367 research outputs found

    Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

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    Current teaching suggests that many patients are at risk for prolonged bleeding during and following invasive dental procedures, due to an acquired coagulopathy from systemic disease and/or from medications. However, treatment standards for these patients often are the result of long-standing dogma with little or no scientific basis. The medical history is critical for the identification of patients potentially at risk for prolonged bleeding from dental treatment. Some time-honoured laboratory tests have little or no use in community dental practice. Loss of functioning hepatic, renal, or bone marrow tissue predisposes to acquired coagulopathies through different mechanisms, but the relationship to oral haemostasis is poorly understood. Given the lack of established, science-based standards, proper dental management requires an understanding of certain principles of pathophysiology for these medical conditions and a few standard laboratory tests. Making changes in anticoagulant drug regimens are often unwarranted and/or expensive, and can put patients at far greater risk for morbidity and mortality than the unlikely outcome of postoperative bleeding. It should be recognised that prolonged bleeding is a rare event following invasive dental procedures, and therefore the vast majority of patients with suspected acquired coagulopathies are best managed in the community practice setting

    Unpacking the relationships between impulsivity, neighborhood disadvantage, and adolescent violence : an application of a neighborhood-based group decomposition

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    The research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP/2007–2013)/ERC Grant Agreement no. 615159 (ERC Consolidator Grant DEPRIVEDHOODS, Socio-spatial inequality, deprived neighbourhoods, and neighbourhood effects); and from the Marie Curie programme under the European Union’s Seventh Framework Programme (FP/2007–2013)/Career Integration Grant no. PCIG10-GA-2011-303728 (CIG Grant NBHCHOICE, Neighbourhood choice, neighbourhood sorting, and neighbourhood effects).Scholars have become increasingly interested in how social environments condition the relationships between individual risk-factors and adolescent behavior. An appreciable portion of this literature is concerned with the relationship between impulsivity and delinquency across neighborhood settings. The present article builds upon this growing body of research by considering the more nuanced pathways through which neighborhood disadvantage shapes the development of impulsivity and provides a situational context for impulsive tendencies to manifest in violent and aggressive behaviors. Using a sample of 12,935 adolescent from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (mean age = 15.3, 51% female; 20% Black, 17% Hispanic), we demonstrate the extent to which variation in the association between impulsivity and delinquency across neighborhoods can be attributed to (1) differences in mean-levels of impulsivity and violence and (2) differences in coefficients across neighborhoods. The results of a series of multivariate regression models indicate that impulsivity is positively associated with self-reported violence, and that this relationship is strongest among youth living in disadvantaged neighborhoods. The moderating effect of neighborhood disadvantage can be attributed primarily to the stronger effect of impulsivity on violence in these areas, while differences in average levels of violence and impulsivity account for a smaller, yet nontrivial portion of the observed relationship. These results indicate that the differential effect of impulsivity on violence can be attributed to both developmental processes that lead to the greater concentration of violent and impulsive adolescents in economically deprived neighborhoods as well as the greater likelihood of impulsive adolescents engaging in violence when they reside in economically disadvantaged communities.Publisher PDFPeer reviewe

    Age and skill bias of trade liberalisation? : heterogeneous employment effects of EU Eastern Enlargement

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    This study analyses the 2004 Eastern Enlargement to the European Union to obtain evidence on the employment effects of an increase in trade liberalisation. The Enlargement is thought to generate a trade-induced demand shock with no (or only limited) supply effects. Besides the variation over time induced by the Enlargement, identification of the effects is based on a Melitz (2003) type productivity term to differentiate firms by the extent of exposure to the demand shock. The idea is that the effects of the demand shock should be driven by differences in firm-level productivity from the period before the new member countries actually entered the EU. German linked employer-employee data allow to observe the relation of initial establishment productivity with employment changes over a long panel from 1995 to 2009. The estimates show that the Enlargement had a negative effect on establishment-level employment growth, which is driven by increased worker separations and increased job destruction. Besides the overall employment effect, the study focuses on effect heterogeneity across age and skill groups of the workforce. These estimates point to a skill bias in the effect of the Enlargement that disadvantages low- and medium-skilled workers in terms of higher worker separation and job destruction. In addition, lowskilled workers suffer fewer accessions by firms, where against medium-skilled workers enjoy increased accessions and creation of new jobs. Besides this indication for a skill bias, there are no clear indications that point to an age bias in the employment effect of the Eastern Enlargement

    The disruption of proteostasis in neurodegenerative diseases

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    Cells count on surveillance systems to monitor and protect the cellular proteome which, besides being highly heterogeneous, is constantly being challenged by intrinsic and environmental factors. In this context, the proteostasis network (PN) is essential to achieve a stable and functional proteome. Disruption of the PN is associated with aging and can lead to and/or potentiate the occurrence of many neurodegenerative diseases (ND). This not only emphasizes the importance of the PN in health span and aging but also how its modulation can be a potential target for intervention and treatment of human diseases.info:eu-repo/semantics/publishedVersio

    The cost of holding foreign exchange reserves

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    Recent studies that have emphasized the costs of accumulating reserves for self-insurance purposes have overlooked two potentially important side-effects. First, the impact of the resulting lower spreads on the service costs of the stock of sovereign debt, which could substantially reduce the marginal cost of holding reserves. Second, when reserve accumulation reflects countercyclical LAW central bank interventions, the actual cost of reserves should be measured as the sum of valuation effects due to exchange rate changes and the local-to-foreign currency exchange rate differential (the inverse of a carry trade profit and loss total return flow), which yields a cost that is typically smaller than the one arising from traditional estimates based on the sovereign credit risk spreads. We document those effect s empirically to illustrate that the cost of holding reserves may have been considerably smaller than usually assumed in both the academic literature and the policy debate

    The role of art education in adult prisons: The Western Australian experience

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    Incarceration costs are high; in Australia, for example, each prisoner costs an average of AUD 115,000 per year. Other countries are also feeling the fiscal pinch of high incarceration costs, and a number of jurisdictions are now closing some of their prisons. Most prison costs are non-discretionary (accommodation, meals, etc.). But some of the costs relate to discretionary activities, services and facilities (including schooling). In terms of correctional education, many prison managers try to invest any meagre correctional education resources available to them in those classes and courses which have proven to have the best results, such as improved labour market outcomes and reduced recidivism, minimising subsequent re-imprisonment. Course offers for prisoner-students include vocational training, adult basic education (ABE) and art studies. The two-tiered question this paper asks is: do art classes and courses produce these measurable outcomes and, if not, are there other reasons why they should continue to be funded? Addressing these issues, the authors argue that (1) these measurable outcomes are too narrow and do not reflect the complex but less quantifiable benefits to the individual and the community of studying art in prison, and (2) better measures of all impacts of art studies in prisons are needed, including qualitative and humanitarian aspects
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