781 resultados para lobos marinos
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Background/Aims: Peginterferon alfa-2a plus ribavirin improves sustained virological responses compared with interferon alfa-2b and ribavirin, or peginterferon alfa-2a alone in chronic hepatitis C. We examined the impact of these treatments on health related quality of life (HRQOL). Methods: Patients (n = 1121) were randomized to peginterferon alfa-2a weekly plus ribavirin or placebo, or interferon alfa-2b thrice weekly plus ribavirin. HRQOL was assessed with the SF-36 Health Survey and Fatigue Severity Scale (FSS). Results: Patients receiving peginterferon alfa-2a plus ribavirin reported better HRQOL than those receiving interferon alfa-2b plus ribavirin. These differences were statistically significant for three SF-36 domains and both FSS scores (p < = 0.05). Patients receiving peginterferon alfa-2a plus placebo had the least impairment; adding ribavirin significantly decreased five domains of the SF-36 and both FSS scores. Sustained virological response was associated with improvement at follow-up on all SF-36 and FSS scores. Conclusions: The effects of combination therapy on HRQOL and fatigue are less with peginterferon alfa-2a plus ribavirin than interferon alfa-2b plus ribavirin. Each medication in combination therapy with interferon and ribavirin, affects patients' quality of life differently. Understanding the relationship of specific therapeutic options to HRQOL may help physicians minimize the impact of therapy on HRQOL. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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The emergence of innovative and revolutionary Integration Technologies (IntTech) has highly influenced the local government authorities (LGAs) in their decision-making process. LGAs that plan to adopt such IntTech may consider this as a serious investment. Advocates, however, claim that such IntTech have emerged to overcome the integration problems at all levels (e.g. data, object and process). With the emergence of electronic government (e-Government), LGAs have turned to IntTech to fully automate and offer their services on-line and integrate their IT infrastructures. While earlier research on the adoption of IntTech has considered several factors (e.g. pressure, technological, support, and financial), inadequate attention and resources have been applied in systematically investigating the individual, decision and organisational context factors, influencing top management's decisions for adopting IntTech in LGAs. It is a highly considered phenomenon that the success of an organisation's operations relies heavily on understanding an individual's attitudes and behaviours, the surrounding context and the type of decisions taken. Based on empirical evidence gathered through two intensive case studies, this paper attempts to investigate the factors that influence decision makers while adopting IntTech. The findings illustrate two different doctrines - one inclined and receptive towards taking risky decisions, the other disinclined. Several underlying rationales can be attributed to such mind-sets in LGAs. The authors aim to contribute to the body of knowledge by exploring the factors influencing top management's decision-making process while adopting IntTech vital for facilitating LGAs' operational reforms.
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Suicide in correctional facilities is a major issue institutions have to face on a daily basis. Identifying potential risks and factors could help prevent suicide as well as aid in the foundation of more rehabilitative programs. This paper examines suicide and the main factors that influence this phenomenon.