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It would not be possible to undertake a meaningful intermodal benchmarking study without collecting performance and background data directly from all the main service providers and customers. The extent to which such studies could draw on published information provided by third parties would depend on the nature and scope of each individual intermodal benchmarking study. This would need to be examined on a country-by-country basis. Case study of an integrated intermodal port There are many geographic groupings that could provide interesting and meaningful intermodal container transport benchmarking studies. For any such grouping, or indeed for any benchmarking study, it is imperative to include an entity that can be considered as "best practice". In this way, the benchmarking study establishes the magnitude of performance improvement that other participants should be capable of achieving and provides a guide to the practical steps that could be taken to achieve these productivity improvements. Port performance will be central to the effective intermodal operations of supply chains that involve a sea transport component. Thus, it is important that intermodal container transport studies include ports that have implemented leading practices to ensure effective intermodal integration. A recent study carried out for the Australian Marine and Ports Group MPG, 1998 ; 22 by Tasman Asia Pacific and Meyrick and Associates, examined measures to improve the efficiency and effectiveness of container and breakbulk ports. Examining measures to improve intermodal integration was a central part of this study, which included an international factfinding mission covering eight leading ports: Vancouver, Seattle, Tacoma, London, Felixstowe, Rotterdam, Antwerp and Zeebrugge. Intermodal integration was a problem in all the ports visited in the MPG study. Port authorities and service providers were generally well aware of the problems encountered by shippers and were initiating a range of actions to improve the flow of cargo. However, many of the problem areas lay outside their jurisdictions. The ports with the best record in achieving integration between modes took a proactive approach to removing bottlenecks by bringing together parties with a mutual interest in solving the problem or by directly providing services themselves. From an institutional perspective, the most innovative solutions to this problem were found in Vancouver. While Vancouver has many problems to be resolved within its transport chain, it does provide a useful case study of what can be achieved through co-operation among the different players in the chain. For immediate portrelated problems, the Vancouver Port Corporation provides a particularly useful role model as a strategic, wholeofport collaborative manager. At the city level, the Greater.
The purity of the pCSPG was assessed by sodium dodecyl sulfatepolyacrylamide gel electrophoresis SDSPAGE ; . The pCSPG and even the core protein released by treatment with chondroitinase ABC did not enter a 5% polyacrylamide gel data not shown ; . Even on 4% polyacrylamide and 0.5% agarose copolymer gels, the pCSPG and core protein barely entered the gel Figure 2A ; . However, these electrophoretic analyses indicated that the pCSPG is completely free of the contaminating lower-molecular-weight proteins. To investigate the size of the residual core protein or peptide moiety ; in total cCSA and in the cCSA fractions I and II, the samples were analyzed by SDSPAGE using 15% gel before and after treatment with chondroitinase ABC Figure 2, and data not shown ; . The majority of the cCSA electrophoresed as a broad diffused band in the size 637.
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Costs of these are based on the expected number of patients requiring treatment over the year or from expected launch dates for new drugs ; . The trust's planning and advisory committee assigned a high priority to the drug proposals submitted to the commissioners. Supporting documentation summarised evidence from a range of sources, including randomised trials reported in peer reviewed journals, independent reports, 6 and unpublished data, alongside statements of funding needs and implications. Collecting evidence The commissioners then obtained further evidence by contacting doctors, searching Medline for relevant drug trials that had taken place between 1970 and 1997, retrieving secondary references, and contacting pharmaceutical companies. Published reports were appraised for each drug proposal, to assess its validity, relevance, and cost effectiveness.7 The impact of new interventions on survival and quality of life were compared, where evidence was available, with standard.
PCI versus medical therapy or CABG. Compared with balloon angioplasty, coronary stent implantation has improved procedural success, decreased acute occlusion, need for emergency bypass, and the risk of restenosis. For these reasons, stent therapy has become the dominant method of percutaneous revascularization. Operators now routinely intervene in patient and lesion subsets that previously were the domain of cardiac surgeons. The year 2005 provided us with the first long-term results of comparative efficacy of bare-metal stents BMS ; versus coronary artery bypass surgery. Serruys et al. 41 ; reported the five-year follow-up of 1, 205 patients with multivessel disease randomized to BMS or bypass. At five years, mortality 8% vs. 7.6%, p NS ; and freedom from death, stroke, and myocardial infarction 18.2% vs. 14.9%, p NS ; were similar for stent or bypass patients. Target vessel revascularization TVR ; was higher for the stent group 30.3% vs. 8.8%, p 0.001 ; , and a trend to higher mortality occurred in the subgroup of 208 patients with diabetes treated with stents 13.4% vs. 8.3%, p 0.27 ; . Rodriguez et al. 42 ; reported strikingly similar five-year results from the 450 patients treated in the Argentine Randomized Trial of Coronary Angioplasty with Stenting versus Coronary Bypass Surgery in Patients with Multivessel Disease ERACI ; II. Mortality and freedom from death myocardial infarction were similar, but TVR was higher for the stent-treated patients.
Theory of Werner, the black veins were consequently of a more recent formation than the white. Being a disciple of the school of Freyberg, I could not but pause with satisfaction at the rock of Uinumane, to observe the same phenomena near the equator, which I had so often seen in the mountains of my own country. I confess that the theory which considers veins as clefts filled from above with various substances, pleases me somewhat less now than it did at that period; but these modes of intersection and driving aside, observed in the stony and metallic veins, do not the less merit the attention of travellers as being one of the most general and constant of geological phenomena. On the east of Javita, all along the Cassiquiare, and particularly in the mountains of Duida, the number of veins in the granite increases. These veins are full of holes and druses; and their frequency seems to indicate that the granite of these countries is not of very ancient formation. We found some lichens on the rock Uinumane, opposite the island of Chamanare, at the edge of the rapids; and as the Cassiquiare near its mouth turns.
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Evaluation Data What have you learned through your participation in this course? If any of this was a new insight, please indicate this. New insights into chronic illness, compliance. Learnt about the new terms of adherence and concordance. Learnt in depth about Rheumatoid Arthritis and gained insight into what it is like to live with this disease. Learnt that words have connotations, i.e. one cannot take them at face value. This was definitely a new insight. I have learnt the implications of a chronic disease to a patient. I have learnt that pharmacists have an important role to play in a chronic patient, and what this role is. I have learnt not to take what a patient says at face value, but rather to dig deeper. This course was extremely valuable. It gave me a great understanding about chronic illness and chronic patients. I got better insight into how to deal with chronic patients and how to manage them. I got a great understanding of concordance, compliance and adherence which was very valuable. Interviewing an actual patient, with a chronic illness was great. It was very good experience and I learnt a lot from this. Also very interesting and enjoyable. Most importantly, I learnt how to distinguish between what we as health care givers may perceive an illness to be, vs. how a patient may experience this illness. This difference emphasized the need for concordance in establishing a health care regimen for a patient, to attempt to influence adherence. The course incorporated all forms of chronic illness, not just Rheumatoid Arthritis, but I did feel that I now more aware and knowledgeable regarding RA drugs, their indications and side effects. Not only did we focus on the use of language and empathy in conversation with the patient, we established that words used within their context or intent may be interpreted differently by another, and the impact this has on the mind, attitude and opinions. How concordance works; comparison between concordance, adherence and compliance, gave me deep insight on how to improve patient quality of life. Conducting interview on real patient, gives the opportunity to experience what one can expect as a pharmacist in real life. How to present reports and to discuss the findings. I have learnt to take the whole person into account when designing pharmaceutical care plans. Also learnt about meanings of "words" to patients. That chronic illness is so far very different to any other illness, it needs a different approach and complete participation of the patient. There is disparity between understanding between the health professional and patients. To achieve common understanding there should be compromises from both parties and tracleer.
Fiji water started as rainfall 450 years ago. It filters down through volcanic rock, the remoteness of the South Pacific keeping it pure.
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Leskinen, S. 2002. The Late Neolithic house at Rusavierto. In H. Ranta ed. ; , Huts and Houses: Stone Age and Early Metal Age Buildings in Finland: 147-70. National Board of Antiquities, Helsinki. Lompolo, V. 2002. Sodankyln Kitisen kivikautiset ja varhaismetallikautiset kohteet. Vaajasuvanto SE: n, Matti-Vainaan palo 2: n ja Poikamellan asuinpaikkojen sisisen rakenteen analyysi. Unpublished MA thesis. Institute for Cultural Studies, Department of Archaeology, University of Turku. Meinander, C.F. 1976. Hyddbottnar av Madeneva-typ. Iskos 1: 26-9. Olsen, B. 1994. Bosetning og samfunn i Finnmarks forhistorie. Universitetsforslaget, Oslo. Pesonen, P. 1996. Posion Kuorikkikankaan asumus. Muinaistutkija 1 1996: 19-25. Pesonen, P. 2002. Semisubterranean houses in Finland: a review. In H. Ranta ed. ; , Huts and Houses: Stone Age and Early Metal Age Buildings in Finland: 9-41. National Board of Antiquities, Helsinki. Ranta, H. 2002 ed. ; . Huts and Houses: Stone Age and Early Metal Age Buildings in Finland. National Board of Antiquities, Helsinki. Ukkonen, P. 1993. The post-glacial history of the Finnish mammalian fauna. Annales Zoologici Fennici 30: 249-64. Viljanmaa, S. 2004. Ehj liuske-esineist asuinpainanteista: ktkettyj muinaiskaluja. Muinaistutkija 3 2004: 18-25.
Vagina 1.RS.35. vitreous 1.CM.35. vocal folds 1.GA.35. vulva 1.RW.35. wound see Pharmacotherapy, soft tissue or skin, by site ; Instruction see also Education or Training ; activities of daily living eating, bathing, grooming, transfers, housekeeping ; 6.VA.50. biofeedback 7.SP.59. monitoring health status vital signs, glucose level, self exam, detection disease ; 7.SP.59. physical exercize 7 .59. self care administration management of oxygen, medication, healthcare devices, wounds ; 7 .59. visual aid appliances 7 .59. weight loss or gain ; 7.SP.59. Instrumentation atlas and axis with bone grafting 1.SA.75. without bone grafting 1.SA.74. joints, occipitoatlantal, without bone grafting 1.SA.74. root canal 1.FF.59. spinal vertebrae with bone grafting 1 .75. without bone grafting 1 .74. Insufflation cavity, pleural 1.GV.35. eustachian tube 1.DJ.35. fallopian 2.RF.58. lungs NEC 1.GT.35. Insulin level 4.CY.39.02 antibody 4.KC.27.02 Insulin like growth factor 4.CY.37.02 Interposition uterus 1.RM.74. Interpretation language services 7.SF.19. Interruption innervation peripheral, central or perivesical ; , bladder 1.PM.11. vena cava 1.IS.51. Interview, diagnostic see Assessment, by type ; Intimectomy 1.JE.57. Intraatrial mapping of tachycardia sites ; 2.HZ.24. Intracardiac electrophysiological recording studies 2.HZ.24. Intraventricular mapping of tachycardia sites ; 2.HZ.24. Intrinsic factor antibody 4.KC.28.02 Intubation ducts, bile 1.OE.50. esophagus 1.NA.52. eustachian tube 1.DJ.53. trachea [endotracheal] 1.GJ.53. Inversion diverticulum intestine large 1.NM.80. small 1.NK.80. tunica vaginalis 1.QH.80. Iodine level 4.CM.10.02 Iridectomy peripheral, sector ; 1.CH.87. for drainage of anterior chamber of eye 1.CJ.52. Iridocyclectomy 1.CG.87. Iridocystectomy peripheral ; 1.CH.87. Iridoplasty 1.CH.80. Iridosclerotomy 1.CH.87. Iridotomy NOS laser ; 1.CH.87 and tranylcypromine.
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Table 4. 'H-Thymidine Uptake of the Kasumi-1 Cells With Recombinant Hematopoietic Growth Factors.
MSKCC-98014, NCI-G981445 Phase III Randomized Study of the Effect of a Diet Low in Fat and High in Soy, Fruits, Vegetables, Green Tea, Vitamin E, and Fiber on PSA Levels in Patients With Prostate Cancer Chairperson: Moshe Shike. Telephone: 212-639-7846. Lead organization: Memorial Sloan-Kettering Cancer Center. Age range: 18 and over. UCLA-0001030, NCI-G011973 Phase II Randomized Study of the Effects of a Low Fat, High Fiber Diet or Androgen Deprivation Therapy on Serum Factors in Patients With Prostate Cancer Chairperson: William Aaronson. Telephone: 310-268-3446. Lead organization: Jonsson Comprehensive Cancer Center, University of California, Los Angeles. Age range: 40 to 80. SWOG-0000, NCI-P00-0172 Phase III Randomized Study of Selenium and Vitamin E for the Prevention of Prostate Cancer SELECT Trial ; Chairperson: Eric Klein. Telephone: 216-444-5591. Lead organization: Southwest Oncology Group. Age range: 55 and over 50 and over for African Americans and treprostinil.
1. 2. 3. Need identified for creation of practice protocol for bone protection: Prevention screening diagnosis treatment follow-up. Need identified for practice leaflet for non-pharmacological interventions i.e. lifestyle modification for primary and secondary prevention. Need identified for dietary education, which could reduce calcium prescribing. Practice protocol for rational standardised prescribing habits established. Practice questionnaire for assessment risk factors for osteoporosis established. Clear-cut recall system for repeat DEXA scanning at interval not less than 2 years established for the practice. Need to improve communication between primary and secondary care and ensure rationale for bone protective agents was clearly defined and if not, standard letter sent back to the consultant to establish need for drugs.
Poisoning by agents primarily affecting blood constituents 964.0 Iron and its compounds Ferric salts and triac.
Dust, and requires a stable supply of electricity and highly trained lab technicians. To date there has been little investment in developing monitoring tools that can be used in resource-poor settings and it could be several years before recently-launched initiatives bring needed monitoring tools to market. Long-term management of HIV AIDS calls for access to first-line and second-line combinations with minimal side-effects and tools for simplified virological monitoring to allow accurate detection of treatment failure and identification of the optimal time to switch to second-line. These and other challenges require a shift in research and development efforts to ensure that new tools are designed with specific concern for the problems of providing treatment in resource-poor settings.
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Introduction Several studies have shown that male infertility can be caused by sperm DNA damage Aitken, 1999; Host et al., 2000; Larson et al., 2000; Morris et al., 2002; Tomsu et al., 2002; Benchaib et al., 2003; Carrel et al., 2003; Henkel et al., 2004; Tesarik et al., 2004a ; . However, the pathophysiological mechanism leading to sperm DNA damage is understood only incompletely, and no specific treatment for infertility caused by this condition has yet been proposed. Even though the pattern of sperm DNA damage fragmentation ; closely resembles that resulting from programmed cell death also called apoptosis ; in somatic cells, several studies have questioned the causal relationship between the activation of the classical apoptotic pathway and DNA frragmentation of mature human spermatozoa Sakkas et al., 2002; Henkel et al., 2004; Moustafa et al., 2004; Lachaud et al., 2004 ; . We have shown recently that the classical cell death signalling pathway, in which caspase activation is followed by phosphatidylserine externalization marking the cell as target for phagocytosis, is active while germ cells remain in 226 and triazolam
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