14 resultados para malaise

em Deakin Research Online - Australia


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Much of Regional Australia is suffering from an overall decline in population with a specific loss of young adults (16-30 year olds). A decline in population, linked with the Australia-wide problems of ageing populations and diminishing birth rates, is leading to a social and economic malaise in many regional cities and towns that threatens their long-term sustainability due to the lack of skilled workers and professionals. This paper examines the concept of “place” marketing, and the approach of local government to market regions, cities, and towns to attract targeted population to help maintain the sustainability of Regional Australia.

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While there is considerable evidence about the prevalence of student alcohol use, little empirical work has examined the range and level of exposure to alcohol-related risks facing student populations, and the views of key stakeholders about these. This study was conducted at a large multi-campus university in order to gauge the scale and severity of students’ alcohol-related problems, and ways in which these may be mitigated. Student perspectives on campus based policy making with respect to alcohol were also canvassed. This study utilised a range of evaluative instruments, including standardised questionnaire protocols, structured interviews and focus groups. Data gained from students showed a large level of exposure to alcohol-related harm, and staff informants reported student harms such as drink-driving, interpersonal aggression, social nuisance, inadequate security, sexually risky behaviour, and physical malaise. As a group, students seem receptive to campus-based policies that have a harm reduction focus, but are less supportive of institutionalised measures aimed at the student body. Given the divergence of views about the harms arising from student drinking, and a general repudiation of institutional policy measures which may lessen these, the development of harm-reducing policy on alcohol remains challenging.

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In this paper, I offer a strong criticism of Giorgio Agamben’s recent political texts. I argue that these texts bring to fruition a larger, contentious trend in the theoretical academy coupling one-dimensional, pessimistic accounts of modernity with strands of messianism. Since the political prospects of messianism, as Agamben’s analyses show, are very thin indeed, I reflectively question the presuppositions that lead him to this prescriptive juncture. In Part I, recurring to Scholem’s classic analyses of Jewish messianism, I show how Agamben’s messianism borrows more or less directly (in The Open) from kabalistic, antinomian, utopian messianism. Having established this exegetical point, I argue two theses in parts II and III. The first, specifically theoretical thesis is that Agamben is driven into his political messianism by the transcendental logic of his analyses of ‘the political’, one which by its nature occludes meaningfully political distinctions by instead seeking out their ontological grounds. The second, specifically political thesis is that the widespread embrace of ontological messianism by thinkers in the post-Marxian academy is a symptom of, rather than a cure for, the wider malaise of the political left in the first world. If critical theory is serious about engaging with progressive praxis, one thing it must do is recall the difference between politics and prima philosophia, so that it does not continue to seek out ‘redemption’ – or at least an apology – in the bowels of the latter.

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It is of considerable translational importance whether depression is a form or a consequence of sickness behavior. Sickness behavior is a behavioral complex induced by infections and immune trauma and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behavior and depression, for example, behavioral inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic (fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In clinical depression, however, a transition occurs to sensitization of immuno-inflammatory pathways, progressive damage by oxidative and nitrosative stress to lipids, proteins, and DNA, and autoimmune responses directed against self-epitopes. The latter mechanisms are the substrate of a neuroprogressive process, whereby multiple depressive episodes cause neural tissue damage and consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory pathways underpin the physiology of sickness behavior and the pathophysiology of clinical depression explaining their partially overlapping phenomenology. Inflammation may provoke a Janus-faced response with a good, acute side, generating protective inflammation through sickness behavior and a bad, chronic side, for example, clinical depression, a lifelong disorder with positive feedback loops between (neuro)inflammation and (neuro)degenerative processes following less well defined triggers.

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This paper proposes a neuro-immune model for Myalgic Encephalomyelitis/Chronic fatigue syndrome (ME/CFS). A wide range of immunological and neurological abnormalities have been reported in people suffering from ME/CFS. They include abnormalities in proinflammatory cytokines, raised production of nuclear factor-κB, mitochondrial dysfunctions, autoimmune responses, autonomic disturbances and brain pathology. Raised levels of oxidative and nitrosative stress (O&NS), together with reduced levels of antioxidants are indicative of an immuno-inflammatory pathology. A number of different pathogens have been reported either as triggering or maintaining factors. Our model proposes that initial infection and immune activation caused by a number of possible pathogens leads to a state of chronic peripheral immune activation driven by activated O&NS pathways that lead to progressive damage of self epitopes even when the initial infection has been cleared. Subsequent activation of autoreactive T cells conspiring with O&NS pathways cause further damage and provoke chronic activation of immuno-inflammatory pathways. The subsequent upregulation of proinflammatory compounds may activate microglia via the vagus nerve. Elevated proinflammatory cytokines together with raised O&NS conspire to produce mitochondrial damage. The subsequent ATP deficit together with inflammation and O&NS are responsible for the landmark symptoms of ME/CFS, including post-exertional malaise. Raised levels of O&NS subsequently cause progressive elevation of autoimmune activity facilitated by molecular mimicry, bystander activation or epitope spreading. These processes provoke central nervous system (CNS) activation in an attempt to restore immune homeostatsis. This model proposes that the antagonistic activities of the CNS response to peripheral inflammation, O&NS and chronic immune activation are responsible for the remitting-relapsing nature of ME/CFS. Leads for future research are suggested based on this neuro-immune model.

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This paper paints the philosophical and ethical backdrop to some of the issues raised in Australian Universities’ Review vol. 53, no. 2. It links academic performance pay; the measurement of research output; and the astonishing pay levels of vice chancellors to the present global financial crisis. These are explained as part of a general malaise of institutions, which has its roots in the early Enlightenment. Drawing from semioticians Charles Sanders Peirce and John Deely it uses the terms ideoscopy and cenoscopy to characterise the hijacking of unwarranted scientific status for much of the way our world is managed. But crisis can lead to opportunity. Consequently, the paper points to the glaring opportunity for thinkers who can articulate the present situation in a way which could avert disaster.

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Introduction: The World Health Organization has classified myalgic encephalomyelitis (ME) as a neurological disease since 1969 considering chronic fatigue syndrome (CFS) as a synonym used interchangeably for ME since 1969. ME and CFS are considered to be neuro-immune disorders, characterized by specific symptom profiles and a neuro-immune pathophysiology. However, there is controversy as to which criteria should be used to classify patients with “chronic fatigue syndrome.”

Areas covered: The Centers for Disease Control and Prevention (CDC) criteria consider chronic fatigue (CF) to be distinctive for CFS, whereas the International Consensus Criteria (ICC) stresses the presence of post-exertion malaise (PEM) as the hallmark feature of ME. These case definitions have not been subjected to rigorous external validation methods, for example, pattern recognition analyses, instead being based on clinical insights and consensus.

Expert opinion: Pattern recognition methods showed the existence of three qualitatively different categories: (a) CF, where CF evident, but not satisfying full CDC syndrome criteria. (b) CFS, satisfying CDC criteria but without PEM. (c) ME, where PEM is evident in CFS. Future research on this “chronic fatigue spectrum” should, therefore, use the abovementioned validated categories and novel tailored algorithms to classify patients into ME, CFS, or CF.

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Hepatitis is a major health related disease spread worldwide with frequent occurrence of epidemics. It is a zoonotic disease which leads to jaundice, anorexia, malaise and death. Although, vaccines have been developed against hepatitis A and hepatitis B, it is a challenge to generate vaccines against other prevalent forms of hepatitis which are equally harmful and spread worldwide. Natural products that are obtained from living organisms and found freely in nature have proven to be effective against several types of hepatitis due to presence of pharmacologically important bioactive compounds. Since they are natural products they do not cause much harm to body and can be easily applied or consumed. Our main focus is on hepatitis E virus (HEV) which is an opportunistic pathogen and leads to acute jaundice. This virus is mainly present in developing countries with poor sanitation facilities and effects individuals having weak immune response, mainly children, old people, organ transplant patients and pregnant women. HEV infection makes the patient more susceptible to infections from other viruses as well as HIV. In this review, we discussed about the natural protein known as lactoferrin which is isolated from milk colostrum and extracts of some medicinal plants that have proven to be effective against various forms of hepatitis. Such form of natural therapies forms the basis of modern medicine and major pharmaceutical discoveries.

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As argued by Norman Bryson, the still-life genre is sorely neglected by theorists and critics, largely because its concern with ‘low-plane reality’ (everyday items and acts) has obscured its genuine relevance to material thinking. By reappraising rather than abandoning the genre’s traditional themes of death and time—using a cross-cultural, Chinese-Western approach—it is possible to re-energise materialisms of time, writing and death within still life. Such a move depends above all on a re-evaluation of still life as ‘Vanitas’—the term which to date has unified, and more to the point limited, traditional still-life understandings of death and time. This article tracks a more explosive and creative materialism of still life simultaneously through the specifically Chinese approach to death (which includes the ‘Yin Yang’ 阴阳 as a sort of author of time) and via Gilles Deleuze’s cinematic philosophy of the time-image; what connects these is the very Deleuzean notion of time that subtends Chinese engagements with death. In this way, the still-life genre may be recovered from its current critical and theoretical malaise. Reconnecting with practice is a crucial aspect of this recovery, and so in its early stages this article analyses an example of still-life, creative non-fiction (authored by Cher Coad), and it concludes by establishing the value of this potentially ‘new chapter of the “still life” genre’ (in Matilde Marcolli’s terms) for the cross-artform analysis of the short story ‘Nhill’ (authored by Patrick West). Analysis, though, is only half the picture: a fully recovered still-life genre would see theory and practice endlessly circulating through each other, spurring on practice and impelling theory. Coad’s and West’s literary examples are introduced in the hope that they might trigger fresh theoretical and practice-based, still-life discoveries in prose and also in poetry.

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Objective
Somatization is a symptom cluster characterized by ‘psychosomatic’ symptoms, that is, medically unexplained symptoms, and is a common component of other conditions, including depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This article reviews the data regarding the pathophysiological foundations of ‘psychosomatic’ symptoms and the implications that this has for conceptualization of what may more appropriately be termed physio-somatic symptoms.

Method
This narrative review used papers published in PubMed, Scopus, and Google Scholar electronic databases using the keywords: depression and chronic fatigue, depression and somatization, somatization and chronic fatigue syndrome, each combined with inflammation, inflammatory, tryptophan, and cell-mediated immune (CMI).

Results

The physio-somatic symptoms of depression, ME/CFS, and somatization are associated with specific biomarkers of inflammation and CMI activation, which are correlated with, and causally linked to, changes in the tryptophan catabolite (TRYCAT) pathway. Oxidative and nitrosative stress induces damage that increases neoepitopes and autoimmunity that contribute to the immuno-inflammatory processes. These pathways are all known to cause physio-somatic symptoms, including fatigue, malaise, autonomic symptoms, hyperalgesia, intestinal hypermotility, peripheral neuropathy, etc.

Conclusion

Biological underpinnings, such as immune-inflammatory pathways, may explain, at least in part, the occurrence of physio-somatic symptoms in depression, somatization, or myalgic encephalomyelitis/chronic fatigue syndrome and thus the clinical overlap among these disorders.

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Background: Published clinical trials of the treatment of HCV are largely multicentre prospective pharmaceutical trials. Patients in clinical trials tend to have more favorable outcomes than patients in the 'real-world', due to strict patient selection and differences in treatment conditions and available resources. Objectives: To assess the outcomes of Hepatitis C infected patients treated at the Barwon Health Liver Clinic with combination Pegylated interferon (PEG-IFN) and Ribavirin (RBV) therapy and to determine factors associated with a treatment response. Methods: Retrospective review of patients who received treatment for Hepatitis C at our institution's Liver Clinic from January 2001-September 2011. Patient demographics, comorbidities, treatment-related parameters and side effects were extracted from medical records and analyzed. Results: A total of 190 patients (120 male, 70 female) with a mean age of 42.8 years (range 20-68 years) commenced treatment. The most common genotype was genotype 3 (48.9%), followed by genotype 1 (42.6%). 150 of 190 patients (78.9%) completed treatment and had end of treatment data available. 107 of 182 patients, (58.8%) for whom sustained virologic response (SVR) rate data was available achieved an SVR. Overall response rates were; 46.9%, 68.8% and 62.4% in genotypes 1, 2 and 3 respectively. The response rate was significantly lower in 29 patients with documented cirrhosis (20.7%). Age, diabetes and alcohol abuse did not predict treatment response in our cohort. Side effects reported in 81.6% of patients included general malaise, hematological disturbance and psychiatric issues, and necessitated cessation of therapy in 16 patients (8.4%) and dose reduction in 26 patients (13.7%). Conclusions: Response rates to combination PEG-IFN and RBV therapy at our institution are comparable to other 'real-world' and pharmaceutical registration trials. Side effects of combination therapy were prominent but resulted in fewer discontinuations of therapy compared to pharmaceutical trials.

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This chapter explains the development of the Human Nexus, being an original interpretation of ethics based on David Hume's exploration of morality. Recognizing the current moral malaise in global business practice, and searching for a contemporary approach to relational ethics, his elegant reasoning is concisely adapted for global managers. The Human Nexus is proposed as a tool for conveying humanism in global business decision-making today. A matrix of Humean variables from Hume's moral treatise counterbalances usefulness and agreeableness with considerations of self-interest, selflessness and the human connection with ecology. The analysis explores the interaction of variables, relationships and decision processes common in global management. A longitudinal reflective study underpins the research. The resultant construct is presented in context with foundational and emerging literature about the challenge of abstract moral perspectives for global managers, highlighting the desire for something more practical. The Human Nexus shows potential for pragmatically encouraging and enhancing humanistic engagement in ethical decision-making.

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This paper presents the outcomes of an 18-month developmental action research study to enhance the governance capability of a national sport organization. Bowls Australia, the national governing body for lawn bowls
in Australia, includes nine independent state and territory member-associations. An intervention was designed and implemented with the Bowls Australia Board. The purpose of the intervention was to enact collaborative governance to overcome a perceived cultural malaise in the governance of the sport. This study is one of the first to examine collaborative governance in a federal sport structure. Results demonstrate the utility of collaborative governance to overcome adversarial national, member-state relations for the purpose of establishing a common and unifying vision for bowls, while also enhancing governance capability. This study identified the importance of collective board leadership in governance decision-making throughout the sport. It also highlights future research directions in relation to collective board leadership in federal governance structures.