment to guide the management of patients with N0 high-risk CSCC of the head and neck. CONCLUSIONS Appropriate work-up for occult nodal disease may occasionally be warranted in patients with high-risk CSCC. END may play a role in only a very limited number of patients with high-risk CSCC. [source] Evaluation of a cognitive behaviourally oriented service for relapse prevention in schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010S. Klingberg Klingberg S, Wittorf A, Fischer A, Jakob-Deters K, Buchkremer G, Wiedemann G. Evaluation of a cognitive behaviourally oriented service for relapse prevention in schizophrenia. Objective:, There is little work demonstrating the effectiveness of cognitive behaviourally oriented interventions in routine service settings. This pragmatic trial is designed to test the impact of a group treatment service on relapse rates under the conditions of routine health care. Method:, A total of 169 schizophrenia patients were randomly allocated either to a comprehensive cognitive behaviourally oriented service (CBOS) or to treatment as usual (TAU). The primary outcome is the time until the first relapse after discharge from hospital. Relapse was defined as an increase in positive or negative symptoms as assessed with the Positive and Negative Syndrome Scale. Survival analysis has been conducted up to the 6-month assessment. Results:, The mean time to relapse after discharge from hospital in the CBOS group was significantly longer than in the TAU group (log rank test, P = 0.033). This was due to less exacerbations regarding negative symptoms in the CBOS condition (log rank test, P = 0.014). The number of social contacts was improved in the CBOS group only. Conclusion:, The CBOS intervention appears to be beneficial in reducing early negative symptom exacerbations. [source] Idiopathic Circumscripta Calcinosis Cutis of the KneeDERMATOLOGIC SURGERY, Issue 12 2003FACS, Luigi Valdatta MD Background. Calcinosis cutis, a disease characterized by the presence of calcium deposits in the skin, is classified into four types according to etiology: dystrophic, metastatic, iatrogenic and idiopathic. The dystrophic form is the most common while the idiopathic one is the rarest, but specific incidence and frequency data are not available in scientific literature. Objective. Calcinosis cutis circumscripta is a very rare form of idiopathic calcinosis cutis arising in the second half of life. It typically involves the extremities and is associated with prior trauma and scleroderma. We dealt with a very rare form of calcinosis cutis circumscripta in a healthy patient, for whom surgical excision revealed to be an effective and successful treatment. Methods and materials. We present the case of a 46-year-old woman affected by idiopathic circumscripta calcinosis cutis of the left knee, successfully treated by surgical removal. Discussion. Medical and surgical treatment are options to cure calcinosis cutis. Medical therapy is not very effective. Surgical excision has shown to be beneficial, as it can provide a symptomatic relief. However, since calcinosis cutis limits are not always well defined a recurrence of the lesions may occur. [source] Social Implications of Hyperfunctional Facial LinesDERMATOLOGIC SURGERY, Issue 5 2003J. Charles Finn MD The face is the focus of human interactions, and facial appearance profoundly affects self-esteem. Facial appearance is not only a compilation of the dimensions of the primary morphologic features but is also a direct result of the emotional expressions exhibited on the face. Facial expressions are central in the communication of emotions, as well as in signaling characteristics such as age. The repeated expression of emotions produces hyperfunctional facial lines, and the presence of these lines when the face is at repose may give an erroneous impression of emotions or personality characteristics. These lines are also perceived as a sign of aging. Treatment of hyperfunctional facial lines is beneficial for patients who believe that their faces are not communicating their emotions properly, who want to delay the outward appearance of aging, or who simply want to look their best. [source] Botulinum Toxin Type B for Dynamic Glabellar Rhytides Refractory to Botulinum Toxin Type ADERMATOLOGIC SURGERY, Issue 5 2003Tina S. Alster MD Background. Botulinum toxin type B (BTX-B; Myobloc) has recently been introduced for the treatment of dynamic rhytides. This serotype is structurally similar to botulinum toxin type A (BTX-A; Botox) and appears to produce equivalent muscular paralysis. Because of the fact that some patients may become resistant to the effects of BTX-A with its continued use or may require large doses of type A to exert adequate muscular paralysis, the use of BTX-B may prove beneficial in these cases. Objective. To determine the effect of BTX-B on glabellar rhytides refractory or showing decreased clinical effect to treatment with BTX-A. Methods. Twenty females (mean age, 43 years) with vertical glabellar rhytides showing decreased or negligible clinical effect to BTX-A were treated with intramuscular injections of BTX-B. Five standardized intramuscular sites (procerus, inferomedial corrugator muscles, superior middle corrugator muscles) received a total dose of 2,500 U. Patients were evaluated at pretreatment and 48 to 72 hours, 1 week, and 2 and 4 months after injection. Results. All glabellar rhytides improved after treatment with BTX-B injections. Peak clinical effect was noted 1 month after treatment, with 50% of peak effect evident at the 2-month follow-up. Near complete dissolution of effect was seen at 4 months after treatment. Side effects were transient and were limited to moderate injectional pain and rare bruising and frontal brow tightness. Conclusions. BTX-B is an effective treatment modality for glabellar rhytides refractory or exhibiting decreased clinical effect to BTX-A. The duration of effect using the 2,500 U dosing schedule described herein was shorter than that typically achieved after equivalent BTX-A injection. [source] Epigenetic regulation in neural stem cell differentiationDEVELOPMENT GROWTH & DIFFERENTIATION, Issue 6 2010Berry Juliandi The central nervous system (CNS) is composed of three major cell types , neurons, astrocytes, and oligodendrocytes , which differentiate from common multipotent neural stem cells (NSCs). This differentiation process is regulated spatiotemporally during the course of mammalian development. It is becoming apparent that epigenetic regulation is an important cell-intrinsic program, which can interact with transcription factors and environmental cues to modulate the differentiation of NSCs. This knowledge is important given the potential of NSCs to produce specific CNS cell types that will be beneficial for clinical applications. Here we review recent findings that address molecular mechanisms of epigenetic and transcription factor-mediated regulation that specify NSC fate during CNS development, with a particular focus on the developing mammalian forebrain. [source] Recent advances in craniofacial morphogenesisDEVELOPMENTAL DYNAMICS, Issue 9 2006Yang Chai Abstract Craniofacial malformations are involved in three fourths of all congenital birth defects in humans, affecting the development of head, face, or neck. Tremendous progress in the study of craniofacial development has been made that places this field at the forefront of biomedical research. A concerted effort among evolutionary and developmental biologists, human geneticists, and tissue engineers has revealed important information on the molecular mechanisms that are crucial for the patterning and formation of craniofacial structures. Here, we highlight recent advances in our understanding of evo,devo as it relates to craniofacial morphogenesis, fate determination of cranial neural crest cells, and specific signaling pathways in regulating tissue,tissue interactions during patterning of craniofacial apparatus and the morphogenesis of tooth, mandible, and palate. Together, these findings will be beneficial for the understanding, treatment, and prevention of human congenital malformations and establish the foundation for craniofacial tissue regeneration. Developmental Dynamics 235:2353,2375, 2006. © 2006 Wiley-Liss, Inc. [source] Managing childhood obesity: when lifestyle change is not enoughDIABETES OBESITY & METABOLISM, Issue 11 2010C. Hearnshaw The management of childhood obesity is a clinical dilemma. Paediatricians will see those children whose weight is at the severe end of the spectrum with obesity-related co-morbidities and for whom more intensive weight loss therapies may be appropriate. A literature review was performed (January 1995,January 2010) of the roles of pharmacotherapy or bariatric surgery in the management of childhood obesity. Three hundred and eighty-three abstracts were reviewed and 76 full-text articles were requested. Of these, 34 were excluded and a total of 21 pharmacotherapy papers and 22 papers on surgery were reviewed in detail. All studies involved adolescents. Pharmacotherapy: Most studies were small and of short duration, the notable exceptions being two large RCTs of sibutramine and orlistat. Sibutramine led to a mean estimated change in BMI from baseline of ,3.1 kg/m2 vs. ,0.3 kg/m2 for placebo over 12 months. Orlistat was also beneficial with a mean reduction in BMI of 0.55 vs. an increase of 0.31 kg/m2 in the placebo group at 12 months. Bariatric surgery: Most papers presented clinical observations and there were no randomised controlled trials (RCTs). Robust selection criteria were not used and ideal candidate selection remains unclear. Most papers showed a significant benefit of surgery in severely obese adolescents in the short term but long-term data were sparse. There were a surprisingly large number of papers examining the benefits of intensive weight management in obese adolescents. The study design of many was inadequate and the role of pharmacotherapy or surgery in childhood obesity remains unclear. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||