Worst Part Research Articles

Be proud of the health service

I love my job and I work with a wonderful team. I think people in the UK should be positive about our unique health service. By all means weed out the bad parts, but do not forget the people who work daily to provide high quality care with smiles on their faces. Ignorance breeds negativity, while knowledge ensures best practice.

Lipodystrophy and quality of life in HIV: symptom management issues

The purpose of this study was to examine the incidence and prevalence of lipodystrophy-related symptoms in persons with HIV ( n = 165) and to determine the impact of these symptoms on health-related quality of life. Since the introduction of highly active antiretroviral therapy in HIV, the quality of life of persons is affected across the spectrum of the disease. The sample was composed of 165 persons from three national outpatient HIV settings (clinics and community-based organizations) in Boston, MA, Fresno, CA, and Victoria, TX. The descriptive, cross-sectional study included self-report instruments measuring lipodystrophy-associated symptom presence, intensity, and quality of life. The sample was primarily male (75.8%), with ethnicity represented across several groups including African American (30.9%), Hispanic/Latino (26.7%), White/Anglo (38.8%), Native American/Indian (1.8%), and other (1.8%). On quality-of-life measures, only 7.9% of the sample indicated excellent health, 28.5% indicated very good health, 22.4% indicated good health, and more than 40% indicated fair or poor health. Most of the participants indicated that aspects of their quality of life have equally good and bad parts (37.6%). Quality of life was significantly correlated with adequacy of income ( r = .241, p = .002), most recent CD4 count ( r = −.276, p = .012), and most recent viral load value ( r = .379, p = .019). In addition, bodily pain was significantly correlated with most recent CD4 count ( r = −.312, p = .004) and with lowest CD4 count ( r = −.191, p = .050). The results of the study indicate that quality of life is affected by HIV symptoms and that lipodystrophy-related symptoms may negatively affect quality of life.

Comparison of endoscopic procedures for colorectal cancer screening in women with mammography and Pap smear

Background This study compared the experiences of women who underwent endoscopic screening for colorectal cancer vs. their experiences with breast and cervical cancer screening by mammography and Pap smear, respectively. Methods Women who had either flexible sigmoidoscopy or colonoscopy as a screening procedure for colorectal cancer were asked to return a questionnaire by mail. In the questionnaire, they were asked about the procedure they had just undergone and to compare it with recent mammograms and Pap smears. Flexible sigmoidoscopy was performed without sedating the patient; colonoscopy was performed with the patient under deep sedation (midazolam, fentanyl, and propofol administered by an anesthesiologist). Results Responses were obtained from 258 women (88%). Of these, 152 had colonoscopy and 106 had flexible sigmoidoscopy. A total of 72% of respondents found colonoscopy to be a comfortable test. Only 26% found flexible sigmoidoscopy uncomfortable, which was similar to mammography and Pap smear, at 22%. In terms of the test considered to be the most embarrassing, the highest response rate (38%) was for the Pap smear. Most women had no preference as to the gender of the endoscopist, but 46% preferred a woman doctor for a Pap smear ( p < 0.001). Preparation was regarded as the worst part of the colonoscopy procedure; for flexible sigmoidoscopy, the procedure itself and the preparation were equivalent. Conclusions Women found flexible sigmoidoscopy or colonoscopy comfortable and less embarrassing than a Pap smear or a mammography. There was no preference with respect to the gender of the physician who performed the colorectal screening procedures, unlike the Pap smear. Most respondents would have the procedure again and would recommend it to others.

The worst part of the job

The worst part of the job

Quality control problem in printed circuit board manufacturing—An extended rough set theory approach

This paper presents a new heuristic algorithm, called extendedrough set theory, for reduct selection in rough set theory (RST) applications. This algorithm is efficient and quick in selecting reducts especially if the problem size is large. The algorithm is able to derive the rules and identify the most significant features simultaneously, which is unique and useful in solving quality control problems. A detailed comparison between traditional statistical methods, the RST approach, and the extended RST approach is presented. The developed algorithm is applied to an industrial case study involving quality control of printed circuit boards (PCBs). The case study addresses one of the common quality problems faced in the PCB manufacturing, namely, solder ball defects. Several features that cause solder ball defects were identified and the features that significantly impact the quality were considered in this case study. Two experiments with equal and unequal weights were conducted and the results were compared. The end result of the extended RST investigation is a set of decision rules that shows the cause for the solder ball defects. The rules help to discriminate the good and bad parts to predict defective PCBs. A large sample of 3,568 PCBs was used to derive the set of rules. Results from the extended RST are very encouraging compared to statistical approaches. The rules derived from the data set provide an indication of how to effectively study this problem in further investigations. This paper forms the basis for solving many other similar problems that occur in manufacturing and service industries.

The Dangers of Mechanical Investment Decision-Making: The Case of Hedge Funds

Over the last 20 years, investors have come to approach investment decision-making in an increasingly mechanical manner. Optimisers are filled up with historical return data and the 'optimal' portfolio follows almost automatically. In this paper we argue that such an approach can be extremely dangerous, especially when alternative investments such as hedge funds are involved. Proper hedge fund investing requires a much more elaborate approach to investment decision-making than currently in use by most investors. The available data on hedge funds should not be taken at face value, but should first be corrected for various types of biases and autocorrelation. Tools like mean-variance analysis and the Sharpe ratio that many investors have become accustomed to over the years are no longer appropriate when hedge funds are involved as they concentrate on the good part while completely skipping over the bad part of the hedge fund story. Investors also have to find a way to figure in the long lock-up and advance notice periods, which make hedge fund investments highly illiquid. In addition, investors will have to give weight to the fact that without more insight in the way in which hedge funds generate their returns it is very hard to say something sensible about hedge funds' future longer-run performance. The tools to accomplish this formally are not all there yet, meaning that more than ever investors will have to rely on common sense and doing their homework.

Bier's block using prilocaine: safe, cheap and well tolerated

To examine the safety of prilocaine Bier's block performed for Colles fracture manipulation, and assess patient satisfaction. Fifteen-year retrospective review of all patients undergoing Colles fracture manipulation with a prilocaine Bier's block looking for the incidence of significant neurological or cardiovascular events. A confidential questionnaire was administered to 50 consecutive patients to assess patient satisfaction with the method of anaesthesia. 1504 males with mean age 48 years and 5906 females with mean age 66 years received a prilocaine Bier's block for distal radial fracture manipulation. There were no documented incidences of anaphylaxis, arrhythmia, convulsions or collapse. Of 50 consecutive patients, all but two were satisfied with this form of anaesthesia. The pressure cuff inflation was considered the worst part of the procedure. Bier's block performed with prilocaine is at least as safe as other commonly used methods of anaesthesia for distal radial fracture reduction with high patient satisfaction. The procedure can be safely carried out by a single medical practitioner with appropriate patient monitoring and assistance from trained nursing staff.

Real Work, Not Busy Work

We know the complaints well: This reading is boring, the assignment doesn't make sense, and those random facts must be memorized. Students receive homework and must force themselves to complete it. They agonize for hours in front of the computer writing a paper, yet they eagerly spend even longer creating and updating their web pages. Why? Other complaints are even more familiar because we teachers often make them: so much grading to do, so many superficial essays to read, so many maps to scrutinize. We see grading as the worst part of our job and, if possible, we dump the task on teaching assistants. For hours we wade through blue books piled high on our desks, yet we relish spending even more time with our seminar students. Why?

The partnership.

The partnership.

Booby Trap: Cancer gene spurs production of DNA-assaulting chemicals that alert and defuse rescue molecule (Cancer; Oxidative damage)

Advancing age doesn't just spur ear hair growth and the development of crow's feet, it's also a powerful carcinogen: Cancer risk increases dramatically as people get older. Malignant cells possess severely jumbled DNA, which lays the groundwork for the genetic havoc that allows unbridled cell division. It's "like a bomb went off in the nucleus," says molecular geneticist Ronald DePinho of the Dana-Farber Cancer Institute in Boston. A new study suggests that cancer-spurring genes detonate these bombs at least in part by generating harmful molecules that might hamper the very protein that normally diverts a cell from the dark side. Researchers have long known that when mutations crank up the expression of cancer-causing genes called oncogenes, the p53 protein restrains cell division. If additional mutations disable p53, as is the case in more than half of all human cancers, tumors can result. How oncogene activation calls p53 to arms is mysterious, but researchers know that p53 responds to DNA damage. "We wondered whether oncogenes were creating a biochemical change in the cell that ultimately led to DNA damage, and that's why p53 was being activated," says Geoffrey Wahl, a geneticist at the Salk Institute for Biological Studies in La Jolla, California, and the paper's senior author. To find out, his group studied normal human fibroblasts--connective tissue cells--engineered to contain a copy of the c-myc oncogene that switches on in response to a drug. Activating c-myc yielded rampant DNA damage, particularly the double-stranded breaks so common in cancer cells. Wahl suspected that c-myc might wreck DNA by spurring the formation of toxic reactive oxygen species (ROS) (see "The Two Faces of Oxygen" ). Using a fluorescent dye that binds the chemicals, the scientists uncovered a two- to threefold increase in the amount of ROS upon c-myc activation. Adding the antioxidant N -acetyl- l -cysteine to cells that produce c-Myc protein significantly decreased ROS concentrations and cut the amount of DNA damage by about 80%. Cells that churn out c-Myc also carry elevated amounts of p53 in its functional form, further experiments revealed. Together, the results suggest that c-Myc might fire up p53 by creating ROS, which in turn damage DNA. Although these events would normally prompt p53 to halt cell division, c-Myc also appears able to override p53. The oncogene counteracted p53's ability to put the brakes on cell proliferation in response to ionizing radiation. Ten times more c-Myc-producing cells than control cells continued splitting after exposure to gamma rays. Wahl speculates that oncogene-induced ROS could cause additional mutations that diminish p53 function and allow a small percentage of cells to become cancerous. Other studies have linked ROS to cancer, but this is the first to show that activated oncogenes can generate ROS and contribute to the genomic instability that characterizes cancer cells, says DePinho. The issue of genome instability "stands at the nexus of aging and age-related disorders," he adds. Understanding the phenomenon could uncover ways to reduce the cancer risk that comes with age. That prospect raises hopes for leaving cancer worries behind and making spurious tendrils the worst part of growing old. --Christie Aschwanden O. Vafa, M. Wade, S. Kern, M. Beeche, T. K. Pandita, G. M. Hampton, G. M. Wahl, c-Myc can induce DNA damage, increase reactive oxygen species, and mitigate p53 function: A mechanism for oncogene-induced genetic instability. Mol. Cell 9 , 1031-1044 (2002). [Abstract] [Full Text]

The Challenge of School Completion among Youths with Behavioral Disorders: Another Side of the Story

Youths with behavioral disorders (BD) are less likely to complete high school than are their peers with or without disabilities. This study used individual interviews with 33 students with BD to identify factors that may affect high school completion. Interview questions directed attention to what youths perceived as the best and worst part of school, advantages or disadvantages with staying in school, changes to help individual youths stay in school, general recommendations for helping more youths stay in school, examples of how a teacher had really helped them, and their views of a high school diploma. We categorized youths’ responses for each of five questions, along with providing information on demographic and school history features. The responses, when combined with demographic and school history information, provide insight into changes that might help more youths to complete high school.

Georg Simmel and the Masculinity of Modernity

Current evaluations of Simmel’s theoretical writings on men, women and modernity have read these too generously, relying on a curate’s egg motif culling the good parts from the bad parts. The good parts are judged insightful and prescient, revealing the workings of a sociological imagination and even anticipating elements of contemporary feminist epistemology. The bad parts reveal the unfortunate incursion of ideological baggage or blinkered romanticism that periodically surface and impede the productive workings of the sociological imagination. A more astute reading is proposed here: one which recuperates the bad parts as symptomatic of the workings of Simmel’s philosophical imagination where he crafts a deep ontology of gender, in the form of an a priori, absolute duality of incommensurate modes of male and female being. This deep ontology of gender fatefully consigns woman to the wastelands of his philosophical imagination, whilst releasing man, and man alone, into the more fertile and productive workings of his sociological imagination. Hence, Simmel constructs a masculine ontology of the social. This is induced by Simmel’s ontological grounding of the objective in the male and by the ‘radical dualism’ he recommends as a more women-friendly alternative to ‘relative dualism’.

NSF: the views of organizations for older people

The National Service Framework for Older People will affect many different services for older people. Representatives from the Independent Healthcare Association, Social Care Association and Age Concern give their views on the good and bad parts of the framework.

John Adams and the Problem of Virtue

Shortly after starting his diary, John Adams reflected on his new role as schoolmaster. He thought that he sat at head of world in miniature: I sometimes, in my sprightly moments, consider my self, in my great Chair at School, as some Dictator at head of a commonwealth... my little school like great World, is made up of Kings, Politicians, Divines, LD., Fops, Buffoons, Fidlers, Sychophants, Fools Coxcombs, and every other Character drawn in History or seen in World. Adams saw himself as judicious spectator. Is it not then highest Pleasure my Friend to preside in this little World, to bestow proper applause upon virtuous and generous Actions, to blame and punish every vicious and contracted Trick, he wrote. He admitted that his comments were odd talk for J. Adams. By way of explanation, he offered a story that revealed attraction of working with undisguised characters of school children: About 4 months since a poor Girl in this neighbourhood walking by meeting H[ouse] upon some Occasion, in evening, met a Gentleman with laced hat and wast coat, and a sword who sollicited her to turn aside with him into horse Stable. Girl relucted a little, upon which he gave her 3 Guineas, and wished he might be damned if he did not have her in 3 months. Into horse Stable they went. 3 Guineas proved 3 farthings-and Girl proves with Child, without a Friend upon Earth that will own her, or knowing father of her 3 farthing Bastard.1 task of judging characters of his pupils was a relatively simple one. real world presented a much more complicated picture, though, even to' most observant of spectators. girl was accosted by a fine Gentleman with laced hat and wast coat, and a sword. Such accouterments were supposed to denote not simply polished manners but an inner refinement.2 Instead, they proved mere stage props, as false as three guineas he promised. early diary entry presented lessons about judging character to which Adams would cling throughout his life. He engaged in a never-ending attempt to see beneath laced hats and waistcoats of society, to strip away false trappings of men in his often vexing search for virtue. Adams recognized elusive nature of his quest. In his reading, he noted a passage from Bolingbroke: True moral virtue is something very real. It is cause of our happiness. Beside it Adams scribbled: This is divine and eternal truth. But alas! how shall we define true moral virtue? And where shall we find it? To discover virtue, he believed that he had to pierce veil of appearances in order to see underlying truth, a Sisyphean effort considering how often appearances misled. He admired Bonaparte's expression The Scenery of Business: The scenery has often if not commonly in all business of human life, at least of public life, more effect than characters of dramatis personae or ingenuity of plot. Nor could one even trust one's self. In an essay printed in Boston Gazette in 1763, Adams claimed that self-deceit was the source of far greatest and worst part of vices and calamities among mankind. In a world where appearances deceived and one's motives were cloudy, he plaintively asked, Who shall judge?3 Adams's worries about virtue mirror scholars' problems today in judging place of virtue in his own thought. Some have seen him as a backward-looking republican, out of touch with emerging democratic polity. Others have cast him as a liberal political thinker who envisioned an emerging nation that did not rely on virtue. essay considers Adams's personal efforts to lead a virtuous life, his larger national vision as coherent parts of same whole, and his struggles with his own unruly passions in forming his larger political vision. In end, Adams's obsessive search served not so much to identify and protect few sources of real virtue as to call into question any possible source of virtue. …

Smarter viruses: Onyx Pharmaceuticals, Inc.

Braithwaite thinks a compromise may be possible. “We appear to be at opposite poles from Onyx and others,” he says. But “the differences may be quantitative rather than qualitative.”The final verdict may come from Onyx’s phase III trial for head and neck cancer. The phase II trial, combining ONYX-015 with chemotherapy, “gave us a great deal of confidence,” says CEO Renton. Nineteen of thirty patients with advanced tumors showed 50% or greater response to therapy.Clinical trials and the debate about mechanism coincided. “It did not slow us down,” says Renton. “As long as (ONYX-015) had a good strong therapeutic index we wanted to go ahead.” The trials showed no correlation between treatment success and p53 status, although p14ARF function was not measured. In the phase III trials “the idea is to take all comers and retrospectively analyze who does best,” says McCormick.Side effects have been minimal so far, perhaps because the selectively replicating virus can be used at lower doses than traditional non-replicating gene therapy vectors. One “legitimate concern,” according to McCormick, was apoptosis of normal cells in response to even a non-productive infection. In culture ONYX-015 induces a significant amount of cell death, but whatever cell death occurs in vivo does not appear to be a problem.Also ongoing are phase II trials for multiple cancer types, and a phase I trial using intravenous delivery (other trials involve direct injection into tumors). Onyx is designing new viruses – viruses that will make prodrug-converting enzymes, and viruses targeted to receptors on tumor cells – in the hope that these viruses will have an even greater selective advantage. “The kind of results we are getting are as exciting as anything else in cancer therapy,” says McCormick, “and we are just starting.”

Geek Player, Love Slayer

GEEK PLAYER, LOVE SLAYER/Steve Almond COMPUTER BOY SWAGGERS over to my cube to help me open this one knucklehead e-mail Phoenix sent me, and within about two seconds, Tm ready to whip offhis khakis and blow him right there. He's leaning over my keyboard with his lousy beautiful sideburns and his Right Guard wafting all over the place, and underneath that this kind of wounded musk that makes my nipples go stiff, and his teeth, which I could fucking eat they look so healthy. I have, mind you, already offered him my seat, but he can't allow that. No-no-no. Don't you move your pretty little self, he tells me, which is when neighbor Brisby starts snarking away, snickety-snark, and I think, for chrissakes, why does this obnoxious creature, this dopey slab of masculine grace, whose name is (try not to laugh) Lance, and whom I have taken to calling Lancelot, Sir Lance-me-a-lot, why does this totally throat-lickable hotty have to be such a shitbrain? So I just sit there smelling him, watching his unreasonably defined triceps pulse and unpulse, noticing the blond hairs on his earlobe, like tiny spears of wheat, and the way his firm little rump tenses up when he gets a system error. The worst part of it is that he keeps going on about how I must be doing something to my machine, how my keystrokes must be pretty vigorous—keystrokes, get it?—and even though I'm kind of impressed by his use of the word "vigorous," there's no way I can flirt back without losing total office cred with Brisby, who's outright laughing at this point. It's not like I have time for this crap anyway; I'm on deadline. Though the worst part is my leched-out imagination, wherein Lancelot is bending me like a bandsaw and this can'tbe happening, this cannot be happening. I cannotbe lusting after the Computer Guy while on deadline. That is too lame for even me. Now Brisby's on the phone with his fiancée, for the twelfth time this hour, and Lancey tells me he's going to have to reboot and suddenly down he goes, under my desk, and I forget to scoot my chair back because I'm too busy staring at his back and counting the individual muscle groups, sort of flow-charting them. Then something rubs against my knee—his wrist I guess—but I've got these jeans on because it's forty fucking degrees in here; the hotter it gets outside, the colder they keep the office. Then, just to balance himself I suppose, Lancey sets his hand on the bridge of my foot and starts in with these little appraising squeezes, like he's fitting me for a pair ofpumps, and I want to tell him, 126 · The Missouri Review Hey, bright boy, there's a whole calf and thigh where that came from! But before I can say anything, he turns and informs me that I'vegot real soul, and I want to barf and run my tongue along the pink canals behind his ears all at once. I can hear Brisby mumbling his I-love-yous and hanging up. Then my screen goes blank, and Lancey rolls back on his haunches just enough to send a ripple under his shirt, and I imagine looping my arms around him, taking the meat of his shoulders Ui my palms, and his front teeth—his goddamn perfect front teeth—biting my clavicle. I know Brisby's going to slag me for the rest of eternity, until death do us part, but it's too late; I'm halfway off my chair in a cartine posture and my knees are trembling. Ahem. You're aU set, Lance tells me. Just turn it on. He's back to hovering over me. You know how to turn it on, don't you? It's not the turning on I'm worried about, I say. It's keeping the hard drive going. Immediately I regret having reduced myself to lurid banter with Computer Boy, who gives me his...

Deep Roles: Twelve Primordial Roles of Mind and Organization

The thesis in this paper is that there are 12 archetypal roles in groups and organizations. These "deep roles" have their origin in the roles of the essential family-father, mother, son, and daughter. In groups and organizations, each of these images of family roles will-through the basic defense mechanisms of splitting and projection-be polarized into a good and bad part: The father as God or devil, the mother as queen or witch, the son as crown prince or black sheep, and the daughter as princess or whore. In addition to these eight primary deep roles, there come two secondary ones: the helpers-Shaman and Slave-whose function are to help the family survive spiritually and materially, respectively. The two last deep roles are of a transcendental nature: the hero (winner) and the clown (loser), i.e., the one who has won a good family role, and the one who has lost it-or never gained it. These 12 deep roles are well known from such cultural artifacts as fairy tales and mythology. In groups and organizations, deep roles are attended with power and interest. Those who are attributed a deep role in their organization will have a similar symbolic power as characters in fairy tales and mythology.

Anoxia pre-dates Frasnian–Famennian boundary mass extinction horizon in the Great Basin, USA

Major and trace metal results from three Great Basin stratigraphic sections with strong conodont biostratigraphy identify a distinct anoxic interval that precedes, but ends approximately 100 kyr before, the Frasnian–Famennian (F–F, mid-Late Devonian) boundary mass extinction horizon. This horizon corresponds to the final and most severe step of a more protracted extinction period. These results are inconsistent with data reported by others from the upper Kellwasser horizon in Europe, which show anoxia persisting up to the F–F boundary in most sections. Conditions returned to fully oxygenated prior to the F–F boundary in the study area. These data indicate that the worst part of the F–F extinction was not related directly to oceanic anoxia in this region and potentially globally.

On the Therapist’s Reverie and Containing Function

Containment and interpretation are two inseparable aspects of the psychoanalytic technique. This is better understood by Bion’s clinical metaphors of “container-contained” relationship and the capacity for reverie. Bion, continuing and expanding Klein’s concept of projective identification, has transposed this from what happens to an infant to what happens in the link between mother and infant; until now he laid emphasis on the mother’s (or therapist’s) ability to contain the primitive anxieties which the infant (or the patient) experiences. He described three types of links—love, hate, and knowledge—and proposed two metaphors which laid the foundation of a new and efficient frame of reference of the analytic process and technique, namely, the container-contained relationship and the reverie.Two clinical vignettes will illustrate the pivotal function of the therapist’s reverie within the therapist—patient interaction. In the first case, a dead (internal) object of the patient was contained in the context of the session, enabling the patient to contain and sustain the psychic pain and her self-destructive tendencies; the second case stresses how the therapist’s reverie, during a silence, revealed a bad part of the patient’s self, which was lost through projective identification.

Policing the Affective Society: Beyond Governmentality in the Theory of Social Control

This article argues that certain consistent themes are evident in police studies research (including my own) with respect to the issue of emotion. I have described these ‘emotional repertoires’ as paranoid in character. By this I mean that it is a milieu which overvalues order, homogeneity and stasis while being suspicious of difference, fluidity and change. It tends to split the world into good and bad parts with very rigid boundaries, and it projects negative qualities onto those groups and individuals imagined to be ‘bad’. It is also a milieu which strongly displays a collective desire to order, control or, sometimes, attack outgroups onto which bad qualities have been projected. The article develops an initial theoretical framework for understanding this apparent linkage between a particular occupational milieu and a specific range of emotional orientations to the world. I argue that we might think in terms of the institutional production of affective subject positions - and use ideas taken from Jacques Lacan, Slavoj Žižek, Theodor Adorno and Max Horkheimer, Gilles Deleuze and Felix Guattari and Elizabeth Grosz for this purpose.