897 resultados para Cohort Studies


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This paper describes a thorough thermal study on a fleet of DC traction motors which were found to suffer from overheating after 3 years of full operation. Overheating of these traction motors is attributed partly because of the higher than expected number of starts and stops between train terminals. Another probable cause of overheating is the design of the traction motor and/or its control strategy. According to the motor manufacturer, a current shunt is permanently connected across the motor field winding. Hence, some of the armature current is bypassed into the current shunt. The motor then runs above its rated speed in the field weakening mode. In this study, a finite difference model has been developed to simulate the temperature profile at different parts inside the traction motor. In order to validate the simulation result, an empty vehicle loaded with drums of water was also used to simulate the full pay-load of a light rail vehicle experimentally. The authors report that the simulation results agree reasonably well with experimental data, and it is likely that the armature of the traction motor will run cooler if its field shunt is disconnected at low speeds

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We review all journal articles based on “PSED-type” research, i.e., longitudinal, empirical studies of large probability samples of on-going, business start-up efforts. We conclude that the research stream has yielded interesting findings; sometimes by confirming prior research with a less bias-prone methodology and at other times by challenging whether prior conclusions are valid for the early stages of venture development. Most importantly, the research has addressed new, process-related research questions that prior research has shunned or been unable to study in a rigorous manner. The research has revealed an enormous and fascinating variability in new venture creation that also makes it challenging to arrive at broadly valid generalizations. An analysis of the findings across studies as well as an examination of those studies that have been relatively more successful at explaining outcomes give good guidance regarding what is required in order to achieve strong and credible results. We compile and present such advice to users of existing data sets and designers of new projects in the following areas: Statistically representative and/or theoretically relevant sampling; Level of analysis issues; Dealing with process heterogeneity; Dealing with other heterogeneity issues, and Choice and interpretation of dependent variables.

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Visual impairment is an important contributing factor in falls among older adults, which is one of the leading causes of injury and injury-related death in this population. Visual impairment is also associated with greater disability among older adults, including poorer health-related quality of life, increased frailty and reduced postural stability. The majority of this evidence, however, is based on measures of central visual function, rather than peripheral visual function. As such, there is comparatively limited research on the associations between peripheral visual function, disability and falls, and even fewer studies involving older adults with specific diseases which affect peripheral visual function, the most common of which is glaucoma. Glaucoma is one of the leading causes of irreversible vision loss among older adults, affecting around 3 per cent of adults aged over 60 years. The condition is characterised by retinal nerve fibre loss, primarily affecting peripheral visual function. Importantly, the number of older adults with glaucomatous visual impairment is projected to increase as the ageing population grows. The first component of the thesis examined the cross-sectional association between glaucomatous visual impairment and health-related quality of life (Study 1a), functional status (Study 1b) and postural stability (Study 1c) among older adults. A cohort of 74 community-dwelling adults with glaucoma (mean age 74.2 ± 5.9 years) was recruited and completed a baseline assessment. A number of visual function measures was assessed, including central visual function (visual acuity and contrast sensitivity), motion sensitivity, retinal nerve fibre analysis and monocular and binocular visual field measures (monocular 24-2 and binocular integrated visual fields (IVF): IVF-60 and IVF-120). The analyses focused on the associations between the outcomes measures and severity and location of visual field loss, as this is the primary visual function affected by glaucoma. In Study 1a, we examined the association between visual field loss and health-related quality of life, measured by the Short Form 36-item Health Survey (SF-36). Greater binocular visual field loss, on both IVF measures, was associated with lower SF-36 physical component scores, adjusted for age and gender (Pearson's r =|0.32| to |0.36|, p<0.001). Furthermore, inferior visual field loss was more strongly associated with the SF-36 physical component than superior field loss. No association was found between visual field loss and SF-36 mental component scores. The association between visual field loss and functional status was examined in Study 1b. Functional status outcomes measures included a physical activity questionnaire (Physical Activity Scale for the Elderly, PASE), performance tests (six-minute walk test, timed up and go test and lower leg strength) and an overall functional status score. Significant, but weak, correlations were found between binocular visual field loss and PASE and overall functional status scores, adjusted for age and gender (Pearson's r =|0.24| to |0.33|, p<0.05). Greater inferior visual field loss, independent of superior visual field loss, was significantly associated with poorer physical performance results and lower overall functional status scores. In Study 1c, we examined the association between visual field loss and postural stability, using a swaymeter device which recorded body movement during four conditions: eyes open and closed, on a firm and foam surface. Greater binocular visual field loss was associated with increased postural sway, both on firm and foam surfaces, independent of age and gender (Pearson’s r =|0.44| to |0.46|, p <0.001). Furthermore, inferior visual field was a stronger contributor to postural stability, more so than the superior visual field, particularly on the foam condition with the eyes open. Greater visual field loss was associated with a reduction in the visual contribution to postural sway, which underlies the observed association with postural sway. The second component of the thesis examined the association between severity and location of visual field loss and falls during a 12-month longitudinal follow-up. The number of falls was assessed prospectively using monthly fall calendars. Of the 71 participants who successfully completed the follow up (mean age 73.9 ± 5.7 years), 44% reported one or more falls, and around 20% reported two or more falls. After adjusting for age and gender, every 10 points missed on the IVF-120 increased the rate of falls by 25% (rate ratio 1.25, 95% confidence interval 1.08 - 1.44) or every 5dB reduction in IVF-60 increased the rate of falls by 47% (rate ratio 1.47, 95% confidence interval 1.16 - 1.87). Inferior visual field loss was a significant predictor of falls, more so than superior field loss, highlighting the importance of the inferior visual field area in safe and efficient navigation. Further analyses indicated that postural stability, more so than functional status, may be a potential mediating factor in the relationship between visual field loss and falls. Future research is required to confirm this causal pathway. In addition, the use of topical beta-blocker medications was not associated with an increased rate of falls in this cohort, compared with the use of other topical anti-glaucoma medications. In summary, greater binocular visual field loss among older adults with glaucoma was associated with poorer health-related quality of life in the physical domain, reduced functional status, greater postural instability and higher rates of falling. When the location of visual field loss was examined, inferior visual field loss was consistently more strongly associated with these outcomes than superior visual field loss. Insights gained from this research improve our understanding of the association between glaucomatous visual field loss and disability, and its link with falls among older adults. The clinical implications of this research include the need to include visual field screening in falls risk assessments among older adults and to raise awareness of these findings to eye care practitioners and adults with glaucoma. The findings also assist in developing further research to examine strategies to reduce disability and prevent falls among older adults with glaucoma to promote healthy ageing and independence for these individuals.

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Like other nations, Australia has experienced significant change in the past few decades as its society has become increasingly diverse. The new cultures and traditions that result from ethnic and religious diversity have both enriched Australian society and presented it with some challenges. Other challenges have resulted from increased globalisation. For example, the economic fallout from the recent global financial crisis indicates that global issues can impact across a range of levels, from multinational corporations and nation-states to local sites and individual livelihoods. Some suggest that Australia fared better than other nations during this economic crisis because of its export trade with China. Although this is disputed by economists, it highlights another facet of change that is impacting on Australian society and this relates to Australia’s growing engagement with the nations of Asia. There is increasing awareness in education systems that if young people are to achieve their potential as future citizens they need to be able to negotiate the cultural, social, political and economic ties that connect them to the global and regional community through work, leisure and citizenship. Multicultural education, global studies and studies of Asia play a particular part in helping young people to: • appreciate cultural diversity within and beyond their own nation • imagine with some accuracy how others view their world • participate in shaping a better future. This chapter explores the origins, distinctions and common features of each approach.

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Aims To assess self-reported lifetime prevalence of cardiovascular disease (CVD) among colorectal cancer survivors, and examine the cross-sectional and prospective associations of lifestyle factors with co-morbid CVD. Methods Colorectal cancer survivors were recruited (n = 1966). Data were collected at approximately 5, 12, 24 and 36 months post-diagnosis. Cross-sectional findings included six CVD categories (hypercholesterolaemia, hypertension, diabetes, heart failure, kidney disease and ischaemic heart disease (IHD)) at 5 months post-diagnosis. Longitudinal outcomes included the probability of developing (de novo) co-morbid CVD by 36 months post-diagnosis. Lifestyle factors included body mass index, physical activity, television (TV) viewing, alcohol consumption and smoking. Results Co-morbid CVD prevalence at 5 months post-diagnosis was 59%, and 16% of participants with no known CVD at the baseline reported de novo CVD by 36 months. Obesity at the baseline predicted de novo hypertension (odds ratio [OR] = 2.20, 95% confidence intervals [CI] = 1.09, 4.45) and de novo diabetes (OR = 6.55, 95% CI = 2.19, 19.53). Participants watching >4 h of TV/d at the baseline (compared with <2 h/d) were more likely to develop ischaemic heart disease by 36 months (OR = 5.51, 95% CI = 1.86, 16.34). Conclusion Overweight colorectal cancer survivors were more likely to suffer from co-morbid CVD. Interventions focusing on weight management and other modifiable lifestyle factors may reduce functional decline and improve survival.

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This paper describes the design process and curriculum for a learning cohort of eight managers who came from public and private providers of vocational education and training. While the authors found no discussion on developing research knowledge and skills of managers using learning cohorts, the general learning cohorts literature provided a number of recommendations for learning cohort design. The initial stages of the learning cohort were evaluated. The results highlighted the importance of clarifying the psychological contract and its use in self-selection, supported the recommendations in the literature of the significance of the careful design and implementation of an initial residential workshop and also found support for further residential workshops of a similar design. The attendance of the cohort members in tow faculty wide core research units drew mixed comments.

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The professional doctorate is a degree that is specifically designed for professionals investigating real world problems and relevant issues for a profession, industry and/ or the community. The study on which this paper is based sought to track the scholarly skill development of a cohort of professional doctoral students who commenced their course in January 2008 at an Australian University. Via an initial survey and two focus groups held six months apart, the study aimed to determine if there had been any qualitative shifts in students’ understandings, expectations and perceptions regarding this developing knowledge and skills. Three key findings has emerged from this study were: (i) the appropriateness of using a blended learning approach for this doctoral cohort; (ii) the challenges of using wikis as an online technology of creating communities of practice: and (iii) that the transition from student to scholar is a process that is unlikely to be achieved in a short time frame.

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This paper considers the scope to develop an approach to the spatial dimensions of media and culture that is informed by cultural-economic geography. I refer to cultural-economic geography as that strand of research in the field of geography that has been informed on the one hand by the ‘cultural turn’ in both geographical and economic thought, and which focuses on the relationship between, space, knowledge and identity in the spheres of production and consumption, and on the other to work by geographers that has sought to map the scale and significance of the cultural or creative industries as new drivers of the global economy. The paper considers the extent to which this work enables those engaged with urban cultural policy to get beyond some of the impasses that have arisen with the development of “creative cities” policies derived from the work of authors such as Richard Florida as well as the business management literature on clusters. It will frame these debates in the context of recent work by Michael Curtin on media capitals, and the question of whether cities in East Asia can emerge as media capitals from outside of the US-Europe-dominated transnational cultural axis.

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The shift from 20th century mass communications media towards convergent media and Web 2.0 has raised the possibility of a renaissance of the public sphere, based around citizen journalism and participatory media culture. This paper will evaluate such claims both conceptually and empirically. At a conceptual level, it is noted that the question of whether media democratization is occurring depends in part upon how democracy is understood, with some critical differences in understandings of democracy, the public sphere and media citizenship. The empirical work in this paper draws upon various case studies of new developments in Australian media, including online- only newspapers, developments in public service media, and the rise of commercially based online alternative media. It is argued that participatory media culture is being expanded if understood in terms of media pluralism, but that implications for the public sphere depend in part upon how media democratization is defined.

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The shift from 20th century mass communications media towards convergent media and Web 2.0 has raised the possibility of a renaissance of the public sphere, based around citizen journalism and participatory media culture. This paper will evaluate such claims both conceptually and empirically. At a conceptual level, it is noted that the question of whether media democratization is occurring depends in part upon how democracy is understood, with some critical differences in understandings of democracy, the public sphere and media citizenship. The empirical work in this paper draws upon various case studies of new developments in Australian media, including online-only newspapers, developments in public service media, and the rise of commercially based online alternative media. It is argued that participatory media culture is being expanded if understood in terms of media pluralism, but that implications for the public sphere depend in part upon how media democratization is defined.

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This article reflects on aspects of what is claimed to be the distinctiveness of Australian communication, cultural and media studies, focusing on two cases – the cultural policy debate in the 1990s, and the concept of creative industries in the 2000s – and the relations between them, which highlight the alignment of research and scholarship with industry and policy and with which the author has been directly involved. Both ‘moments’ have been controversial; the three main lines of critique of such alignment of research and scholarship with industry and policy (its untoward proximity to tenets of the dominant neo-liberal ideology; the evacuation of cultural value by the economic; and the possible loss of critical vocation of the humanities scholar) are debated.

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Objective--To determine whether heart failure with preserved systolic function (HFPSF) has different natural history from left ventricular systolic dysfunction (LVSD). Design and setting--A retrospective analysis of 10 years of data (for patients admitted between 1 July 1994 and 30 June 2004, and with a study census date of 30 June 2005) routinely collected as part of clinical practice in a large tertiary referral hospital.Main outcome measures-- Sociodemographic characteristics, diagnostic features, comorbid conditions, pharmacotherapies, readmission rates and survival.Results--Of the 2961 patients admitted with chronic heart failure, 753 had echocardiograms available for this analysis. Of these, 189 (25%) had normal left ventricular size and systolic function. In comparison to patients with LVSD, those with HFPSF were more often female (62.4% v 38.5%; P = 0.001), had less social support, and were more likely to live in nursing homes (17.9% v 7.6%; P < 0.001), and had a greater prevalence of renal impairment (86.7% v 6.2%; P = 0.004), anaemia (34.3% v 6.3%; P = 0.013) and atrial fibrillation (51.3% v 47.1%; P = 0.008), but significantly less ischaemic heart disease (53.4% v 81.2%; P = 0.001). Patients with HFPSF were less likely to be prescribed an angiotensin-converting enzyme inhibitor (61.9% v 72.5%; P = 0.008); carvedilol was used more frequently in LVSD (1.5% v 8.8%; P < 0.001). Readmission rates were higher in the HFPSF group (median, 2 v 1.5 admissions; P = 0.032), particularly for malignancy (4.2% v 1.8%; P < 0.001) and anaemia (3.9% v 2.3%; P < 0.001). Both groups had the same poor survival rate (P = 0.912). Conclusions--Patients with HFPSF were predominantly older women with less social support and higher readmission rates for associated comorbid illnesses. We therefore propose that reduced survival in HFPSF may relate more to comorbid conditions than suboptimal cardiac management.

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Background: Young motorists engaging in anti-social and often dangerous driving manoeuvres (which is often referred to as “hooning” within Australia) is an increasing road safety problem. While anecdotal evidence suggests that such behaviour is positively linked with crash involvement, researchers have yet to examine whether younger drivers who deliberately break road rules and drive in an erratic manner (usually with peers) are in fact over represented in crash statistics. This paper outlines research that aimed to identify the characteristics of individuals most likely to engaging in hooning behaviours, as well as examine the frequency of such driving behaviours and if such activity is linked with self-reported crash involvement.---------- Methods: A total of 717 young drivers in Queensland voluntarily completed a questionnaire to investigate their driving behaviour and crash history.---------- Results: Quantitative analysis of the data revealed that almost half the sample reported engaging in some form of “hooning” behaviour at least once in their lifetime, although only 4% indicated heavy participation in the behaviour e.g., >50 times. Street racing was the most common activity reported by participants followed by “drifting” and then “burnouts”. Logistic regression analysis indicated that being younger and a male was predictive of reporting such anti-social driving behaviours, and importantly, a trend was identified between such behaviour and self-reported crash involvement.---------- Conclusions: This research provides preliminary evidence that younger male drivers are more likely to engage in dangerous driving behaviours, which ultimately may prove to increase their overall risk of becoming involved in a crash. This paper will further outline the study findings in regards to current enforcement efforts to deter such driving activity as well as provide direction for future research efforts in this area.---------- Research highlights: ► The self-reported driving behaviours of 717 younger Queensland drivers were examined to investigate the relationship between deliberately breaking road rules and self-reported crash involvement. ► Younger male drivers were most likely to engage in such aberrant driving behaviours and a trend was identified between such behaviour and self-reported crash involvement.

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Goals: Few studies have repeatedly evaluated quality of life and potentially relevant factors in patients with benign primary brain tumor. The purpose of this study was to explore the relationship between the experience of the symptom distress, functional status, depression, and quality of life prior to surgery (T1) and 1 month post-discharge (T2). ---------- Patients and methods: This was a prospective cohort study including 58 patients with benign primary brain tumor in one teaching hospital in the Taipei area of Taiwan. The research instruments included the M.D. Anderson Symptom Inventory, the Functional Independence Measure scale, the Hospital Depression Scale, and the Functional Assessment of Cancer Therapy-Brain.---------- Results: Symptom distress (T1: r=−0.90, p<0.01; T2: r=−0.52, p<0.01), functional status (T1: r=0.56, p<0.01), and depression (T1: r=−0.71, p<0.01) demonstrated a significant relationship with patients' quality of life. Multivariate analysis identified symptom distress (explained 80.2%, Rinc 2=0.802, p=0.001) and depression (explained 5.2%, Rinc 2=0.052, p<0.001) continued to have a significant independent influence on quality of life prior to surgery (T1) after controlling for key demographic and medical variables. Furthermore, only symptom distress (explained 27.1%, Rinc 2=0.271, p=0.001) continued to have a significant independent influence on quality of life at 1 month after discharge (T2).---------- Conclusions: The study highlights the potential importance of a patient's symptom distress on quality of life prior to and following surgery. Health professionals should inquire about symptom distress over time. Specific interventions for symptoms may improve the symptom impact on quality of life. Additional studies should evaluate symptom distress on longer-term quality of life of patients with benign brain tumor.