4 resultados para catheter-related bloodstream infection, nosocomial infection, healthcare associated infection, infection control, antimicrobial catheters, healthcare epidemiology, health economics, economic evaluation, cost-effectiveness, health technology assessment

em Brock University, Canada


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The purpose of this study was to determine if Ontario's health and physical education curriculum contributes sufficiently to ensure the health of our children and young adults. To determine the curriculum effect, the health risk profile of Niagara Region's grade 9 students was compared to Canada's adolescent population. All subjects completed a "Heart Health Lifestyle" survey and were measured for height, weight, percent body fat, blood pressure, and total cholesterol and performed the 20-metre shuttle run test as part of their physical and health education classes. The Niagara Region grade 9 population had a healthy risk profile. Aerobic power was inversely related, and cholesterol levels were positively associated to body mass index and percent body fat in the whole group analysis. These results indicate that physical education can offer unique and essential aspects allowing individuals a means to learn and control body movements and keep physically fit while providing protection against modern disease. Ontario's health and physical education curriculum does contribute to the health of our children and adolescents; however, there is a need to implement a stronger mandate for daily vigorous physical activity.

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Whereas the role of the anterior cingulate cortex (ACC) in cognitive control has received considerable attention, much less work has been done on the role of the ACC in autonomic regulation. Its connections through the vagus nerve to the sinoatrial node of the heart are thought to exert modulatory control over cardiovascular arousal. Therefore, ACC is not only responsible for the implementation of cognitive control, but also for the dynamic regulation of cardiovascular activity that characterizes healthy heart rate and adaptive behaviour. However, cognitive control and autonomic regulation are rarely examined together. Moreover, those studies that have examined the role of phasic vagal cardiac control in conjunction with cognitive performance have produced mixed results, finding relations for specific age groups and types of tasks but not consistently. So, while autonomic regulatory control appears to support effective cognitive performance under some conditions, it is not presently clear just what factors contribute to these relations. The goal of the present study was, therefore, to examine the relations between autonomic arousal, neural responsivity, and cognitive performance in the context of a task that required ACC support. Participants completed a primary inhibitory control task with a working memory load embedded. Pre-test cardiovascular measures were obtained, and ontask ERPs associated with response control (N2/P3) and error-related processes (ERN/Pe) were analyzed. Results indicated that response inhibition was unrelated to phasic vagal cardiac control, as indexed by respiratory sinus arrhythmia (RSA). However, higher resting RSA was associated with larger ERN ampUtude for the highest working memory load condition. This finding suggests that those individuals with greater autonomic regulatory control exhibited more robust ACC error-related responses on the most challenging task condition. On the other hand, exploratory analyses with rate pressure product (RPP), a measure of sympathetic arousal, indicated that higher pre-test RPP (i.e., more sympathetic influence) was associated with more errors on "catch" NoGo trials, i.e., NoGo trials that simultaneously followed other NoGo trials, and consequently, reqviired enhanced response control. Higher pre-test RPP was also associated with smaller amplitude ERNs for all three working memory loads and smaller ampUtude P3s for the low and medium working memory load conditions. Thus, higher pretest sympathetic arousal was associated with poorer performance on more demanding "catch" NoGo trials and less robust ACC-related electrocortical responses. The findings firom the present study highlight tiie interdependence of electrocortical and cardiovascular processes. While higher pre-test parasympathetic control seemed to relate to more robust ACC error-related responses, higher pre-test sympathetic arousal resulted in poorer inhibitory control performance and smaller ACC-generated electrocortical responses. Furthermore, these results provide a base from which to explore the relation between ACC and neuro/cardiac responses in older adults who may display greater variance due to the vulnerabihty of these systems to the normal aging process.

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Since the first offshore Lake Erie well was drilled in 1941, the Grimsby and Thorold formations of the Cataract Group have been economically important to the oil and gas industry of Ontario. The Cataract Group provides a significant amount of Ontario's gas production primarily from wells located on Lake Erie. The Grimsby - Thorold formations are the result of nearshore estuarine processes influenced by tides on a prograding shelf and are composed of subtidal channel complexes, discrete tidal channels, mud flats and non-marine deposits. Deposition was related to a regressive - transgressive cycle associated with eustatic sea level changes caused by the melting and resurgence of continental glaciation centred in Africa in the Late Ordovician/Early Silurian. Grimsby deposition began during a regression with the deposition of subtidal channel complexes incised into the marine deposits of the Cabot Head Formation. The presence of mud drapes and mud couplets suggest that these deposits were influenced by tides. These deposits dominate the lower half of the Grimsby. Deposition continued with a change from these subtidal channel complexes to laterally migrating, discrete, shallow tidal channels and mud flats. These were in turn overlain by the non-marine deposits of the Thorold Formation. Grimsby - Thorold deposition ended with a major transgression replacing siliciclastic deposition with primarily carbonate deposition. Sediment was sourced from the east and southeast and associated with a continuation of the Taconic Orogeny into the Early Silurian. The fluvial head of the estuary prograded from a shoreline that was located in western New York and western Pennsylvania running NNE-SSW and then turning NW-SE and paralleling the present day Lake Erie shoreline. iii The facies attributed to the Grimsby - Thorold formations can be ascribed to the three zones within the tripartite zonation suggested by Dalrymple et ale (1992) for estuaries, that is, a marine-dominated facies, a mixed energy facies, and a facies that is dominated by fluvial processes. Also, sediments within the Grimsby - Thorold are commonly fining upwards sequences which are common in estuarine settings whereas deltaic deposits are normally composed of coarsening upwards sequences in a vertical wedge shape with coarser material near the head. The only coarsening observed was in the Thorold Formation and attributed to non-marine deposition by palynological evidence. The presence of a lag deposit at the base of the sediments of the Grimsby Thorold formations suggests that they were incised into the Cabot Head Formation. Further, the thickness of Early Silurian sediments located between the top of the Queenston Formation, where Early Silurian sedimentation began, to the top of the Reynales - Irondequoit formation are constant whether the Grimsby - Thorold formations are present or not. Also, cross-sections using a sand body located in the Cabot Head Formation for correlation further imply that the Grimsby Formation has been incised into the previous deposits of the Cabot Head.

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This thesis tested a model of neurovisceral integration (Thayer & Lane, 2001) wherein parasympathetic autonomic regulation is considered to play a central role in cognitive control. We asked whether respiratory sinus arrhythmia (RSA), a parasympathetic index, and cardiac workload (rate pressure product, RPP) would influence cognition and whether this would change with age. Cognitive control was measured behaviourally and electrophysiologically through the error-related negativity (ERN) and error positivity (Pe). The ERN and Pe are thought to be generated by the anterior cingulate cortex (ACC), a region involved in regulating cognitive and autonomic control and susceptible to age-related change. In Study 1, older and younger adults completed a working memory Go/NoGo task. Although RSA did not relate to performance, higher pre-task RPP was associated with poorer NoGo performance among older adults. Relations between ERN/Pe and accuracy were indirect and more evident in younger adults. Thus, Study 1 supported the link between cognition and autonomic activity, specifically, cardiac workload in older adults. In Study 2, we included younger adults and manipulated a Stroop task to clarify conditions under which associations between RSA and performance will likely emerge. We varied task parameters to allow for proactive versus reactive strategies, and motivation was increased via financial incentive. Pre-task RSA predicted accuracy when response contingencies required maintenance of a specific item in memory. Thus, RSA was most relevant when performance required proactive control, a metabolically costly strategy that would presumably be more reliant on autonomic flexibility. In Study 3, we included older adults and examined RSA and proactive control in an additive factors framework. We maintained the incentive and measured fitness. Higher pre-task RSA among older adults was associated with greater accuracy when proactive control was needed most. Conversely, performance of young women was consistently associated with fitness. Relations between ERN/Pe and accuracy were modest; however, isolating ACC activity via independent component analysis allowed for more associations with accuracy to emerge in younger adults. Thus, performance in both groups appeared to be differentially dependent on RSA and ACC activation. Altogether, these data are consistent with a neurovisceral integration model in the context of cognitive control.