6,960 research outputs found

    Punitive Damages in Medical Malpractice: An Economic Evaluation

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    The States, Balanced Budgets, and Fundamental Shifts in Federalism

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    The Year 2000: Dreams and Nightmares.

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    My dreams at night are very vivid--full of detail, dialogue, and complex plots. Often when I wake up, the dreams linger with me all day as if they were real. My dreams and nightmartes for the infroamtion world of 2000 are the same in mind--detailed and real. 2000 is too sooN for most of them, but by then we may be well on our way to some of these, for better or for worse

    Mathematical modelling of ethanol metabolism in normal subjects and chronic alcohol misusers

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    The time course of ethanol disappearance from the blood has been examined in normal males and females and in alcohol misusers. Blood alcohol estimations were made over a period of 3 hr, following an oral dose of ethanol (0.8 g/kg body weight) administered in the form of whisky. Attempts were made to fit the data to zero order, first order and mixed zero + first order kinetics. In the majority (75%) of normal females the blood ethanol concentration was still increasing at 30 min. This was only seen in 50% of normal males and in 50% of non-dependent alcohol misusers, but not in dependent alcohol misusers. In all of the normal females the disappearance of ethanol could be adequately described by zero order kinetics. However, in the normal male group only 20% could be described by zero order kinetics, 10% fitted first order kinetics and the remainder required a mixed model of zero + first order. The rate constant for the zero order component of the control male group was identical to zero order rate constant obtained for the female control group. In the female alcohol misuser group, 40% of the curves could not be described by zero order kinetics and fitted best to a mixed model. The zero order component of the entire group was significantly increased (by 35%) compared to that obtained for the female control group. In the male dependent and non-dependent alcohol misuser groups, all blood alcohol concentration curves fitted best to mixed zero and first order kinetics. However, no significant differences were noted in the values of the kinetic parameters when compared with the male control group. It is suggested that the zero order component of the blood alcohol concentration curves is due to the action of liver alcohol dehydrogenase and the first order component represents redistribution to the tissues. The presence or absence of a first order component is attributed to differences in absorption rates from the gut

    Issues of alcohol misuse among older people : attitudes and experiences of social work practitioners

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    This small-scale qualitative research focused on the experiences of social workers vis--vis older people who misuse alcohol. Based in an Older People's Team in the west of Scotland, the study explored service provision for alcohol misuse and examined whether practitioners felt the existing services provided by the Substance Misuse Team were effective in meeting the needs of older people with an alcohol problem. Using semi-structured interviews, data were collected from 18 participants, the majority (14) of whom were female and whose ages ranged from 31 to 54 years. Several key themes emerged including the extent of alcohol problems among older people and the complex reasons that cause older people to misuse alcohol. These reasons commonly related to the increasing challenges of old age. The data also demonstrated that current services are not meeting the needs of older people. Practitioners identified a need for an 'age-specific' approach to target more effectively the complex needs of older people. Recommendations from practitioners included ways to develop new and more effective services, including a more age-specific service, such as providing longer term support in older people's own homes, using a specialised support worker, and increasing staff training on alcohol use among older people

    Reviews

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    500 Computing Tips for Teachers and Lecturers by Phil Race and Steve McDowell, London: Kogan Page, 1996. ISBN: 0–7494–1931–8. 135 pages, paperback. £15.99

    Clinical expression of plakophilin-2 mutations in familial arrhythmogenic right ventricular cardiomyopathy

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    Background - Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disorder characterized by loss of cardiomyocytes and their replacement by adipose and fibrous tissue. It is considered a disease of cell adhesion because mutations in desmosomal genes, desmoplakin and plakoglobin, have been implicated in the pathogenesis of ARVC. In a recent report, mutations in plakophilin-2, a gene highly expressed in cardiac desmosomes, have been shown to cause ARVC.Methods and Results - We investigated 100 white patients with ARVC for mutations in plakophilin-2. Nine different mutations were identified by direct sequencing in 11 cases. Five of these mutations are novel (A733fsX740, L586fsX658, V570fsX576, R413X, and P533fsX561) and predicted to cause a premature truncation of the plakophilin-2 protein. Family studies showed incomplete disease expression in mutation carriers and identified a number of individuals who would be misdiagnosed with the existing International Task Force and modified diagnostic criteria for ARVC.Conclusions - In this study, we provide new evidence that mutations in the desmosomal plakophilin-2 gene can cause ARVC. A systematic clinical evaluation of mutation carriers within families demonstrated variable phenotypic expression, even among individuals with the same mutation, and highlighted the need for a more accurate set of diagnostic criteria for ARVC
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