Transient Benign Hyperphophatasemia - A Systematic Review of The Literature

BACKGROUND:: Sometimes, a temporary increase in alkaline phosphatase level is found in healthy infants and toddlers without evidence of liver or bone disease. The condition is customarily termed transient benign hyperphosphatasemia of infancy and early childhood. Most textbooks do not refer to the condition. METHODS:: We completed a systematic review of the literature using the principles underlying the UK Economic and Social Research Council guidance on the conduct of narrative synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS:: The 142 reports retained for analysis included 813 cases (male:female ratio = 1.1:1.0): 80 in subjects >18 years and 733 in subjects ≤18 years of age. The alkaline phosphatase ratio, calculated by dividing the measured level by the upper normal limit, was ≥5.0 in ≈70% and the duration of the elevation ≤4 months in 80% of the cases. Transient benign hyperphosphatasemia often followed a benign infection but available data fail to demonstrate a causal link. The prevalence of transient benign hyperphosphatasemia ranged 1.1-3.5% in infants 2 to 24 months of age. CONCLUSIONS:: Transient benign hyperphosphatasemia is likely the most common cause of hyperphosphatasemia among healthy infants and toddlers. Sometimes, it also occurs in older children and adults, indicating that the traditional term transient benign hyperphosphatasemia of infancy and early childhood might not be correct. The elevation in alkaline phosphatase persists for >4 months in ≈20% of the cases. Recognition of this benign condition is crucial to avoid unnecessary investigations.

Traditional chinese medicine (phytotherapy): health technology assessment report - selected aspects

Objective: A summary of main aspects from a Health Technology Assessment report on Traditional Chinese Medicine (TCM) in Switzerland concerning effectiveness and safety is given. Materials and Methods: Literature search was performed through 13 databases, by scanning reference lists of articles and by contacting experts. Assessed were quality of documentation, internal and external validity. Results: Effectiveness: 43 articles concerning 'gastrointestinal tract and liver' were assessed. The studies covering 7,436 patients were undertaken in China (35), Japan (3), USA (2) and Australia (3); 33/43 being controlled studies. 34/40 show significantly better results in the TCM-treated group. A comparison of studies on results of treatment based on a diagnosis according to TCM criteria and studies on results of treatment according to Western diagnosis shows that treatment based on TCM diagnosis improves the result. The comparison of treatment by individual medication and standard medication showed a trend in favor of individual medication. Safety: TCM training and practice for physicians in Switzerland are officially regulated. Side effects occur, but no severe effects have been registered up to now in Switzerland. TCM medicinals are imported; admission regulations are being installed. Problems due to production abroad, Internet trade, self-medication or admixtures are possible. Conclusion: The evaluation of the literature search provides evidence for a basic clinical effectiveness of TCM therapy. Severe side effects were not observed in Switzerland. Regulations for trading and use of medicinals prevent treatment risks. Further clinical studies in a Western context are required.

Financial decision making about found oil and gas in Ghana : real options vs. traditional methods

This research is a study of the use of capital budgeting methods for investment decisions. It uses both the traditional methods and the newly introduced approach called the real options analysis to make a decision. The research elucidates how capital budgeting can be done when analysts encounter projects with high uncertainty and are capital intensive, for example oil and gas production. It then uses the oil and gas find in Ghana as a case study to support its argument. For a clear understanding a thorough literature review was done, which highlights the advantages and disadvantages of both methods. The revenue that the project will generate and the costs of production were obtained from the predictions by analysts from GNPC and compared to others experts’ opinion. It then applied both the traditional and real option valuation on the oil and gas find in Ghana to determine the project’s feasibility. Although, there are some short falls in real option analysis that are presented in this research, it is still helpful in valuing projects that are capital intensive with high volatility due to the strategic flexibility management possess in their decision making. It also suggests that traditional methods of evaluation should still be maintained and be used to value projects that have no options or those with options yet the options do not have significant impact on the project. The research points out the economic ripples the production of oil and gas will have on Ghana’s economy should the project be undertaken. These ripples include economic growth, massive job creation and reduction of the balance of trade deficit for the country. The long run effect is an eventually improvement of life of the citizens. It is also belief that the production of gas specifically can be used to generate electricity in Ghana which would enable the country to have a more stable and reliable power source necessary to attract more foreign direct investment.

Nosocomial infections and their relationship to non-traditional risk factors in a medical intensive care unit

Background. Nosocomial infections are a source of concern for many hospitals in the United States and worldwide. These infections are associated with increased morbidity, mortality and hospital costs. Nosocomial infections occur in ICUs at a rate which is five times greater than those in general wards. Understanding the reasons for the higher rates can ultimately help reduce these infections. The literature has been weak in documenting a direct relationship between nosocomial infections and non-traditional risk factors, such as unit staffing or patient acuity.^ Objective. To examine the relationship, if any, between nosocomial infections and non-traditional risk factors. The potential non-traditional risk factors we studied were the patient acuity (which comprised of the mortality and illness rating of the patient), patient days for patients hospitalized in the ICU, and the patient to nurse ratio.^ Method. We conducted a secondary data analysis on patients hospitalized in the Medical Intensive Care Unit (MICU) of the Memorial Hermann- Texas Medical Center in Houston during the months of March 2008- May 2009. The average monthly values for the patient acuity (mortality and illness Diagnostic Related Group (DRG) scores), patient days for patients hospitalized in the ICU and average patient to nurse ratio were calculated during this time period. Active surveillance of Bloodstream Infections (BSIs), Urinary Tract Infections (UTIs) and Ventilator Associated Pneumonias (VAPs) was performed by Infection Control practitioners, who visited the MICU and performed a personal infection record for each patient. Spearman's rank correlation was performed to determine the relationship between these nosocomial infections and the non-traditional risk factors.^ Results. We found weak negative correlations between BSIs and two measures (illness and mortality DRG). We also found a weak negative correlation between UTI and unit staffing (patient to nurse ratio). The strongest positive correlation was found between illness DRG and mortality DRG, validating our methodology.^ Conclusion. From this analysis, we were able to infer that non-traditional risk factors do not appear to play a significant role in transmission of infection in the units we evaluated.^

Influencia del tratamiento "a fuego" en las características del estuco tradicional con cal = Influence of treatment "by fire" in the characteristics of traditional lime stucco

Esta investigación avanza en el intento de recuperar la técnica tradicional del estuco a fuego, paradigma de la decoración de espacios interiores hasta la mitad del s. XX por sus imitaciones marmóreas de gran calidad. Para ejecutarlos se utilizaban morteros de cal con áridos de mármol, pigmentos minerales y grasas; con estos materiales se preparaban y tendían las masas, se pintaban al fresco y se terminaban con el paso de una herramienta metálica caliente. Como sucede con otras técnicas, el paso del tiempo ha difuminado los conocimientos sobre la materia, haciendo muy difícil la conservación o restauración de los ejemplos en nuestro patrimonio. A partir de la escasa bibliografía existente se ha recuperado el proceso, sometiendo las muestras elaboradas a diferentes ensayos que han caracterizado el acabado final,tanto en sus características intrínsecas como en las que le son conferidas al proteger finalmente las muestras con una capa de cera, tal y como se realizaba tradicionalmente.---ABSTRACT---This research advances in the attempt to recover the traditional technique of stucco by fire; paradigm of indoor decoration until half of 20th century due to its high quality marbled imitations. On its implementation process, it was used lime mortars with marble aggregates, mineral pigments and greases. With these materials, masses were prepared and extended into the walls, they were painted in fresco and ended with the passage of a heated metal tool. As with any other technique, the time passing over has blurred the knowledge on the subject, making very difficult the preservation or restoration of examples in our heritage. Despite of the limited literature, the process has been recovered; subjecting the samples prepared at different trials that have characterized the finished, both in its merits and its conferred characteristics by finally protecting the samples with a layer of wax, as was done traditionally.

Cultural conflict: Conveyance of traditional Iranian values and the effects on sense of self of Iranian-American women

The literature on Iranians who immigrated to countries with modern cultures is sparse. This paper presents a theoretical understanding of the research with a particular appreciation on issues related to gender roles, sexuality, and acculturation within this population. In addition, treatment suggestions with this Iranian immigrant population will be presented through the lens of self psychology and a new perspective about the effects on the sense of self of young immigrant Iranian females will be discussed.

Quality of pharmaceutical advertising and gender bias in medical journals (1998-2008): a review of the scientific literature

Objective: To review the scientific literature on pharmaceutical advertising aimed at health professionals in order to determine whether gender bias has decreased and the quality of information in pharmaceutical advertising has improved over time. Methods: We performed a content analysis of original articles dealing with medical drug promotion (1998-2008), according to quality criteria such as (a) the number, validity and accessibility of bibliographic references provided in pharmaceutical advertising and (b) the extent to which gender representations were consistent with the prevalence of the diseases. Databases: PUBMED, Medline, Scopus, Sociological Abstract, Eric and LILACS. Results: We reviewed 31 articles that analyzed advertising in medical journals from 1975-2005 and were published between 1998 and 2008. We found that the number of references used to support pharmaceutical advertising claims increased from 1975 but that 50% of these references were not valid. There was a tendency to depict men in paid productive roles, while women appeared inside the home or in non-occupational social contexts. Advertisements for psychotropic and cardiovascular drugs overrepresented women and men respectively. Conclusions: The use of bibliographic references increased between 1998 and 2008. However, representation of traditional male-female roles was similar in 1975 and 2005. Pharmaceutical advertisements may contribute to reinforcing the perception that certain diseases are associated with the most frequently portrayed sex.

An ethnopharmacological and historical analysis of “Dictamnus”, a European traditional herbal medicine

Ethnopharmacological relevance and background: “Dictamnus” was a popular name for a group of medicinal herbaceous plant species of the Rutaceae and Lamiaceae, which since the 4th century have been used for gynaecological problems and other illnesses BCE and still appear in numerous ethnobotanical records. Aims: This research has as four overarching aims: Determining the historical evolution of medical preparations labelled “Dictamnus” and the different factors affecting this long-standing herbal tradition. Deciphering and differentiating those medicinal uses of “Dictamnus” which strictly correspond to Dictamnus (Rutaceae), from those of Origanum dictamnus and other Lamiaceae species. Quantitatively assessing the dependence from herbal books, and pharmaceutical tradition, of modern Dictamnus ethnobotanical records. Determining whether differences between Western and Eastern Europe exist with regards to the Dictamnus albus uses in ethnopharmacology and ethnomedicine. Methods: An exhaustive review of herbals, classical pharmacopoeias, ethnobotanical and ethnopharmacological literature was conducted. Systematic analysis of uses reported which were standardized according to International Classification of Diseases – 10 and multivariate analysis using factorial, hierarchical and neighbour joining methods was undertaken. Results and discussion: The popular concept “Dictamnus” includes Origanum dictamnus L., Ballota pseudodictamnus (L.) Benth. and B. acetabulosa (L.) Benth. (Lamiaceae), as well as Dictamnus albus L. and D. hispanicus Webb ex Willk. (Rutaceae), with 86 different types of uses. Between 1000 and 1700 CE numerous complex preparations with “Dictamnus” were used in the treatment of 35 different pathologies. On biogeographical grounds the widespread D. albus is a far more likely prototypical “Dictamnus” than the Cretan endemic Origanum dictamnus. However both form integral parts of the “Dictamnus” complex. Evidence exists for a sufficiently long and coherent tradition for D. albus and D. hispanicus, use to treat 47 different categories of diseases. Conclusions: This approach is a model for understanding the cultural history of plants and their role as resources for health care. “Dictamnus” shows how transmission of traditional knowledge about materia medica, over 26 centuries, represents remarkable levels of development and innovation. All this lead us to call attention to D. albus and D. hispanicus which are highly promising as potential herbal drug leads. The next steps of research should be to systematically analyse phytochemical, pharmacological and clinical evidence and to develop safety, pharmacology and toxicology profiles of the traditional preparations.

The modern study of literature; an introduction to literary theory and interpretation by Richard Green Moulton ...

Introduction: Dominant ideas of modern study: unity, induction, evolution.--book I. Literary morphology: varieties of literature and their underlying principles.--book II. The field and scope of literary study.--book III. Literary evolution as reflected in the history of world literature.--book IV. Literary criticism: the traditional confusion and the modern reconstruction.--book V. Literature as a mode of philosophy.--book VI. Literature as a mode of art. Conclusion: the traditional and the modern study of literature. Syllabus. Works of the author. General index. Seventh impression, June, 1928

Remains of Nithsdale and Galloway song: with historical and traditional notices relative to the manners and customs of the peasantry.

Almost wholly the work of Allan Cunningham, who supplied Cromek with original poems, disguised as old ballads, etc. Whether Cromek suspected the imposition is not clear. cf. Dict. nat. biog. and D. Hogg, Life of A. Cunningham. 1875 (esp. p. 49-, & 79)

Why are health care interventions delivered over the internet? A systematic review of the published literature

Background: As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are using the networking potential of the Internet, and several of them have evaluated these interventions. Objective: The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect on the work of the pioneers in this field in order to inform future research. Methods: We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the Internet, and these reasons were categorized. Results: We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention. A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this mode of delivery. Conclusions: One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility, and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question: What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery? © Griffiths, Frances, Lindenmeyer, Antje, Powell, John, Thorogood, Margaret.

Multi-criteria decision making approaches for supplier evaluation and selection:a literature review

Supplier evaluation and selection problem has been studied extensively. Various decision making approaches have been proposed to tackle the problem. In contemporary supply chain management, the performance of potential suppliers is evaluated against multiple criteria rather than considering a single factor-cost. This paper reviews the literature of the multi-criteria decision making approaches for supplier evaluation and selection. Related articles appearing in the international journals from 2000 to 2008 are gathered and analyzed so that the following three questions can be answered: (i) Which approaches were prevalently applied? (ii) Which evaluating criteria were paid more attention to? (iii) Is there any inadequacy of the approaches? Based on the inadequacy, if any, some improvements and possible future work are recommended. This research not only provides evidence that the multi-criteria decision making approaches are better than the traditional cost-based approach, but also aids the researchers and decision makers in applying the approaches effectively.

Virtual manufacturing:a study of some important issues relating to the transformation of traditional manufacturing organisations

This thesis starts with a literature review, outlining the major issues identified in the literature concerning virtual manufacturing enterprise (VME) transformation. Then it details the research methodology used – a systematic approach for empirical research. next, based on the conceptual framework proposed, this thesis builds three modules to form a reference model, with the purpose of clarifying the important issues relevant to transforming a traditional manufacturing company into a VME. The first module proposes a mechanism of VME transformation – operating along the VME metabolism. The second module builds a management function within a VME to ensure a proper operation of the mechanism. This function helps identify six areas as closely related to VME transformation: lean manufacturing; competency protection; internal operation performance measurement; alliance performance measurement; knowledge management; alliance decision making. The third module continues and proposes an alliance performance measurement system which includes 14 categories of performance indicators. An analysis template for alliance decision making is also proposed and integrated into the first module. To validate these three modules, 7 manufacturing organisations (5 in China and 2 in the UK) were investigated, and these field case studies are analysed in this thesis. The evidence found in these organisations, together with the evidence collected from the literature, including both researcher views and literature case studies, provide support for triangulation evidence. In addition, this thesis identifies the strength and weakness patterns of the manufacturing companies within the theoretical niche of this research, and clarifies the relationships among some major research areas from the perspective of virtual manufacturing. Finally, the research findings are summarised, as well as their theoretical and practical implications. Research limitations and recommendations for future work conclude this thesis.

This was uncalled for : Dave Eggers' A heartbreaking work of staggering genius subverts the genre of traditional autobiography as an attempt at rendering his life

The purpose of this thesis was to explore why and how the author Dave Eggers subverts the genre of traditional autobiography in his memoir A Heartbreaking Work of Staggering Genius. I compared Eggers' work to Gertrude Stein's The Autobiography of Alice B. Toklas and William S. Burroughs' Junky. I found that like Stein and Burroughs, Eggers utilized various rhetorical devices outside of traditional autobiography because he could not find the means to express himself within the genre. Eggers employed various rhetorical methods reserved for fictional texts, such as stream of consciousness, characterization, and irony, in order to reconcile his feelings towards his parents' deaths and render those feelings in his memoir. I established that Eggers concluded his memoir with impossibility of arriving at one Meaning that could summate his tragic experience. Thus, I proved that Eggers gave the reader the only authentic interpretation he could: the memoir as a small, incomplete glimpse into his life.

Utilizing Traditional Cognitive Measures of Academic Preparation to Predict First-Year Science, Technology, Engineering, and Mathematics (STEM) Majors' Success in Math and Science Courses

For the past several years, U.S. colleges and universities have faced increased pressure to improve retention and graduation rates. At the same time, educational institutions have placed a greater emphasis on the importance of enrolling more students in STEM (science, technology, engineering and mathematics) programs and producing more STEM graduates. The resulting problem faced by educators involves finding new ways to support the success of STEM majors, regardless of their pre-college academic preparation. The purpose of my research study involved utilizing first-year STEM majors’ math SAT scores, unweighted high school GPA, math placement test scores, and the highest level of math taken in high school to develop models for predicting those who were likely to pass their first math and science courses. In doing so, the study aimed to provide a strategy to address the challenge of improving the passing rates of those first-year students attempting STEM-related courses. The study sample included 1018 first-year STEM majors who had entered the same large, public, urban, Hispanic-serving, research university in the Southeastern U.S. between 2010 and 2012. The research design involved the use of hierarchical logistic regression to determine the significance of utilizing the four independent variables to develop models for predicting success in math and science. The resulting data indicated that the overall model of predictors (which included all four predictor variables) was statistically significant for predicting those students who passed their first math course and for predicting those students who passed their first science course. Individually, all four predictor variables were found to be statistically significant for predicting those who had passed math, with the unweighted high school GPA and the highest math taken in high school accounting for the largest amount of unique variance. Those two variables also improved the regression model’s percentage of correctly predicting that dependent variable. The only variable that was found to be statistically significant for predicting those who had passed science was the students’ unweighted high school GPA. Overall, the results of my study have been offered as my contribution to the literature on predicting first-year student success, especially within the STEM disciplines.