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Et me make a confession straight away. I teach in the Dept of HSS- the "lukkha" department. Worse, I teach English. Now that I have exposed myself to the full blast of your scorn, let me plough ahead. I've been asked to address the question that apparently many of you are asking: "Why, why must we be inflicted with so many HSS courses? We are B.Tech students after all." It is a difficult job that I have on hand. Not because I unconvinced about the relevance of my discipline or of others in H&SS. But because for some time now we have been inhabiting two separate continents in the academia. You live on the one that is called Science & Technology and I on the one called Humanities & Social Sciences. And there has been so little trade or conversation between us that we tend to mishear each other.
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Difference for measuring change within a single patient allowing for individual variation [22]. However, AQLQ scores were compared between two patient groups where it can be expected that the individual variation within the two groups should be similar and a smaller difference could be considered clinically relevant. Thus the differences observed of 0.4 points in overall HRQL, as well as in the symptoms subscale, and of 0.6 points in the environmental exposure subscale are not only statistically significant but also borderline clinically relevant. Non-guideline treatment seems to have the least effect on emotional function of the asthma patients, which is in line with other studies in which the treatment regime appeared to have more impact on symptoms and environmental exposure than on emotional function [23]. In general, the HRQL among the patients participating in the study mean 5.5 ; was relatively high. Other studies have also found that the average HRQL in mild-to-moderate asthma patients is close to that of the general population [24]. A strong link between asthma-related quality of life and disease severity has been reported [20, 25], and this relationship was also observed in the current study. For all patients, irrespective of their treatment, the HRQL decreased from 6.1 for severity class 1 patients to 4.8 for the most severe patients, which is similar to that seen in other studies [20]. It is most likely that the relationship between HRQL and asthma severity is due to the relationship between HRQL and asthma symptoms [26, 27]. Since no objective severity classification for treated asthma patients exists, the severity classification presented in the NIH guideline was used in the current study [5]. This classification uses a combination of day-time and night-time symptoms, need for inhaled short-acting b-agonist and lung function to determine asthma severity. It is often used to categorise patients in research, but may underestimate actual severity in patients that are well controlled with treatment [28]. In a first attempt to validate the assessment of asthma severity in patients mostly taking treatment, it was concluded that the severity classification recommended by clinical guidelines, such as the NIH, is useful for clinical assessment and management of asthma patients in general practice [29]. In the current study, a possible underestimation of severity does not affect the assessment on whether the treatment is adherent to the guideline, because treatment recommendations follow a step-wise progression. Treatment for a higher severity is always in addition to treatment from a lower severity either with respect to increasing the dose of an existing medication or the addition of a new medication. Thus, adequate treatment according to the guideline for a particular severity class implies that the treatment will also be considered adequate for a lower severity class. While the response rate in this study was rather low 40% ; , sufficient numbers of patients with adherent and with nonadherent treatment regimes were recruited. There were no large differences between participants and nonrespondents in terms of age, sex or prescribed medication. The low response rate may be related to the age group targeted 1849 yrs ; , since this group comprises a large proportion of the workforce and.
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To the Editor: Michelle Lutton's1 reaction to the way her resident group arranged to feign misery during her absence, misled her during the next session, brought her to tears, and then told her it was all a joke, struck me as, to say the least, very odd. I do not consider myself, or our group, as humorless, but I would be greatly offended if I were mocked in this way. Her appreciation of the group's "joy" and cohesiveness in pulling off their little trick ignores the fact that their behavior was quite hostile to her, for whatever reason. I might add that I do not consider it my responsibility to "keep the interns and prevnar.
Xiv Contributors Gilles Jacoud is Professor Economics at the University of Saint-Etienne, France. He is author of several books and articles on money and banking and on the history of economic thought. Olivier Jenn-Treyer is a lecturer at the University of Paris XII, and member of PHARE University of Paris 1 ; . Lars Jonung has been Research Adviser at DG ECFIN, the European Commission, Brussels, since September 2000 dealing with macroeconomic issues. He was previously Professor of Economics at the Stockholm School of Economics. His research is focused on monetary and fiscal policies, particularly on the policy of the Riksbank, on monetary unions and exchange rate arrangements, on inflationary expectations and perceptions, business cycle issues, and on the history of economic thought. He served as chief economic adviser to Prime Minister Carl Bildt in 199294. He has been on the board of a number of listed Swedish companies. He was economic adviser to the Skandinaviska Enskilda Banken in 198991. Jonung has published several books, The Stockholm School of Economics Revisited 1991 ; , Lessons for EMU from the History of Monetary Unions with M.D. Bordo ; , and Bertil Ohlin: A Centennial Celebration, 18991999 with R. Findlay and M. Lundahl, co-editors ; . Axel Leijonhufvud is Professor of Monetary Theory and Policy at the University of Trento, Italy, and Professor Emeritus at the University of California at Los Angeles, USA. He is a specialist in several fields, including the evolution of modern macroeconomics, the transformation of socialist systems, monetary theory, European economic history, and computable economics. He has published many articles in the American Economic Review, the Journal of Economic Literature, the Swedish Journal of Economics, Oxford Economic Papers, the European Journal of the History of Economic Thought, the Journal of Economic Methodology, the Southern Economic Journal, and many books. He has also contributed to a number of collected volumes. Lars Magnusson is Professor and Chairman of the Department of Economic History, Uppsala, and Research Director at the National Institute for Working Life, Stockholm, Sweden. He is the author of Mercantilism: The Shaping of an Economic Language Routledge, 1994 ; and An Economic History of Sweden Routledge, 2000 ; . Robert Nadeau is Professor of Philosophy in the Department of Philosophy at the Universit du Qubec Montral. His general field of research is philosophy of social sciences but he specialises in comparative epistemology and methodology of economics. He has edited or co-edited many books and special issues of different journals in this area. He contributed to the Handbook of Economic Methodology 1998 ; , edited by John B. Davis, D. Wade Hands and.
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Updated Information & Services References Updated information and services, including high-resolution figures, can be found at: : chestjournal cgi content full 128 3 1121 This article cites 25 articles, 17 of which you can access for free at: : chestjournal cgi content full 128 3 1121#BIBL This article has been cited by 1 HighWire-hosted articles: : chestjournal cgi content full 128 3 1121 Information about reproducing this article in parts figures, tables ; or in its entirety can be found online at: : chestjournal misc reprints.shtml Information about ordering reprints can be found online: : chestjournal misc reprints.shtml Receive free email alerts when new articles cite this article sign up in the box at the top right corner of the online article.
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Adding an overlapping STH schistosomiasis program to an lymphatic filariasis program was estimated at ##TEXT##.20 to purchase praziquantel plus 10, 30 and 50% of ##TEXT##.155 the stand-alone program cost of ##TEXT##.50 minus ##TEXT##.125 for the second treatment with albendazole or mebendazole minus ##TEXT##.22 for the cost of praziquantel and albendazole or mebendazole ; . For each program targeting populations outside the lymphatic filariasis endemic zone, the whole stand-alone per-person cost Table 4 ; would apply. Analyzing outcomes Projecting health outcomes of the integrated disease control packages in sub-Saharan Africa relies on the PCP treatment to prevent the major clinical manifestations of each disease, including blindness onchocerciasis and trachoma ; , severe skin disease and itching onchocerciasis ; , lymphedema and hydrocele lymphatic filariasis ; , liver, kidney, and bladder disease schistosomiasis ; , anemia STH and schistosomiasis ; and protection from infection with STHs. We estimated the number of cases prevented by multiplying the estimated rates of incidence of each clinical manifestation by the percentage of the at-risk population in sub-Saharan Africa covered by the integrated PCPs. To estimate the incidence of disease Table 6 ; , we divided prevalence assumed to be stable within the population ; by duration of the clinical manifestation. Life expectancy in sub-Saharan Africa was estimated at 48.6 years see : census.gov ipc www idbnew. html ; . The percentage of the whole at-risk population targeted for treatment in 2006 was used to calculate the projected health outcomes of the programs currently underway. Where the published estimates varied, we determined low and high approximations for each outcome by applying different prevalence or duration estimates, and used the average value as a final estimate. The percentage of the at-risk adult population covered for STH control was based on the lymphatic filariasis program target for adults divided by the number of adults at risk for STH disease, because the lymphatic filariasis drugs for MDA albendazole and ivermectin ; are also highly effective treatments for STH infections [14, 15]. Costs Estimating the target populations eligible for treatment Table 3 ; , the per-person cost of drug treatment in stand-alone programs Table 4 ; , the overlap of the NTD programs, and the per-person cost of drug treatment in integrated programs Table 5 ; enabled us to calculate the total cost savings that can be made from disease program integration in sub-Saharan Africa. The projected cost of treating each disease separately in 2006 is 0 million Table 4 ; . By contrast, the estimated total cost for an integrated NTD intervention package in 2006 if all 2006-targeted populations were to be incorporated into the integrated programs ; , including lymphatic filariasis, onchocerciasis, STH disease, schistosomiasis and trachoma, ranges from million at a 10% `add-on cost' to million at a 50% `add-on cost' Table 5 that is, 52 million less, or a projected and primidone.
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XX ; infants with virilizing 21-hydroxylase deficiency have varying degrees of masculinization ranging from clitoral enlargement to complete development of male external genitalia, which may lead to inaccurate sex assignment at birth. Male infants XY ; have normal male genitalia. Approximately three-quarters of affected infants also have mineralocorticoid deficiency that leads to salt-wasting. Symptoms of hyponatremia, hyperkalemia, volume depletion, and decreased blood pressure generally appear within the first 2 weeks of life. Nonclassic 21-hydroxylase deficiency is thought to have an incidence as high as 1: 000 and is characterized by marginally decreased 21hydroxylase activity.5 Affected individuals typically do not have developmental abnormalities or salt-wasting. Presentation is in childhood or post puberty with evidence of androgen excess. In boys, increased androgens typically manifest as sexual precocity, whereas in girls increased pubic hair growth and or clitoral enlargement is seen. In women, nonclassic 21-hydroxylase deficiency is frequently confused with polycystic ovary syndrome. The genetic diagnosis of 21-hydroxylase deficiency is complex because of the large number of unique mutations that may result in decreased enzyme activity and interactions between CYP21A2 and its pseudogene CYP21A. The majority of mutations arise from 2 types of recombination between CYP21A2 and CYP21A: 1 ; deleterious mutations that have been transferred from the pseudogene to CYP21A2 during mitosis 75% of cases ; , and 2 ; unequal recombinations during meiosis between the gene and pseudogene that result in deletion of the intervening 30-kb segment 20% of cases ; .5 Although over 60 relevant mutations have been identified, 11 account for approximately 90% of those found in heterozygous carriers.5 Additionally, in affected individuals, 1% to 2% of abnormal alleles contain spontaneous mutations that are not carried by either parent. Enzyme activity varies with the mutations present, and 3.
Calculated as the mean of the theophyline score and the cortisol score for all nonmissing data. Procedure Parents were recruited for this study on the second day of their child's admission. All parents were informed that their participation in this study was completely voluntary and in no way influenced the medical care their family received during the day program stay. They were informed about confidentiality and assured that no member of the treatment team would have access to information provided. Speech samples were obtained in a laboratory completely separate from the medical unit. When parents agreed to participate, their child's physician during the admission was then also recruited to participate in the study. Physicians were informed about confidentiality and assured that neither parent nor child would have access to information provided. Informed consent was also obtained from the physician. The protocol for this study was reviewed and approved by the institutional review board at the National Jewish Medical and Research Center. At admission, two speech samples were obtained from the parent. One speech sample pertained to his or her relationship with the child, and the second was about his or her relationship with the referring physician. At discharge, a speech sample was collected about the child's physician during the day program stay. Also at discharge, physicians were asked to provide speech samples about their relationship with the parent. Blood chemistry data was obtained from chart review following discharge. Prevalence rates were obtained for negative partnerships and emotional overinvolvement in the parent-physician relationships as expressed by the parent at admission and discharge although these reports covered two different relationships ; . Prevalence rates were also obtained for negative partnerships and emotional overinvolvement in the parent-physician relationship as expressed by the day program physicians at discharge and probenecid.
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30% to 70% more patients were seeking treatment than in the last months of 2002. Many patients were keen to get prescriptions for drugs and for glasses, because under the new health reforms part of their costs are not going to be covered. The argument between doctors, the health ministry, and health insurance companies over how the fee would be administered was solved at the last minute. Doctors had protested about having to take responsibility for administering the fees, which are passed on to the health insurance companies without any compensation for doctors.
MACHINERY AND EQUIPMENT It goes without saying that all machine tools power tools should be adequately guarded. WorkCover advisors, Department of Labour Inspectors, etc can provide assistance and advice on guarding problems. Hearing protection may be required with some tools and processes. The following is a series of questions designed to raise an awareness of problems associated with machinery, tools etc. Machinery and Equipment 1. Is equipment or machinery difficult to operate? Are controls a hard to reach? What might go wrong Fatigue and errors and procainamide.
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HOW SUPPLIED The physician must attest to meeting the qualifications and accepting the responsibilities in the DOSAGE AND ADMINISTRATION section of this package insert by submitting the Physician's Attestation form to PRAECIS PHARMACEUTICALS INCORPORATED to be enrolled in the PlenaxisTM PLUS Program. PRAECIS PHARMACEUTICALS INCORPORATED and its agents will only provide PlenaxisTM and procaine
Lancet 1994; 344: 707-711 Nagtegaal ID, Marijnen CA, Kranenbarg EK, van de Velde CJ, van Krieken JH. Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit. J Surg Pathol 2002; 26: 350-357 Compton CC, Greene FL. The staging of colorectal cancer: 2004 and beyond. CA Cancer J Clin 2004; 54: 295-308 Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1986; 1: 1479-1482 Improved survival with preoperative radiotherapy in resectable rectal cancer. Swedish Rectal Cancer Trial. N Engl J Med 1997; 336: 980-987 Ortholan C, Francois E, Thomas O, Benchimol D, Baulieux J, Bosset JF, Gerard JP. Role of radiotherapy with surgery for T3 and resectable T4 rectal cancer: evidence from randomized trials. Dis Colon Rectum 2006; 49: 302-310 Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 2001; 345: 638-646 Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004; 351: 1731-1740 Adjuvant radiotherapy for rectal cancer: a systematic overview of 8, 507 patients from 22 randomised trials. Lancet 2001; 358: 1291-1304 Brown G, Richards CJ, Newcombe RG, Dallimore NS, Radcliffe AG, Carey DP, Bourne MW, Williams GT. Rectal carcinoma: thin-section MR imaging for staging in 28 patients. Radiology 1999; 211: 215-222 Beets-Tan RG, Beets GL, Vliegen RF, Kessels AG, Van Boven H, De Bruine A, von Meyenfeldt MF, Baeten CG, van Engelshoven JM. Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet 2001; 357: 497-504 Poon FW, McDonald A, Anderson JH, Duthie F, Rodger C, McCurrach G, McKee RF, Horgan PG, Foulis AK, Chong D, Finlay IG. Accuracy of thin section magnetic resonance using phased-array pelvic coil in predicting the T-staging of rectal cancer. Eur J Radiol 2005; 53: 256-262 Brown G, Radcliffe AG, Newcombe RG, Dallimore NS, Bourne MW, Williams GT. Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging. Br J Surg 2003; 90: 355-364 Brown G, Daniels IR, Richardson C, Revell P, Peppercorn D, Bourne M. Techniques and trouble-shooting in high spatial resolution thin slice MRI for rectal cancer. Br J Radiol 2005; 78: 245-251 Kim MJ, Lim JS, Oh YT, Kim JH, Chung JJ, Joo SH, Kim NK, Lee KY, Kim WH, Kim KW. Preoperative MRI of rectal cancer.
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