Continuous Assessment through Objective Structured Clinical Examinations in Veterinary Clinical Propaedeutics

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Exit strategies for business tenants

Many businesses in the UK occupy premises on fixed term leases, which usually run for several years. During this time property requirements can change. This research critically examines the three main mechanisms by which tenants can bring their leases to an end; breaks, assignment and subletting. We examine the legal rules governing these devices and undertake an analysis of lease data and surveys. Break clauses are providing a useful exit mechanism for many tenants, but they cannot give the more general flexibility of assignment and subletting. However, change is necessary to ensure that these latter provisions provide real flexibility for tenants.

Fora, networks and public examinations: the role and significance of public participation in the new regional plan for South East England

This paper overviews the main conceptual frameworks for understanding participatory approaches to land use planning and explores their utility in analysing the experience of a recent regional planning exercise in South East England. In particular it examines the contribution of recent ‘New Institutionalist’ ideas to our understanding of participatory processes and the implications for practice of using them to build strategies of public involvement in policy-making and implementation.

Litigation against fracking bans and moratoriums in the US: exit, voice and loyalty

A number of US states, counties and municipalities have responded to the public health and environmental concerns surrounding fracking by imposing bans or moratoriums on unconventional oil and gas drilling. These restrictions have, in recent years, given rise to litigation challenges by oil and gas companies and by property owners deprived of potential revenues. The current article begins by examining precisely who has litigated. Have large companies dominated or is it mostly smaller independents? Is there a difference in litigation rates between private and public companies? The article then considers how Hirschman’s ideas of exit, voice and loyalty might apply in the context of bans and moratoriums and further explores some of the factors that may have driven litigation in the area.

Entrance surface dose measurements in pediatric radiological examinations

A survey of pediatric radiological examinations was carried out in a reference pediatric hospital of the city of Sao Paulo. in order to investigate the doses to children undergoing conventional X-ray examinations. The results showed that the majority of pediatric patients are below 4 years, and that about 80% of the examinations correspond to chest projections. Doses to typical radiological examinations were measured in vivo with thermoluminescent dosimeters (LiF: Mg, Ti and LiF: Mg, Cu, P) attached to the skin of the children to determine entrance surface dose (ESD). Also homogeneous phantoms were used to obtain ESD to younger children, because the technique uses a so small kVp that the dosimeters would produce an artifact image in the patient radiograph. Four kinds of pediatric examinations were investigated: three conventional examinations (chest, skull and abdomen) and a fluoroscopic procedure (barium swallow). Relevant information about kVp and mAs values used in the examinations was collected, and we discuss how these parameters can affect the ESD. The ESD values measured in this work are compared to reference levels published by the European Commission for pediatric patients. The results obtained (third-quartile of the ESD distribution) for chest AP examinations in three age groups were: 0.056 mGy (2-4 years old); 0,068 mGy (5-9 years old)-. 0.069 mGy (10-15 years old). All of them are below the European reference level (0.100mGy). ESD values measured to the older age group in skull and abdomen AP radiographs (mean values 3.44 and 1.20mGy, respectively) are above the European reference levels (1.5mGy to skull and 1.0 mGy to abdomen). ESD values measured in the barium swallow examination reached 10 mGy in skin regions corresponding to thyroid and esophagus. It was noticed during this survey that some technicians use, improperly, X-ray fluoroscopy in conventional examinations to help them in positioning the patient. The results presented here are a preliminary survey of doses in pediatric radiological examinations and they show that it is necessary to investigate the technical parameters to perform the radiographs. to introduce practices to control pediatric patient`s doses and to improve the personnel training to perform a pediatric examination. (c) 2007 Elsevier Ltd. All rights reserved.

Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil

Objectives. A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in Sao Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state. Methods. A postal dosimetric kit with thermoluminescence dosimeters was used to evaluate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the annual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were included, and 1 415 values of ESD were measured. Results. The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary localizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic reference levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. Conclusions. Despite the reduced number of ESD values and rooms for the pediatric patient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out.

Differential effects of TR ligands on hormone dissociation rates: Evidence for multiple ligand entry/exit pathways

Some nuclear receptor (NR) ligands promote dissociation of radiolabeled bound hormone from the buried ligand binding cavity (LBC) more rapidly than excess unlabeled hormone itself This result was interpreted to mean that challenger ligands bind allosteric sites on the LBD to induce hormone dissociation, and recent findings indicate that ligands bind weakly to multiple sites on the LBD surface. Here we show, that a large fraction of thyroid hormone receptor (TR) ligands promote rapid dissociation (T(1/2) < 2 h) of , radiolabeled T(3) vs. T(3) (T(1/2), approximate to 5-7 h). We cannot discern relationships between this effect and ligand size, activity or affinity for TR beta. One ligand, GC-24, binds the TR LBC and (weakly) to the TR beta-LBD surface that mediates dimer/heterodimer interaction, but we cannot link this interaction to rapid T(3) dissociation. Instead, several lines of evidence suggest that the challenger ligand must interact with the buried LBC to promote rapid T(3) release. Since previous molecular dynamics simulations suggest that TR ligands leave the LBC by several routes, we propose that a subset of challenger ligands binds and stabilizes a partially unfolded intermediate state of TR that arises during T(3) release and that this effect enhances hormone dissociation. (C) 2009 Elsevier Ltd. All rights reserved.

O problema do exit em investimentos de risco no Brasil

O trabalho avalia a problemática existente na saída de investimentos de capital de risco no mercado brasileiro enfocando, de forma especial, a alternativa de saída através de ofertas públicas iniciais de ações.

Maxillary osteosarcoma in a young patient undergoing postorthodontic treatment follow-up: The importance of ongoing oral examinations

Osteosarcoma is a common primary malignant tumor in long bones; it generally occurs in young adults. It is considered infrequent in the head and neck regions, where it is usually associated with poor outcomes and rates of survival. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported. The purpose of this article was to present a case report of a maxillary chondroblastic osteosarcoma involving the maxillary sinus and the maxilla of a young woman who was diagnosed during early postorthodontic treatment follow-up. Treatment, prosthetic rehabilitation, and follow-up details are provided. Most importantly, this patient shows the importance of complete and systematic oral examinations during any routine dental treatment. (Am J Orthod Dentofacial Orthop 2011;139:845-8)