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PubMed2003

AACR Special Conference in cancer research: ubiquitination in normal and cancer cells.

The AACR Special Conference 2002 for Ubiquitination in Normal and Cancer Cells took place in Vancouver, BC, Canada. It was, indeed, special: a "special" location, a "special" audience and excellent talks that gave a detailed insight into the ubiquitination/proteasome-field. The following meeting highlights try to give a summary of some topics covered at the meeting, from basic research to successful applications of therapeutic agents, starting with cellular regulation, describing recently discovered structural features of enzymes involved in de-/ubiquitination, and, finally, presenting proteasome inhibition as a new approach in cancer chemotherapy.

Animals↗
PubMed2001

American Academy of Pediatrics: Committee on Injury and Poison Prevention. School bus transportation of children with special health care needs.

School systems are responsible for ensuring that children with special needs are safely transported on all forms of federally approved transportation provided by the school system, and a plan should be developed to provide the most current and proper support to children with special transportation requirements. This statement provides current guidelines for the protection of child passengers with specific health care needs, including those with a tracheostomy, those requiring use of car seats, or those transported in wheelchairs. Guidelines that apply to general school transportation should be followed, including the training of staff, provision of nurses or aides if needed, establishment of a written emergency evacuation plan, and a comprehensive infection control program. Research provides the basis for recommendations concerning occupant securement for children in wheelchairs and children with other special needs who are transported on a school bus. Pediatricians can help their patients by being aware of guidelines for restraint systems for children with special needs and by remaining informed of new resources. Pediatricians can also play an important role at the state and local level in the development of school bus specifications.

Child↗
PubMed2006

Role of insurance for children with special health care needs: a synthesis of the evidence.

OBJECTIVE: Children with special health care needs constitute a particularly vulnerable subpopulation of children. Health insurance coverage has the potential to enhance access to care and improve the quality of life for these children while protecting their families from financially burdensome health care expenses. The purpose of this review is to assess and synthesize recent research in the peer-reviewed literature pertaining to the role of insurance for children with special health care needs. A marked increase in the volume of research on this topic makes this an opportune time to summarize these contributions and begin the process of formalizing an evidence base that can inform health policy decisions. Our intention is to further the evidence base by providing a literature-driven assessment of the role of health insurance in influencing access, utilization, satisfaction, quality, expenditures, and health outcomes for children with special health care needs. METHODS: A systematic literature review was conducted on the effects of insurance status, insurance type, and insurance features on access, utilization, satisfaction, quality, expenditures, and health status. RESULTS: The strongest evidence emerged for the positive effects of insurance on access and utilization. Limited evidence on the effect of insurance on satisfaction with care showed improved satisfaction ratings for the insured. The studies with findings relevant to out-of-pocket expenditures for insured versus uninsured children with special health care needs all found significantly higher out-of-pocket burden and financial problems among the uninsured. Evidence was mixed for the effects of insurance type (public or private) and insurance characteristics (eg, managed care or fee-for-service payment mechanisms) on outcomes. None of the studies that we reviewed attempted to assess the impact of health insurance on health outcomes. CONCLUSIONS: Our review of the literature found plentiful evidence demonstrating the positive and substantial impact of insurance on access and utilization. There also is clear evidence that insurance protects families against financially burdensome expenses. The evidence is less conclusive for satisfaction and quality and is nonexistent for health status. These latter outcomes should be the focus of future studies.

Adolescent↗
PubMed2006

Habitat specialization and the exploitation of allochthonous carbon by zooplankton.

The significance of spatial subsidies depends on consumer resource interactions in the recipient habitat. Lakes are subsidized by terrestrial carbon sources, but the pathways of allochthonous carbon through lake food webs are complex and not well understood. Zooplankton vertically partition resources within stratified lakes in response to life history trade-offs that are governed by predators, the quantity and quality of food, and abiotic conditions (e.g., UV, temperature, and viscosity). We measured habitat specialization of zooplankton in an oligotrophic lake where allochthonous and autochthonous resources varied with depth. During stratification, the quantity and quality of zooplankton food was highest in the hypolimnion. We used a yearlong time series of the delta13C of zooplankton and particulate organic matter (POM) to determine which zooplankton species exploited hypolimnetic rather than epilimnetic resources. Because the delta13C of POM decreased with depth, we used the delta13C of zooplankton to detect inter- and intraspecific variation in habitat selection. We incubated Daphnia pulex at discrete depths in the water column to confirm that the delta13C of zooplankton can indicate habitat specialization. Zooplankton that specialized in the epilimnion relied more on allochthonous carbon sources than those that specialized in the hypolimnion. Therefore, the fate of allochthonous carbon subsidies to lakes depends on spatially explicit consumer-resource interactions.

Analysis of Variance↗
PubMed2006

Vaccination in special situations.

OBJECTIVE: To review the indications, contraindications and efficacy of vaccination in some special situations: immunosuppression, prematurity, pregnancy and post-exposure situations. SOURCES OF DATA: Systematic review of articles published during the two last decades, found in MEDLINE, SciELO and Lilacs databases; guidelines of Programa Nacional de Imunizações (Brazilian National Immunization Program), 2001 to 2004, and of Programa Nacional de DST/AIDS (Brazilian National STD/AIDS Program), 2004. Abstracts published in national and international pediatric and infectious disease congress annals during the last five years were also consulted. SUMMARY OF THE FINDINGS: Some special situations, such as immunosuppression, prematurity, pregnancy and exposure to infectious diseases increased the risk of diseases or adverse post-vaccination events. In these situations, special vaccines or special vaccination schedules are indicated, or vaccines should be postponed or even forbidden. In general, toxoid or inactivated vaccines can be used, considering the possibility of insufficient immune response. For immunosuppressed patients, in accordance with the type of immunosuppression, live virus or bacterial vaccines should be avoided, because of the risk of vaccine agent spread. Immunization should include not only the patient, but his/her home and day-care contacts as well. CONCLUSIONS: Knowledge about the schedule indicated for each situation improves the chances of better vaccine protection and decreases the risk of adverse events. Immunosuppressed or immunodeficient patients whose post-vaccine antibody titers are not available should be considered susceptible when exposed to infectious disease, and all the available prophylactic measures should be implemented, even when the vaccination schedule is correct.

Adolescent↗
PubMed2003

Comparison of prices paid for feeder calves sold at conventional auctions versus special auctions of vaccinated or conditioned calves in Ontario.

OBJECTIVE: To determine whether vaccinated or conditioned feeder calves sold through special auctions in Ontario commanded a premium, compared with feeder calves sold at conventional auctions, and whether various physical characteristics of the calves were associated with the sale price. DESIGN: Cross-sectional study. ANIMALS: 14,037 calves sold through conventional and special auctions at the Keady Livestock Market during the fall of 1999 and 2000. PROCEDURE: Calves were observed as they were sold by lot in the auction ring. Lot characteristics and the price received for each lot were recorded. Multivariate analysis was used to estimate the effect of lot characteristics and sale type on price. RESULTS: Information was recorded for 2,601 calf lots. Multivariate analysis indicated that various lot characteristics were associated with sale price, with 68% of the variation explained by the model. Overall, lots sold at special auctions received a premium of 0.06 dollars/lb (Canadian dollars), compared with lots sold at conventional auctions. However, the premium varied with mean body weight of the lot and year. In addition, frame size, breed, body condition score, uniformity of the lot, weaning status, mean body weight, lot size, sex, year, and sale type were significantly related to sale price. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that producers selling calves at special auctions at this market received a premium, compared with producers selling calves at conventional auctions.

Animal Husbandry↗
PubMed1999

Special medical examination program reform proposal in Korea.

We are at a time when reform in the special medical examination program in keeping with the changing times is desperately needed because the common perception of workers, employers, and medical examination facilities is "special medical examination is merely ritualistic and unproductive." Therefore, we have tried to set forth the basic structure for reforming the special medical examination program by taking a close look at the management status of the current program and analyzing its problems. The specifics of the special medical examination program reform proposal consist of three parts such as the types, health evaluation based on occupational medicine, and the interval, subject selection, items and procedure. Pre-placement medical examination and non-periodic medical examinations-as-necessary are introduced newly. Health evaluation based on occupational medicine consists of classification of health status, evaluation of work suitability, and post-examination measure. Details regarding the medical examination interval, subject selection, items and procedure were changed.

Government↗
PubMed2001

Online data collection with special populations over the World Wide Web.

The quick ascendance of the World Wide Web as the dominant vehicle for internet communication has recently made experimentation in a multimedia environment feasible on the Internet. Although web sites containing online psychology demonstrations and experiments for non-handicapped individuals have appeared in recent years (especially in the areas of cognitive and social psychology), there appear to have been few attempts to conduct online experimentation with special populations. We recently completed two online pilot studies of families with Down syndrome or Williams syndrome members: a) A survey that asks (via Likert rating scales, adjective checklists, multiple-choice style questions, and text-entry boxes) about family background, computer use, and temperament of the special needs family member; and b) An experiment (completed by an individual with special needs) that includes auditory and visual digit span tasks and a memory-for-orientation task in which responses are entered via mouse clicks. Recruiting began with e-mail announcements to representative Down syndrome and Williams syndrome discussion groups, listserves, and bulletin boards, and submission of the project's URL (http://www.cofc.edu/~marcellm/testaw.htm) and key indexing terms to selected search engines. This paper reviews technical aspects of developing the online programmes as well as the strengths and weaknesses of online vs. traditional laboratory-based research in relation to issues such as experimental control, delivery of instructions, experimenter bias, participant recruitment, sample heterogeneity, generalization, attrition, privacy, financial costs, data integrity, and ethics. We conclude by offering our thoughts on two ways of implementing online experimentation with special populations: a) Using a remote parent 'helper' as a proxy to work with the target individual; and b) Collaborating with professional colleagues in Web-based projects conducted in traditional laboratory settings.

Child, Preschool↗
PubMed1996

Activities and users' views of a special seating clinic.

We carried out an audit of the activities of a subregional special seating clinic from the departmental records covering a period of 1 year. A total of 113 patients were seen in the clinic; 64.6% of these were first-time referrals. Cerebral palsy was given as the primary diagnosis for 84.9% of the patients and the mean age was 12.2 years; 62.8% of the patients were provided with special seats, whereas 21.2% needed only a change of wheelchair to a more appropriate model. Though there appears to be a fairly high degree of satisfaction of the special seating clinic, the need for agreed and recorded goals at the assessment clinics, regular review arrangements and further research into usage pattern, as well as in other areas of special seating, is identified.

Adolescent↗
PubMed2001

[A comparison of differences in the outcome (hospitalization and mortality) between two special nursing homes of the same size managed by the same organization].

The purpose of this study was to examine the usefulness of information about outcome in evaluation of the quality of special nursing homes. Two special nursing homes A and B were selected. These two facilities were the same in their service capacity and are also owned as well as managed by the same organization. There were no differences in the structural elements between the two facilities. The hospitalization and mortality rate of the two facilities were compared. There were no significant differences in terms of the distribution of the characteristics of the residents between facility A and B at the time of their admission. However, the average survival time of the persons who died was significantly shorter in facility B than that in facility A. (A facility = 1,165 days, B facility = 831 days; p < 0.05). There were significant differences in cumulative survival and non-hospitalization rate of residents in the two facilities (p < 0.05). The differences were seen even after controlling for the prognostic factors by Cox's proportional hazard model (hazard rate: mortality = 1.562, hospitalization = 2.526, p < 0.01). Furthermore, the proportion of residents hospitalized right after their first visit to the hospital was significantly higher in facility B than that in facility A (A = 9.6%, B = 19.3%; p < 0.05). Also, the mortality risk of hospitalized persons was significantly higher than non-hospitalized persons in facility B (p < 0.05), although there was no significant difference in terms of the mortality risk between the two groups in facility A. Because the differences in the cumulative survival and non-hospitalization rate could occur in the facilities that are similar in institutional structures, it suggests that these outcomes are indicators of the quality of special nursing homes. It would be, therefore, important to collect the information about outcome including cumulative survival and non-hospitalization rate of the residents in order to evaluate the quality of special nursing homes.

Aged↗
PubMed1992

Alzheimer's disease. Special care units in long-term care facilities.

Special units in long-term care facilities have been developed to respond to the needs of residents with Alzheimer's disease. The underlying assumption is that specific environmental and programmatic modifications will enhance the quality of life for Alzheimer's patient's. Descriptive accounts of special care units for Alzheimer's disease reveal wide variations in philosophies, therapeutic approaches, protocols for behavioral management, staff education, and environmental design. Facilities with special care units used fewer chemical and physical restraints, reported a decrease in the number of problem behaviors, and indicated that environmental changes provided a personal sense of freedom and dignity. Nurses should be aware of the potential benefits of special units and advocate for their use if behavioral problems are severe enough to require the use of chemical or physical restraints.

Aged↗
PubMed1991

Quality assurance: monitors in special care.

Special care units need to establish economically feasible and meaningful monitors to evaluate patient care needs. High-cost areas, such as special care, monitor appropriate use of resources in high-risk, high-volume, and problem-prone areas. The monitoring process needs to provide information regarding the quality of care in the special care unit without greatly decreasing time spent by staff in direct patient care. This chapter discusses development of efficient monitoring tools for quality assurance indicators in the special care unit.

Humans↗
PubMed1999

[Why hospitalize stroke patients in a specialized unit?].

A PUBLIC HEALTH CHALLENGE: Cerebral vascular events are the third most frequent cause of death in the adult population and the number one cause of disabilities, a public health challenge both in terms of health care service and health care expenditures. SPECIALIZED UNITS: Structured health care facilities, particularly specialized hospital units, can lower mortality, limit residual disability and reduce the need for long-term institutionalization. OUTLOOK: Specialized research and teaching units are paradigmatic of the impact of health care organization. The limited number of such specialized units in France raises important ethical considerations about effective access to health care. Functioning units could be a useful criteria for auditing quality of hospital facilities.

Adult↗
PubMed2000

A bibliography for the conclusions to the special issue of Science of the Total Environment concerning 'The water quality of UK rivers entering the North Sea'. Sci. Tot. Environ., this volume.

In this document, a bibliography for the conclusions to the special issue of Science of the Total Environment concerning 'The water quality of UK rivers entering the North Sea'. Sci. Tot. Environ., this volume, is presented. It comprises a list of the papers presented in five special issues in learned journals, three in Science of the Total Environment (this volume and volumes 194/195, 1997 and 210/211, 1998) as well as Hydrological Processes (1999, vol 13: Special Issue, River Basin Sediment Dynamics, eds. Anderson, M.G., Peters, N.E. and Walling, D.E.) and Marine Pollution Bulletin [1999, vol 37(3-7) Special Issue: Flux of Materials between Rivers and Coastal Waters, eds. Stebbing, A.R.D., Huntley, D. and Leeks, G.J.L.]. The bibliography comprises six main sections with subsections for specific water quality issues. These are as follows: Section 1 deals with the introduction to LOIS and contained in this section is background material over the nature of the programme, the study area, remit, water quality issues and international context. Section 2 provides the main meat to the bibliography and it splits into Section 2.1 historical and Section 2.2 current water quality issues. Within Section 2.2 there are subsections dealing with specific current aspects of water quality (Section 2.2.1, major ions; Section 2.2.2, pH, dissolved carbon dioxide and dissolved oxygen; Section 2.2.3 nutrients; Section 2.2.4, trace elements; Section 2.2.5 micro-organics; Section 2.2.6 sediments; Section 2.2.7 biology). Section 3 deals with hydrology and climate variability, Section 4, modelling, Section 5 load estimation and Section 6 conclusions. A full listing of the LOIS programme is available from the LOIS programme office, CCMS, Plymouth Laboratory, Prospect Place, West Hoe, Plymouth, PL1 3DH, UK (e-mail lois@ccms.ac.uk).

Carbon↗
PubMed2000

[Value of specialized pain treatment].

The paper describes new forms of specifically organized headache prevention and headache therapy in Germany with the aid of two examples. It provides an overview of the clinical and economic efficiency of facilities with new forms of organization for specialized pain therapy. Their effectiveness can be seen both in a marked reduction in individual suffering and in low-cost provision of services for the institutions bearing the costs and for society. This effectiveness can be seen not only from subjective parameters by interviewing the patients, but also from objective target parameters such as resumption of work, reduction in intake of medication, cost reductions due to reduced demands on the healthcare system, avoidance of premature pensioning. By contrast, patients who do not receive specially organized treatment despite the fact that they need it display either constant suffering or even a worsening of their symptoms and an increased need for financial compensation. In view of this clear situation, specialized headache and pain therapy with a special focus on catering for the needs of chronic headache suffering is called for, both on economic and ethical grounds.

Chronic Disease↗
PubMedDate not supplied

Specialized care for twin gestations: improving newborn outcomes and reducing costs.

OBJECTIVE: To compare newborn outcomes and costs of hospital stays for twins born to mothers receiving care in a specialized twin clinic with a research-based care protocol and one consistent caregiver versus twins whose mothers received standard prenatal care. DESIGN AND SETTING: A retrospective, historical cohort study conducted in a high-risk obstetric clinic in central Texas. PATIENTS: Thirty women pregnant with twins received specialized care. The comparison group consisted of 41 women pregnant with twins who received standard care. INTERVENTIONS: An advanced practice nurse provided prenatal care, which included weekly clinic visits, home visits, and 24-hour availability for phone support. OUTCOME MEASURES: Gestational age at birth, birth weight, length of stay in the neonatal intensive-care unit (NICU), and hospital charges for the newborns. RESULTS: No newborns of less than 30 weeks gestation were born to women in the specialized care group, the mean birth weight was 249 g (SD +/- 77) higher, days in the NICU were reduced from a mean of 17 to 7, and hospital charges were $30,000 less per infant. CONCLUSIONS: Newborn outcomes were improved and length of stay and hospital charges were significantly reduced for newborns whose mothers had received care in the specialized twin clinic.

Adult↗
PubMedDate not supplied

Nursing care of patients with multiple myeloma: a paradigm for the needs of special populations.

Multiple myeloma, a B cell malignancy that has its peak incidence in the elderly and affects African Americans more frequently than Caucasians, may be used as a paradigm to examine the concerns of special populations. Special populations are those who are medically underserved or medically underrepresented. Using this disease entity to focus on concerns of special populations and access to healthcare systems, the oncology nurse can formulate an approach to cancer care with a broader view of patients from special populations and their needs and goals.

Black or African American↗
PubMed2002

Medical devices; apnea monitor; special controls. Final rule.

The Food and Drug Administration (FDA) is issuing a final rule to create a separate classification for the apnea monitor. The device currently is included in the generic type of device called breathing frequency monitors. The apnea monitor will remain in class II, but will be subject to a special control. The special control is an FDA guidance document that identifies minimum performance, testing, and labeling recommendations for the device. Following the effective date of this final classification rule, any firm submitting a 510(k) premarket notification for a "new" apnea monitor will need to address the issues covered in the special control guidance. However, the firm need only show that its device meets the recommendations of the guidance or in some other way provides equivalent assurances of safety and effectiveness. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the guidance document that will serve as the special control. FDA is taking these actions because it believes that they are necessary to provide reasonable assurance of the safety and effectiveness of the apnea monitor.

Apnea↗