...Transmission: Transmitted through direct contact with infected body fluids, skin or mucous membrane contact. (1) Reservoirs: Unknown, but it seems to reside in the rain forests on the African continent and in the Western Pacific. General characteristics: The virus is pleomorphic, appearing as long filamentous forms in a variety of shapes. The virions have a diameter of 80 nm and a length of 970 nm. They are composed of a helical nucleocapsid (2) Identified by ELISA, IFA test, PCR, or by isolating the virus in cell cultur. (3) Signs and Symptoms: After the person is infected, the incubation period can be as short as 2 days or as long as 21 days. Common signs and symptoms can include: weakness, fever, sore throat, dehydration, severe headache, joint and muscle aches, stomach pain, diarrhea, vomiting, and cough. Severe bleeding and coagulation abnormalities, as well as rash may be seen in some patients. (4) Death usually occurs during the second week of the symptoms due to massive blood loss. Virulence Mechanisms: Destruction of the immune system: The majority of patients infected with the virus are unable to develop sufficient immune responses. The main reason for that is the virus’s infection of the fibroblastic reticular system, which plays a role in maximizing immune responses. It is also believed that the infections from circulating monocytes and macrophages cause the transmission of virions between tissues. Damage of the blood vessels: It is also believed...
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...fast-paced decisionmaking environment. Managers make decisions on a day to day basis and it is necessary for them to be able to analyze the data so as to be able to make optimal decisions. This module has ten lesson which cover matrix algebra, markov analysis, Linear programming, differentiation, applications of differentiation to cost, revenue and profit functions, integral calculus, inventory models, sampling and estimation theory, hypothesis testing and chi-square tests. iii MODULE OBJECTIVES By the end of the course, the student should be able to:- 1. Perform various operations on matrices matrix algebra, 2. Apply the concept of matrices in solving simultaneous equations, input-output analysis and markov analysis, 3. Formulate and solve Linear programming using the graphical and simplex method 4. Differentiate various functions and apply to cost, revenue and profit functions 5. Apply...
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...From www.bloodjournal.org by guest on March 10, 2015. For personal use only. How I treat How I treat enteropathy-associated T-cell lymphoma Antonio Di Sabatino,1 Federico Biagi,1 Paolo G. Gobbi,1 and Gino R. Corazza1 1First Department of Medicine, Centro per lo Studio e la Cura della Malattia Celiaca, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, University of Pavia, Pavia, Italy Enteropathy-associated T-cell lymphoma (EATL) is a complication of celiac disease (CD). This tumor derives from the neoplastic transformation of aberrant intraepithelial T lymphocytes emerging in celiac patients unresponsive to a gluten-free diet. Poor adherence to a gluten-free diet, HLA-DQ2 homozygosity, and late diagnosis of CD are recognized as risk factors for malignant evolution of CD. Recurrence of diarrhea, unexplained weight loss, abdominal pain, fever, and night sweating should alert physicians to this complication. The suspicion of EATL should lead to an extensive diagnostic workup in which magnetic resonance enteroclysis, positron emission tomography scan, and histologic identification of lesions represent the best options. Treatment includes high-dose chemotherapy preceded by surgical resection and followed by autologous stem cell transplantation, although biologic therapies seem to be promising. Strict adherence to a gluten-free diet remains the only way to prevent EATL. (Blood. 2012;119(11): 2458-2468) Introduction Celiac disease (CD) is a chronic...
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...Bombay High Court 1 1862 - 2012 A Journey of 150 Years through some Memorable Judgments Part 1 2 PREFACE A tiny kernel of an idea planted by Justice Mridula Bhatkar took root, and has resulted in a humble effort to present before you a compendium of the crux of some of the judgments of the Judges who have served the Bombay High Court since its inception in 1862.1 The initial idea was to document one judgment of the First Court from each year which was modified to include a judgment of the Bombay High Court of each year. I soon realized that it was too expansive an idea to merit a single judgment a year. I could collect and collate, as many as ten judgments which would qualify to show the development of the law we desired to portray. Having found too vast a number of such judgments, I had to settle at a more reasonable figure of about five judgments each year to showcase the progress this Court has made from its illustrious beginnings. Our Chief Justice Mohit Shah and our Justice Chandrachud wholeheartedly supported the idea to complement the Book published on this the sesquicentennial of our Court. As the number of Judges grew, fewer judgments of each Judge would be selected as illustrations. These judgments are not the only path-finding groundbreaking ones; they are also ones with simplicity and legal elegance. The number of judgments we settled upon just would not permit all deserving judgments to be compiled; only a few have been picked from each year as the first in...
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...Change Project NUR 492 November 10, 2014 Dr. Christine Markut Change Project Today’s healthcare providers are struggling more than ever to provide high quality care while controlling the costs of healthcare. The demands of an aging population and shortage of medical personnel have brought challenges to the medical office and physicians somehow need to improve their access. Instead of limiting the time patients are able to spend with their physician discussing their medical concerns, why not increase the time and make it more effective for both the patient and the physician. Incorporating GMA’s may allow our physicians to see more patients, provide more care, and increase practice revenue. The patient benefits with increased access to the provider as well as receiving significant education with their peers that suffer from the same medical conditions (Rhee, 2013). This is a win – win situation for the organization and patients. Patients are typically allotted 15 to 30 minutes to discuss their concerns with the physician but with group medical appointments (GMA), patients are actually able to spend up to 90 minutes with their provider. GMA’s offer an alternative structure in the way effective and efficient care is delivered to chronically ill patients (Schmucker, 2006) and it allows greater interaction time with the provider. A GMA will typically involve approximately 8-12 patients while all of the components of individual appointments can be delivered to include: one-on-one...
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...Op"erations Research This page intentionally left blank Copyright © 2007, 2005 New Age International (P) Ltd., Publishers Published by New Age International (P) Ltd., Publishers All rights reserved. No part of this ebook may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of the publisher. All inquiries should be emailed to rights@newagepublishers.com ISBN (13) : 978-81-224-2944-2 PUBLISHING FOR ONE WORLD NEW AGE INTERNATIONAL (P) LIMITED, PUBLISHERS 4835/24, Ansari Road, Daryaganj, New Delhi - 110002 Visit us at www.newagepublishers.com PREFACE I started my teaching career in the year 1964. I was teaching Production Engineering subjects till 1972. In the year 1972 I have registered my name for the Industrial Engineering examination at National Institution of Industrial Engineering, Bombay. Since then, I have shifted my field for interest to Industrial Engineering subjects and started teaching related subjects. One such subject is OPERATIONS RESEARCH. After teaching these subjects till my retirement in the year 2002, it is my responsibility to help the students with a book on Operations research. The first volume of the book is LINEAR PORGRAMMING MODELS. This was published in the year 2003. Now I am giving this book OPERATIONS RESEARCH, with other chapters to students, with a hope that it will help them to understand...
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...Sustainable Development Sust. Dev. 18, 20–31 (2010) Published online 10 March 2009 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/sd.394 Sustainable Consumption: Green Consumer Behaviour when Purchasing Products William Young1*, Kumju Hwang2, Seonaidh McDonald3 and Caroline J. Oates4 1 Sustainability Research Institute, School of Earth and Environment, University of Leeds, UK 2 Department of Business Administration, College of Business Administration, Chonnam National University, South Korea 3 Aberdeen Business School, Robert Gordon University, UK 4 Management School, University of Sheffield, UK ABSTRACT The ‘attitude–behaviour gap’ or ‘values–action gap’ is where 30% of consumers report that they are very concerned about environmental issues but they are struggling to translate this into purchases. For example, the market share for ethical foods remains at 5 per cent of sales. This paper investigates the purchasing process for green consumers in relation to consumer technology products in the UK. Data were collected from 81 self-declared green consumers through in depth interviews on recent purchases of technology products. A green consumer purchasing model and success criteria for closing the gap between green consumers’ values and their behaviour are developed. The paper concludes that incentives and single issue labels (like the current energy rating label) would help consumers concentrate their limited efforts. More fundamentally, ‘being green’...
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...Annals of Internal Medicine Clinical Guidelines Screening Mammography in Women 40 to 49 Years of Age: A Systematic Review for the American College of Physicians Katrina Armstrong, MD, MSCE; Elizabeth Moye, BA; Sankey Williams, MD; Jesse A. Berlin, ScD; and Eileen E. Reynolds, MD Background: The risks and benefits of mammography screening among women 40 to 49 years of age remain an important issue for clinical practice. Purpose: To evaluate the evidence about the risks and benefits of mammography screening for women 40 to 49 years of age. Data Sources: English-language publications in MEDLINE (1966 – 2005), Pre-MEDLINE, and the Cochrane Central Register of Controlled Trials and references of selected studies through May 2005. Study Selection: Previous systematic reviews; randomized, controlled trials; and observational studies. Data Extraction: Two independent reviewers. Data Synthesis: In addition to publications from the original mammography trials, 117 studies were included in the review. Metaanalyses of randomized, controlled trials demonstrate a 7% to 23% reduction in breast cancer mortality rates with screening mammography in women 40 to 49 years of age. Screening mammography is associated with an increased risk for mastectomy but a decreased risk for adjuvant chemotherapy and hormone therapy. The risk for death due to breast cancer from the radiation exposure involved in mammography screening is small and is outweighed by a reduction in breast cancer mortality...
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...J Clin Epidemiol Vol. 50, No. 12, pp. 1311–1318, 1997 Copyright © 1997 Elsevier Science Inc. 0895-4356/97/$17.00 PII S0895-4356(97)00203-5 The Powerful Placebo Effect: Fact or Fiction? Gunver S. Kienle* and Helmut Kiene ¨ Institut fur Angewandte Erkenntnistheorie und Medizinische Methodologie, D-79112 Freiburg, Germany ABSTRACT. In 1955, Henry K. Beecher published the classic work entitled ‘‘The Powerful Placebo.’’ Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher was the first scientist to quantify the placebo effect. He claimed that in 15 trials with different diseases, 35% of 1082 patients were satisfactorily relieved by a placebo alone. This publication is still the most frequently cited placebo reference. Recently Beecher’s article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him. There were many other factors that could account for the reported improvements in patients in these trials, but most likely there was no placebo effect whatsoever. False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena...
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...Risk and Protective Factors for Depression: Implications for Prevention Depression in Children and Adolescents Linking Risk Research and Prevention Judy Garber, PhD Abstract: The National Institute of Mental Health has called for translational research linking basic knowledge about vulnerabilities that underlie mood disorders to the development of effective preventive interventions. This paper highlights research about risk factors for depression in children and adolescents and links it to current knowledge about interventions aimed at preventing depression in youth. Basic epidemiologic and clinical research indicates that increased risk for depression is associated with being female; a family history of depression, particularly in a parent; subclinical depressive symptoms; anxiety; stressful life events; neurobiological dysregulation; temperament/personality (e.g., neuroticism); negative cognitions; problems in self-regulation and coping; and interpersonal dysfunction. These vulnerabilities both increase individuals’ chances of encountering stress and decrease their ability to deal with the stress once it occurs. Although several existing depression-prevention studies have targeted one or more of these risk factors, the efficacy of these various prevention programs for youth with different combinations of these risk factors needs to be investigated further. Most existing depression-prevention programs in youth have used cognitive– behavioral techniques, with some success...
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...Eur Respir J 1999; 14: 452±467 Printed in UK ± all rights reserved Copyright #ERS Journals Ltd 1999 European Respiratory Journal ISSN 0903-1936 SERIES "CHEST PHYSIOTHERAPY" Edited by S.L. Hill and B. Webber Number 3 in this Series Effects of drugs on mucus clearance E. Houtmeyers, R. Gosselink, G. Gayan-Ramirez, M. Decramer Effects of drugs on mucus clearance. E. Houtmeyers, R. Gosselink, G. Gayan-Ramirez, M. Decramer. #ERS Journals Ltd 1999. ABSTRACT: Mucociliary clearance (MCC), the process in which airway mucus together with substances trapped within are moved out of the lungs, is an important defence mechanism of the human body. Drugs may alter this process, such that it is necessary to know the effect of the drugs on MCC. Indeed, agents stimulating MCC may be used therapeutically in respiratory medicine, especially in patients suspected of having an impairment of their mucociliary transport system. In contrast, caution should be taken with drugs depressing MCC as an undesired side-effect, independently of their therapeutic indication. Since cough clearance (CC) serves as a back-up system when MCC fails, the influence of drugs must be examined not only on MCC but also on CC. Ultimately, the clinical repercussions of alterations in mucus transport induced by drug administration must be studied. Tertiary ammonium compounds (anticholinergics), aspirin, anaesthetic agents and benzodiazepines have been shown to be capable of depressing the mucociliary transport system...
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...Oral Oncology 50 (2014) 577–586 Contents lists available at ScienceDirect Oral Oncology journal homepage: www.elsevier.com/locate/oraloncology Review ACR Appropriateness CriteriaÒ thyroid carcinoma Joseph K. Salama a,⇑, Daniel W. Golden b, Sue S. Yom c, Madhur Kumar Garg d, Joshua Lawson e, Mark W. McDonald f, Harry Quon g, John A. Ridge h, Nabil Saba i, Richard V. Smith j, Francis Worden k, Anamaria Reyna Yeung l, Jonathan J. Beitler m a Duke University, Durham, NC, United States University of Chicago Hospital, Chicago, IL, United States University of California San Francisco, San Francisco, CA, United States d Montefiore Medical Center, Bronx, NY, United States e Lexington Medical Center, West Columbia, SC, United States f Indiana University School of Medicine, Indianapolis, IN, United States g Johns Hopkins University, Baltimore, MD, United States h American College of Surgeons, Fox Chase Cancer Center, Philadelphia, PA, United States i American Society of Clinical Oncology, Emory University, Atlanta, GA, United States j American College of Surgeons, Montefiore Medical Center, Bronx, NY, United States k American Society of Clinical Oncology, University of Michigan, Ann Arbor, Michigan, United States l University of Florida, Gainesville, FL, United States m Emory University School of Medicine, Atlanta, GA, United States b c a r t i c l e i n f o s u m m a r y The ACR Head and Neck Cancer Appropriateness Criteria Committee reviewed relevant medical...
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...Verizon Communications Inc. NYSE: VZ Student Investment Fund Stock Report Analysts: Xi Cheng, Tanner McAndrew, Luke Thompson, and Daniel Wadsworth Recommendation: Buy Market Cap: $86.2 B Recent Price: $32.69(12/1/2009) Target Price: $47.11 Industry: Telecom Services Sector: Technology HIGHLIGHTS VZs subsidiary (Verizon Wireless) is the world’s largest wireless service provide VZ is expanding its presence in wireline services through an advance fiber optics network service called FiOS VZ has experienced growth in revenue over the past five years and is on pace for an 11% increase in 2009 VZ has a consistently increased its dividend payout There is large potential growth and development in the Telecom Industry VZ has competitive advantages in distribution network and pipelines Early Adoption of 4G Network Ranked as top 1 wireless service provider in annual consumer report INVESTMENT THESIS Demand for and dependence upon wireless technology has exhibited a strong upward trend which is expected to continue in the future. Verizon is competitively positioned to take advantage of this trend. Broadband service and the popularity of bundled services have increased substantially. With Verizon’s recent investment in this sector, the firm is expected to capture an increasing portion of demand. VZ’s ability to successfully generate a strong ROIC, add economic value, and further improve their dividend payout coming out of a deep recession demonstrates the...
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...Instructors Manual Case Studies Table of Contents Introduction Shipper Manufacturing Company ………………………………............ C-2 FHE, Inc. ……………………………………………………………….. C-5 Early Supplier Integration in the Design of the Skid-Steer Loader……... C-9 Process Design Eastern Gear, Inc. ………………………………………………………. C-17 Southwest Airlines: Singin’ the (Jet) Blues …………………………….. C-21 The Field Service Division of DMI ……………………………………. C-29 Pharmacy Service Improvement at CVS (A) …………………………… C-36 U.S. Stroller …………………………………………………………….. C-37 Quality Customer-Driven Learning at Radisson Hotels Worldwide ……………. C-41 Quality at Gillette Argentina …………………………………………… C-46 Bayfield Mud Company ………………………………………………… C-47 Six Sigma at 3M, Inc. …………………………………………………... C-53 Capacity and Scheduling Crocs: Revolutionizing an Industry’s Supply Chain Model for Competitive Advantage …………………………………….. C-58 Unifine Richardson …………………………………………………….. C-59 eBags: Managing Growth ……………………………………………… C-60 Merriwell Bag Company ……………………………………………….. C-69 Lawn King, Inc. ………………………………………………………… C-74 World Industrial Abrasives ……………………………………………... C-84 Inventory Consolidated Electric …………………………………………………... C-88 Southern Toro Distributor, Inc. ………………………………………… C-93 ToysPlus, Inc. …………………………………………………………... C-99 SHIPPER MANUFACTURING COMPANY Teaching Notes Synopsis and Purpose Shipper Manufacturing Company is a manufacturer of electrical products, laminated materials...
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...Psychoeducation for schizophrenia (Review) Xia J, Merinder LB, Belgamwar MR This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2013, Issue 1 http://www.thecochranelibrary.com Psychoeducation for schizophrenia (Review) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLAIN LANGUAGE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . . . . . . . . . . . . . . . . . . . BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AUTHORS’ CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . REFERENCES...
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