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There has been a considerable scientific, governmental, and public interest in potential adverse health effects associated with exposure to engineered or synthesized nanomaterials. Although such effects have not been reported in humans, there is accumulating evidence from animal studies that exposure to some nanomaterials may be harmful. There is sparse knowledge as to the likelihood, frequency, and intensity of exposures experienced by those working around engineered nanoparticles. Similarly, there is little knowledge regarding the potential existence, type, and dose dependence of adverse health effects, which might result from workplace exposures to engineered nanoparticles. This uncertainty, reflecting a relative lack of research, makes it difficult at present (and probably for the near future) to fully rely upon firm scientific evidence for the development of rational, preventive, and screening measures to protect against such potential effects. Recognizing this predicament, the American College of Occupational and Environmental Medicine (ACOEM) has developed this guidance document for occupational medicine physicians and their colleagues. The purpose of the document is to offer current prudent preventive recommendations on the topics of exposure monitoring, exposure controls, and medical surveillance. This document will not attempt to review the rapidly evolving animal toxicology literature in detail, as any review would be quickly outdated, but general areas of concern will be discussed.

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

Objective To demonstrate that a distinct group of patients with Grade Ia diastolic dysfunction who do not conform to present ASE/ESE diastolic grading exists. Method and Results Echocardiographic and demographic data of the Grade Ia diastolic dysfunction were extracted and compared with that of Grades I and II in 515 patients. The mean of age of the cohort was 75 ± 9 years and body mass index did not differ significantly between the 3 groups (P = 0.45). Measurements of left atrial volume index (28.58 ± 7 mL/m2 in I, 33 ± 10 mL/m2 in Ia, and 39 ± 12 mL/m2 in II P

Chapter 51 explores the Improve Access to Psychological Therapies (IAPT) program. Its work is grounded on research evidence of the benefits of psychological therapies, and a business case and social justice argument for improving access to them. This chapter summarizes the work of the IAPT programme from case building to implementation and the lessons we have learnt.

Fifty-six patients diagnosed with definite multiple sclerosis (MS) according to Poser criteria were administered the Mini-Mental State Examination (MMSE) and a comprehensive battery of neuropsychological tests. Extent of cerebral lesion involvement was determined by quantitative magnetic resonance imaging (MRI) ratings. The MMSE correlated with overall levels of physical disability, but did not correlate with total lesion area on MRI. Sensitivity of the MMSE to the sub cortical dementia of MS was low (28%) when performance on the neuropsychological testing battery was used as the criterion. Impairment on tests of memory, speed of information processing, abstract reasoning, naming/verbal fluency, as well as visuoperceptual organization, were correlated highly with total lesion area on MRI. The low sensitivity of the MMSE to cognitive impairment in MS is discussed in terms of its item composition and the characteristic pattern of deficits found in MS.

China has made remarkable gains in industrialization and development. Over the past three decades, it has maintained gross domestic product (GDP) growth of about 9 percent per year and lifted more than 400 million people out of poverty. Entering the 21st century, China is determined to ensure the sustainability of its economic and social development, to which the innovativeness of business enterprises is critical. In 2006, the government of China laid out a strategy of enterprise-led indigenous innovation. In implementing this strategy, Chinese enterprises must cope with two severe challenges arising from the current stage of development. First, they must derive their competitiveness increasingly from innovativeness. Second, while they are innovating, they must also create jobs to keep the Chinese labor force employed. The realization of China's vision to promote enterprise-led innovation will entail concerted actions by government, the corporate sector, and the financial sector. What can the government do? The four basic recommendations of this report are to pursue a balanced strategy, to create the right incentives, to build the capacity of the private sector, and to strengthen the ecosystem for the venture capital (VC) industry.