937 resultados para MEDICINE, RESEARCH


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Undoubtedly, the past half-century has witnessed an escalation of changes in the social, political, economic and educational structures in many societies around the world. Some have seen change as a challenge and hope while, for many others, it is a source of concern and worry. Some have adopted change with gusto, while for many it is something to be resisted. Some say we live in a world and times with an increasing awareness that times are changing, while for some the more things change, the more they stay the same.

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Despite the advent of improved pharmacological treatments to alleviate substance-related desires, psychological approaches will continue to be required. However, the current psychological treatment that most specifically focuses on desires and their managementcue exposure (CE)has not lived up to its original promise. This paper argues that current psychological approaches to desire do not adequately incorporate our knowledge about the factors that trigger, maintain, and terminate episodes of desire. It asserts that the instigation and maintenance of desires involve both associative and elaborative processes. Understanding the processes triggering the initiation of intrusive thoughts may assist in preventing some episodes, but occasional intrusions will be inevitable. A demonstration of the ineffectiveness of thought suppression may discourage its use as a coping strategy for desire-related intrusions, and mindfulness meditation plus cognitive therapy may help in accepting their occurrence and letting them go. Competing tasks may be used to reduce elaboration of desires, and competing sensory images may have particular utility. The application of these procedures during episodes that are elicited in the clinic may allow the acquisition of more effective strategies to address desires in the natural environment.

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Schizophrenia is associated with significant brain abnormalities, including changes in brain metabolites as measured by proton magnetic resonance spectroscopy (MRS). What remains unclear is the extent to which these changes are a consequence of the emergence of psychotic disorders or the result of treatment with antipsychotic medication. We assessed 34 patients with first episode psychosis (15 antipsychotic nave) and 19 age- and gender-matched controls using short-echo MRS in the medial temporal lobe bilaterally. Overall, there were no differences in any metabolite, regardless of treatment status. However, when the analysis was limited to patients with a diagnosis of schizophrenia, schizophreniform or schizoaffective disorder, significant elevations of creatine/phosphocreatine (Cr/PCr) and myo-inositol (mI) were found in the treated group. These data indicate a relative absence of temporal lobe metabolic abnormalities in first episode psychosis, but suggest that some treatment-related changes in mI might be apparent in patients with schizophrenia-spectrum diagnoses. Seemingly illness-related Cr/PCr elevations were also specific to the diagnosis of schizophrenia-spectrum disorder and seem worthy of future study.

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The dancing doctorate is an interrogative endeavour which can but nurture the art form and forge a beneficial dynamism between those who seek and those who assess the emerging knowledges of dance. (Vincs, 2009) From 2006-2008 three dance academics from Perth, Brisbane and Melbourne undertook a research project entitled Dancing between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, funded by the ALTC Priority Projects Program. Although assessment rather than supervision was the primary focus of this research, interviews with 40 examiner/supervisors, 7 research deans and 32 candidates across Australia and across the creative arts, primarily in dance, provide an insight into what might be considered best practice in preparing students for higher research degrees, and the challenges that embodied and experiential knowledges present for supervision. The study also gained the industry perspectives of dance professionals in a series of national forums in 5 cities, based around the value of higher degrees in dance. The qualitative data gathered from these two primary sources was coded and analysed using the NVivo system. Further perspectives were drawn from international consultant and dance researcher Susan Melrose, as well as recent publications in the field. Dance is a young addition to academia and consequently there tends to be a close liaison between the academy and the industry, with a relational fluidity that is both beneficial and problematic. This partially explains why dance research higher degrees are predominantly practice-led (or multi-modal, referring to those theses where practice comprises the substantial examinable component). As a physical, embodied art form, dance engages with the contested territory of legitimising alternative forms of knowledge that do not sit comfortably with accepted norms of research. In supporting research students engaged with dance practice, supervisors traverse the tricky terrain of balancing university academic requirements with studies that are emergent, not only in the practice and attendant theory but in their methodologies and open-ended outcomes; and in an art form in which originality and new knowledge also arises from collaborative creative processes. Formal supervisor accreditation through training is now mandatory in most Australian universities, but it tends to be generic and not address supervisory specificity. This paper offers the kind of alternative proposed by Edwards (2002) that improving postgraduate supervision will be effective if supervisors are empowered to generate their own standards and share best practice; in this case, in ways appropriate to the needs of their discipline and alternative modes of thesis presentation. In order to frame the qualities and processes conducive to this goal, this paper will draw on both the experiences of interviewees and on philosophical premises which underpin the research findings of our study. These include the ongoing challenge of dissolving the binary oppositions of theory and practice, especially in creative arts practice where theory resides in and emerges from the doing as much as in articulating reflection about the doing through what Melrose (2003) terms mixed mode disciplinary practices. In guiding practitioners through research higher degrees, how do supervisors deal with not only different forms of knowledge but indeed differing modes of knowledge? How can they navigate tensions that occur between the incompatible competencies (Candlin, 2000) of the spectating academic experts with their irrepressible drive ... to inscribe, interpret, and hence to practise temporal closure, and practitioner experts who create emergent works of residual unfinishedness (Melrose 2006) which are not only embodied but ephemeral, as in the case of live performance?

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The purpose of this paper is to identify and recommend the emergence of an academic research methodology for Journalism the academic discipline, through reviewing various journalistic methods of research those making up a key element in such methodology. Its focus is on journalistic styles of work employed in academic contexts especially research on mass media issues. It proposes that channelling such activity into disciplined academic forms will enhance both: allowing the former to provide more durable and deeper outcomes, injecting additional energy and intensity of purpose into the latter. It will briefly consider characteristics of research methodologies and methods, generally; characteristics of the Journalism discipline, and its relationship with mass media industries and professions. The model of journalism used here is the Western liberal stream. A proposition is made, that teaching and research in universities focused on professional preparation of journalists, has developed so that it is a mature academic discipline. Its adherents are for the most part academics with background in journalistic practice, and so able to deploy intellectual skills of journalists, while also accredited with Higher Degrees principally in humanities. Research produced in this discipline area stands to show two characteristics: (a) it employs practices used generally in academic research, e.g. qualitative research methods such as ethnographic studies or participant observation, or review of documents including archived media products, and (b) within such contexts it may use more specifically journalistic techniques, e.g. interviewing styles, reflection on practice of journalism, and in creative practice research, journalistic forms of writing highlighting journalistic / practitioner capabilities of the author. So the Journalism discipline, as a discipline closely allied to a working profession, is described as one where individual professional skills and background preparation for media work will be applicable to academic research. In this connection the core modus operandi will be the directly research-related practices of: insistent establishment of facts, adept crafting of reportage, and economising well with time. Prospective fields for continuing research are described:- work in new media; closer investigation of relations among media producers and audiences; journalism as creative practice, and general publishing by journalists, e.g. writing histories.

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This paper details research completed in 2007 which investigated autopsy decision making in a death investigation. The data was gathered during the first year of operation of a new Coroners Act in Queensland, Australia, which changed the process of death investigation in three ways which are important to this paper. First, it required a greater amount of information to be gathered at the scene by police, and this included a thorough investigation of the circumstances of the death, including statements from witnesses, friends and family, as well as evidence gathering at the scene. Second, it required Coroners, for the first time, to determine the level of invasiveness of the autopsy required to complete the death investigation. Third, it enabled the communication of a genuine family concern, to be communicated to the Coroner. The outcome of such information was threefold. First, a greater amount of information offered to the Coroner led to a decrease in the number of full internal autopsies ordered, but an increase in the number of partial internal autopsies ordered. Second, this shift in autopsy decision making by Coroners saw certain factors given greater importance than others in decisions to order full internal or external only autopsies. Third, a raised family concern had a significant impact on autopsy decision making and tended to decrease the invasiveness of the autopsy ordered by Coroners.

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Recent theoretical developments (particularly those involving the work of Michel Foucault) have challenged the foundations upon which subcultural analysis is built. It is not the intention of this paper to take issue with the underpinning neo-Marxist assumptions concerning hegemony, consciousness and culture. Rather, the intention is simply to problematise the use of subculture theory in terms of its totalising, normalising and dichotomising nature.

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This paper examines the enabling effect of using blended learning and synchronous internet mediated communication technologies to improve learning and develop a Sense of Community (SOC) in a group of post-graduate students consisting of a mix of on-campus and off-campus students. Both quantitative and qualitative data collected over a number of years supports the assertion that the blended learning environment enhanced both teaching and learning. The development of a SOC was pivotal to the success of the blended approach when working with geographically isolated groups within a single learning environment.

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The high level of scholarly writing required for a doctoral thesis is a challenge for many research students. However, formal academic writing training is not a core component of many doctoral programs. Informal writing groups for doctoral students may be one method of contributing to the improvement of scholarly writing. In this paper, we report on a writing group that was initiated by an experienced writer and higher degree research supervisor to support and improve her doctoral students writing capabilities. Over time, this group developed a workable model to suit their varying needs and circumstances. The model comprised group sessions, an email group, and individual writing. Here, we use a narrative approach to explore the effectiveness and value of our research writing group model in improving scholarly writing. The data consisted of doctoral students reflections to stimulus questions about their writing progress and experiences. The stimulus questions sought to probe individual concerns about their own writing, what they had learned in the research writing group, the benefits of the group, and the disadvantages and challenges to participation. These reflections were analysed using thematic analysis. Following this analysis, the supervisor provided her perspective on the key themes that emerged. Results revealed that, through the writing group, members learned technical elements (e.g., paragraph structure), non-technical elements (e.g., working within limited timeframes), conceptual elements (e.g., constructing a cohesive arguments), collaborative writing processes, and how to edit and respond to feedback. In addition to improved writing quality, other benefits were opportunities for shared writing experiences, peer support, and increased confidence and motivation. The writing group provides a unique social learning environment with opportunities for: professional dialogue about writing, peer learning and review, and developing a supportive peer network. Thus our research writing group has proved an effective avenue for building doctoral students capability in scholarly writing. The proposed model for a research writing group could be applicable to any context, regardless of the type and location of the university, university faculty, doctoral program structure, or number of postgraduate students. It could also be used within a group of students with diverse research abilities, needs, topics and methodologies. However, it requires a group facilitator with sufficient expertise in scholarly writing and experience in doctoral supervision who can both engage the group in planned writing activities and also capitalise on fruitful lines of discussion related to students concerns as they arise. The research writing group is not intended to replace traditional supervision processes nor existing training. However it has clear benefits for improving scholarly writing in doctoral research programs particularly in an era of rapidly increasing student load.

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Background: The reasons that a patient has to start treatment, their Cues to Action, are important for determining subsequent health behaviours. Cues to action are an explicit component of the Health Belief Model of CPAP acceptance adherence. At present there is no scale available to measure this construct for individuals with Obstructive Sleep Apnoea (OSA). This paper aims to develop, validate and describe responding patterns within an OSA patient sample to the Cues to CPAP Use Questionnaire (CCUQ).----- Method: Participants were 63 adult patients diagnosed with OSA who had never tried CPAP when initially recruited. The CCUQ was completed at one month after being prescribed CPAP.----- Results: Exploratory factor analysis (EFA) showed a three factor structure of the 9-item CCUQ, with Health Cues, Partner Cues and Health Professional Cues subscales accounting for 59.91% of the total variance. The CCUQ demonstrated modest internal consistency and split-half reliability. The questionnaire is brief and user-friendly, with readability at a 7th grade level. The most frequently endorsed cues for starting CPAP were Health Professional Cues (prompting by the sleep physician) and Health Cues such as tiredness and concern about health outcomes.----- Conclusions: This study validates a measure of an important motivational component of the Health Belief Model. Health Professional Cues and internal Health Cues were reported to be the most important prompts to commence CPAP by this patient sample.

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Do commencing students possess the level of information literacy (IL) knowledge and skills they need to succeed at university? What impact does embedding IL within the engineering and design curriculum have? This paper reports on the self-perception versus the reality of IL knowledge and skills, across a large cohort of first year built environment and engineering students. Acting on the findings of this evaluation, the authors (a team of academic librarians) developed an intensive IL skills program which was integrated into a faculty wide unit. Perceptions, knowledge and skills were re-evaluated at the end of the semester to determine if embedded IL education made a difference. Findings reveal that both the perception and reality of IL skills were significantly and measurably improved.

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Adjuvant use of nutritional and herbal medicines has potential to increase the efficacy of synthetic pharmaceuticals, and perhaps also decrease their side-effects by allowing lower doses to be prescribed. We evaluated current evidence for adjuvant use of nutritional and herbal medicines with antidepressants, mood stabilizers and benzodiazepines; and explored novel future areas of research. The paper also critiques current evidence for co-administration of St. Johns wort with synthetic antidepressants. We performed a systematic search of MEDLINE, CINAHL, PsycINFO, The Cochrane database, China National Knowledge Infrastructure and the Chinese Science Citation Database. Search results were supplemented by a review of reference lists and a forward search using the Web of Science. Where possible we calculated effect sizes. Encouraging evidence exists for the use of omega-3 fatty acids, SAMe, folic acid and l-tryptophan adjuvantly with antidepressants to enhance response and improve efficacy. Various nutrients also have emerging evidence as effective adjuncts with antipsychotics and mood stabilizers. While some evidence supports nutritional adjuvancy with various psychopharmacotherapies, adjuvant use of herbal therapies has not been sufficiently studied to warrant standard clinical application. This remains a promising area of research via robust, safety-conscious studies.

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Rationale: Piper methysticum (Kava) has been withdrawn in European, British, and Canadian markets due to concerns over hepatotoxic reactions. The WHO recently recommended research into aqueous extracts of Kava. Objective: The objective of this study was to conduct the first documented human clinical trial assessing the anxiolytic and antidepressant efficacy of an aqueous extract of Kava. Design and participants: The Kava Anxiety Depression Spectrum Study was a 3-week placebo-controlled, double-blind crossover trial that recruited 60 adult participants with 1 month or more of elevated generalized anxiety. Five Kava tablets per day were prescribed containing 250 mg of kavalactones/day. Results: The aqueous extract of Kava reduced participants' Hamilton Anxiety Scale score in the first controlled phase by 9.9 (CI = 7.1, 12.7) vs. 0.8 (CI = 2.7, 4.3) for placebo and in the second controlled phase by 10.3 (CI = 5.8, 14.7) vs. +3.3 (CI = 6.8, 0.2). The pooled effect of Kava vs. placebo across phases was highly significant (p < 0.0001), with a substantial effect size (d = 2.24, [sub]p[sub] = 0.428). Pooled analyses also revealed highly significant relative reductions in Beck Anxiety Inventory and MontgomeryAsberg Depression Rating Scale scores. The aqueous extract was found to be safe, with no serious adverse effects and no clinical hepatotoxicity. Conclusions: The aqueous Kava preparation produced significant anxiolytic and antidepressant activity and raised no safety concerns at the dose and duration studied. Kava appears equally effective in cases where anxiety is accompanied by depression. This should encourage further study and consideration of globally reintroducing aqueous rootstock extracts of Kava for the management of anxiety.

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This kit, designed for youth and family services and practitioners, provides an outline of action research, suggested strategies and tools for undertaking action research, as well as discussion of various challenges.

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Participatory design has the moral and pragmatic tenet of including those who will be most affected by a design into the design process. However, good participation is hard to achieve and results linking project success and degree of participation are inconsistent. Through three case studies examining some of the challenges that different properties of knowledge novelty, difference, dependence can impose on the participatory endeavour we examine some of the consequences to the participatory process of failing to bridge across knowledge boundaries syntactic, semantic, and pragmatic. One pragmatic consequence, disrupting the users feeling of involvement to the project, has been suggested as a possible explanation for the inconsistent results linking participation and project success. To aid in addressing these issues a new form of participatory research, called embedded research, is proposed and examined within the framework of the case studies and knowledge framework with a call for future research into its possibilities.