Review of teenage health: time for a new direction

Teenagers represent a large proportion of the population and have the potential for considerable morbidity because of high smoking rates and unwanted teenage pregnancy. The government intends to reduce the incidence of this important morbidity, but there is no coherent strategy for attaining these improvements. Research in this area is limited in the United Kingdom, but research from elsewhere has clarified teenagers' attitudes. There have also been some intervention studies resulting in improvements in specific aspects of teenage health. A worrying theme which emerges from this research is of a new inverse care law. Teenagers with low self-esteem and less hope for their own future are more likely to lead lifestyles which put them at risk and are less likely to ask for advice in relation to their health or lifestyle. Thus, it may be more difficult to alter behaviour in these patients; overall population based improvements may be difficult to achieve. Teenagers' own concerns appear to be at variance with the goals dictated by government and health professionals. It is suggested that the only method of meeting the needs of teenagers and at the same time aiming to reduce morbidity in this age group is to foster an atmosphere of patient centredness in dealings with adolescent patients and for further ther research in this important health gain area.     

Climate strength: a new direction for climate research.

Climate strength was conceptualized within D. Chan's (1998) discussion of compositional models and the concept of culture strength from the organizational culture literature. Climate strength was operationalized in terms of within-group variability in climate perceptions--the less within-group variability, the stronger the climate. The authors studied climate strength in the context of research linking employee service climate perceptions to customer satisfaction. The hypothesis was tested that climate strength moderates the relationship between employee perceptions of service climate and customer satisfaction experiences. Partial support for the hypothesis was reported in both a concurrent and predictive (3-year) test across 118 branches of a bank. In the predictive study only the interaction of climate and climate strength predicted customer satisfaction. Implications for future research on climate and climate strength are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A proposal for a new direction to treat cancer

A new approach is proposed that has the potential to be a successful therapy for most disseminated cancers because it can circumvent the problems posed by three characteristics which are universally expressed by cancer cells: heterogeneity, plasticity, and the lack of a cancer specific or cancer associated characteristic which is not also shared by some normal cells. Analysis shows that almost all current and research approaches for treating disseminated cancers have the same fundamental strategy: they rely on an agent interacting individually and effectively with each cancer cell. We call all these approaches "lock and key" strategies to emphasize the need for this individual agent to cell interaction. The three characteristics preclude current approaches from successfully treating most disseminated cancers because they operate by a "lock and key" strategy which (a) only kills cancer cells expressing a single particular trait, (b) allows other cancer cells to adapt and survive the treatment, and (c) also kills the normal cells which express the same particular trait. The heterogeneity and plasticity of cancer cells can only be circumvented by an attack which is microregional (not cell by cell) and destructive (not killed by conventional endogenous or exogenous cytotoxic agents). All cells in each microregion must be destroyed, including those which do not express an exploitable trait. The proposed approach can achieve such microregional destruction by the delivery to, and long term immobilization of, a large number of radio-isotopes. The proposed approach exploits the additive contribution of multiple mechanisms to enhance tumor specificity of the microregions. Given that all targeting and killing agents are "imperfect", this is the only way specificity can be enhanced. The biological basis of these specificity enhancing mechanisms are well-known. However, they are ignored by current therapies because most of them can only be exploited in the context of the proposed approach. Some of the mechanisms reflect characteristics, such as heterogeneity, genetic instability, and tumor progression which are the result of the micro-evolutionary process of tumor development. These are virtually always present in, and virtually specific to, cancer. Others reflect the somewhat "imperfect" cancer associated characteristics of structures, including cancer cells, extracellular structures, and non-malignant cells within the tumor mass. The additive contribution of the multiple mechanisms gives the process the potential to destroy all the cancer cells with minimal non-tumor toxicity. The cornerstone of the proposed approach is a novel class of soluble chemicals. They can be administered intravenously to subjects, circulate throughout body fluids and are enzymatically converted into an insoluble material when the chemicals reach targeted sites. In this paper, these chemicals are called "soluble precipitable reagents" (SPR) to describe their ability to be converted from a soluble to an insoluble material. The insoluble material is called platform to indicate that it has the ability to bind various agents. The SPR chemicals enable a three-step process to be constructed which can deliver and retain a large number of radio-isotope atoms in tumor tissue. In step 1, a binary reagent comprised of an SPR attached to an imperfect cancer targeting agent is administered. The binary reagent is endocytosed and transported into lysosomes where the targeting agent moiety is digested and the detached SPR is converted by natural intracellular lysosomal enzymes into a platform. As will be discussed, a very large number of platform molecules can be made to accumulate inside targeted cells. In step 2, a supersensitive fraction of the cancer cells, including some which had accumulated platform in step 1, are killed by the administration of a very low dose of an anti-cancer agent. Very few, if any, normal cells will be killed by the very low dose. The death of the ce     

Evaluation of a quality assessment manual: effectiveness in a quality assurance program

1. An occupational health quality assessment manual was evaluated to judge its effectiveness as part of an overall quality assurance program. 2. The first step in the evaluation process examined standards; the second step determined measurable process criteria. 3. A quality assessment evaluation should promote accountability among care providers and clarify standards and criteria.     

一种新的岩体质量综合评价方法初探

工程岩体分级是进行矿山建设和矿山井巷围岩变形控制的基本参考依据。一般情况下通过实验取得的指标为单因素指标,按单指标对岩体进行分类只是利用了岩体的部分特征,无法全面地对一种岩体的质量进行综合评价。根据灰色关联理论,矿山岩体系统可看成是部分信息已知、部分信息未知的灰色系统;根据目前矿山岩体质量评价的基本方法,对已经取得普氏系数法、岩心质量指标法以及龟裂系数法等指标的岩体应用灰色关联理论建立了综合评价模型,并以青海某矿顶、底板岩层的实测评价指标的数据,对本文建立的模型进行了应用。值得研讨。     

A new assessment of quality of life (QOL) for cancer patients

A new assessment of quality of life (QOL) was made for cancer patients. The QOL assessment consists of 12 items: pain; nausea; constipation; general fatigue; sleep; eating; activity; a daily life pattern; conversation; treatment acceptability; satisfaction at the present status and family exhaustion. Ranges of scores are one (best) to five (worst). For visual expression of QOL, the author made an original method called "QOL diagram", drawn with a circle which has 12 diverging lines marked five points indicating the score for each item. QOL changes after cancer pain control with either oral or intravenous morphine were examined in 22 adult cancer patients by the QOL assessment. Laxatives and anti-nausea drugs were mostly prescribed at the same time in order to avoid side effects of morphine. QOL was evaluated and recorded by the author through an individual interview with each patient. It was observed that the psychological factors were improved along with pain relief. Although items such as general fatigue, nausea, constipation, sleep and eating did not change considerably at first, they improved well with time in the oral morphine group. On the other hand, there was no marked time-dependent change in the intravenous morphine group. Items such as activity, a daily life pattern and conversation were rather negative than positive. These items seem to be more important to improve QOL of the cancer patients, in particular, whose general status is relatively good. In conclusion, the QOL diagram helped us to follow subtle changes of status and needs of cancer patients. And it enables us to easily assess risks and benefits of the treatment plans including palliative care and home supportive programs. It is designed for both patients and medical staffs to use easily and repeatedly. However, the further evaluation and refinement will be needed to verify validity and reliability of the QOL diagram before a routine clinical application.     

DNAView: a quality assessment tool for the visualization of large sequenced regions

This communication describes DNAView, a graphical tool for the visualization and printing of large nucleic acid sequences. DNAView uses color coding to compactly display genomic segments of up to 100 kb on a single printed page. The specific color schemes integrated into DNAView can highlight 'local aggregate' properties of large segments of DNA. We have also incorporated a confidence expression for the assigned sequence. This is represented by base color intensity that is proportional to the number of times that base was sequenced. Areas of interest, such as exons, introns, repetitive elements and splice sites, can be emphasized using overlays. The colored image can be saved in a standard TIFF image file format that may be imported and annotated by other application software.     

Trial consultation: A new direction in applied psychology.

Increasingly, professional psychologists are faced with the challenge of the changing marketplace, and some choose to meet that challenge by forging new career paths. In this article, the field of trial consultation is reviewed with special emphasis on common tasks trial consultants undertake. It is argued that because of the large number of civil and criminal trials conducted annually and the comparatively small proportion of consultants, the field remains an untapped source of career options for psychologists who have many of the skills necessary to be successful trial consultants. Controversies concerning the effectiveness of trial consultation, ethical issues surrounding its use, and suggestions for appropriate training in the field are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accuracy of a commercially available digitizer: a new method for assessment of errors in linearity

A commercially available digitizer has been tested for accuracy. The various areas of the digitizing tablet show degrees of precision that can differ for the x- and y-coordinates. The tablet has a mean absolute error of 0.016 mm for the x-coordinate and 0.09 mm for the y-coordinate. Error tended to increase toward the sides of the tablet. Partitioning the error into systematic and random components revealed that the x-error is due mainly to errors in linearity of the digitizer. When compared with the error involved in locating cephalometric landmarks, one can conclude that this type of digitizer is suited for orthodontic purposes. This article describes a new methodological approach to locating and measuring errors in linearity.     

Objective assessment of phantom image quality in mammography: a feasibility study

The need for test objects in mammography quality control programmes to provide an objective measure of image quality pertinent to clinical problems is well documented. However, interobserver variations may be greater than the fluctuations in image quality that the quality control programme is seeking to detect. We have developed a computer algorithm to score a number of features in the Leeds TOR(MAX) mammography phantom. Threshold scoring techniques have been applied in the first instance; scoring schemes which utilize measures such as signal-to-noise ratio and modulation have also been formulated. This fully automatic algorithm has been applied to a set of 10 films which have been digitized at 25 microns resolution using a Joyce-Loebl scanning microdensitometer. The films were chosen retrospectively from quality control test films to demonstrate: (a) a range of optimized imaging systems, and (b) variation from the optimum. The performance of the algorithm has been compared with that of five experienced observers, and has been shown to be as consistent as individual observers, but more consistent than a pool of observers. Problems have been encountered with the detection of small details, indicating that a more sophisticated localization technique is desirable. The computer performs more successfully with the scoring scheme which utilizes the full imaging information available, rather than with the threshold-determined one. However, both the observers and the computer algorithm failed to identify the non-optimum films, suggesting that the sensitivity of the TOR(MAX) test object may not be adequate for modern mammography imaging systems.     

网络会计是未来会计发展的方向

在网络经济环境下 ,会计信息系统的变化 ,网络会计的特征 ,网络会计对传统会计的影响 ,传统会计在会计基本理论和实务上的变化和发展 ,阐明网络会计是未来会计的发展方向。     

External quality assessment scheme for haematology in Germany

1. The purpose of this investigation was to determine non-invasively the changes in autonomic cardiovascular control observed in normal subjects submitted to acute cardiopulmonary blood volume expansion by 100 degrees head-down tilt. The effect of head-down tilt on finger blood pressure and heart rate fluctuations was studied by means of power spectral analysis in 12 healthy men. 2. Amplitude spectra of heart rate and blood pressure rhythmicity were estimated at the low-frequency (60-140 mHz, 10-s rhythm) and high-frequency (area under the curve at mean respiration rate +/- 50 mHz) component. Transfer gain and phase were calculated between systolic blood pressure and heart rate. Forearm vascular resistance was estimated to validate the head-down procedure. 3. Forearm vascular resistance decreased significantly from 19.82 (16.34-26.46) mmHg ml-1 min 100 ml to 18.05 (13.69-22.88) mmHg ml-1 min 100 ml (P < 0.01) during head-down tilt (values are medians and 25 and 75 percentiles). The overall variability (total area under the curve of the spectrum from 20 to 500 mHz) of blood pressure and heart rate time series was consistently reduced with head-down tilt. 4. The spectral pattern of systolic blood pressure showed a diminution of the absolute and relative low-frequency component during head-down tilt: absolute log-transformed values, 2.86 (2.80-2.94) mmHg/Hz1/2 versus 2.77 (2.72-2.82) mmHg/Hz1/2 (P < 0.05); relative values, 35% (32-37%) versus 32% (29-32%) (P < 0.05). In heart rate spectra only the absolute low-frequency component decreased.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pneumoproteinaemia: a new perspective in the assessment of lung disorders

Here we make the hypothesis that the determination of the concentration of lung specific secretory proteins in serum or pneumoproteinaemia could be used in the evaluation of lung disorders with a similar utility as proteinuria in kidney diseases involving the glomeruli. Human and experimental data indicate that comparable structural and functional features govern the passage of proteins across the lung epithelium/blood barrier and the glomerular filter. The concentrations in serum of some lung-specific secretory proteins, such as the bronchiolar Clara cell 16 kDa protein (CC16) and alveolar surfactant-associated proteins A and B (SP-A and SP-B, respectively), might be used to assess the integrity of the bronchoalveolar/blood barrier known to be disrupted in many lung disorders. In addition, if this barrier is intact or slightly compromised, these proteins might serve as peripheral markers to detect changes in secretory epithelial cells in the lung.     

Four-color CGH: a new method for quality control of comparative genomic hybridization

Systemic movement through the phloem of infected host plants is a key process in the life cycle of plant viruses, knowledge of which is scant. A main point to be elucidated is the structural form in which virus infection moves within the phloem. Indirect evidence suggests that virions might be the viral structure that moves in the phloem, but data from direct analysis in phloem sap have not been reported. We have done such analysis in the system cucumber (from which phloem exudate can be collected)/cucumber green mottle mosaic tobamovirus (CGMMV). CGMMV has structurally well-characterized particles. Both CGMMV coat protein and RNA were found in phloem exudate from infected cucumbers. Analysis of the accessibility of CGMMV RNA in phloem exudate to RNase A indicates that it is protected within a ribonucleoprotein structure. The accessibility to RNase A of the RNA in these structures was as in virus particles. Centrifugation analyses showed that the ribonucleoprotein structures in the phloem exudate have the same mass and isopycnic density as virions. Virus particles indistinguishable from purified virions were detected by electron microscopy in phloem exudate. No evidence of free RNA or other CGMMV-related structure was found in phloem exudate of infected plants. These results indicate that CGMMV movement in the phloem occurs mainly, if not exclusively, in the form of virus particles.     

The implant quality scale: a clinical assessment of the health--disease continuum

Implant success is as difficult to describe as the success criteria required for a tooth. A range from health to disease exists in both conditions. The primary criteria for assessing implant quality are pain and mobility. The presence of either one greatly compromises the implant, and removal is usually indicated. Probing depths may be related to the presence of local disease or pre-existing tissue thickness before the implant was inserted. An increasing probing depth is more diagnostic and signifies bone loss, gingival hyperplasia or hypertrophy. Bone loss is usually evaluated best with probing rather than with radiographs. The most common cause of bone loss during the first few years of function are exaggerated factors of stress. The bleeding index is easily observed and indicates inflammation of the gingiva. However, implant health status is not as related to sulcular inflammation as would be the case for a natural tooth. Implant failure is easier to describe and may consist of a variety of factors. Any pain, vertical mobility, uncontrolled progressive bone loss, and/or generalized periradiolucency warrant implant removal. Implant quality factors were established by James and modified by Misch into an implant quality scale which not only assesses the implant health-disease continuum, but relates treatment and prognosis to the existing conditions.