972 resultados para CHLC PAT CLIN


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(-)-CGP12177 is a non-conventional partial agonist that causes modest and transient increases of contractile force in human atrial trabeculae (Kaumann and Molenaar, 2008). These effects are markedly increased and maintained by inhibition of phosphodiesterase PDE3. As verified with recombinant receptors, the cardiostimulant effect of (-)-CGP12177 is mediated through a site at the beta1-adrenoceptor with lower affinity (beta1LAR) compared to the site through which (-)-CGP12177 antagonizes the effects of catecholamines (beta1HAR). However, in a recent report it was proposed that the positive inotropic effects of CGP12177 are mediated through beta3-adrenoceptors (Skeberdis et al 2008). We therefore investigated whether the effects of (-)-CGP12177 on human atrial trabeculae are antagonized by the beta3-adrenoceptor-selective antagonist L-748,337 (1 microM). (-)-CGP12177 (200 nM) caused a stable increase in force which was significantly reduced by the addition of (-)-bupranolol (1 microM), P = 0.002, (basal 4.45 ± 0.78 mN, IBMX (PDE inhibitor) 5.47 ± 1.01 mN, (-)-CGP12177 9.34 ± 1.33 mN, (-)-bupranolol 5.79 ± 1.08 mN, n = 6) but not affected by the addition of L-748,337 (1 microM), P = 0.12, (basal 4.48 ± 1.32 mN, IBMX 7.15 ± 2.28 mN, (-)-CGP12177 12.51 ± 3.71 mN, L-748,337 10.90 ± 3.49 mN, n = 6). Cumulative concentration-effect curves for (-)-CGP12177 were not shifted to the right by L-748,337 (1 microM). The –logEC50M values of (-)-CGP12177 in the absence and presence of L-748,337 were 7.21±0.09 and 7.41±0.13, respectively (data from 25 trabeculae from 8 patients, P=0.2) The positive inotropic effects of (-)-CGP12177 (IBMX present) were not antagonized by L-748,337 but were blunted by (-)-bupranolol (1 microM). The results rule out an involvement of beta3-adrenoceptors in the positive inotropic effects (-)-CGP12177 in human right atrial myocardium and are consistent with mediation through beta1LAR. Kaumann A and Molenaar P (2008) Pharmacol Ther 118, 303-336 Skeberdis VA et al (2008) J Clin Invest, 118, 3219-3227

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The paper describes Personal Access Tutor (PAT),an Intelligent Tutoring System which helps students to learn how to create forms and reports in MS Access. We present the architecture and components of PAT and also the services that PAT provides to the students. Results for an external (system) evaluation of PAT (both qualitative and quantitative data) are presented and discussed.

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The 1AR has two binding sites which can be activated to cause cardiostimulation. The first, termed, 1HAR (high affinity site of 1AR) is activated by noradrenaline and adrenaline and is blocked by relatively low concentrations of β-blockers including carvedilol (Kaumann and Molenaar, 2008). The other, termed, 1LAR (low affinity site of 1AR) has lower affinity for noradrenaline and adrenaline and is activated by some β-blockers including CGP12177 and pindolol, at higher concentrations than those required to block the receptor (Kaumann and Molenaar, 2008). (-)-CGP12177 is a non-conventional partial agonist that causes modest and transient increases of contractile force in human atrial trabeculae (Kaumann and Molenaar, 2008). These effects are markedly increased and maintained by inhibition of phosphodiesterase PDE3. The stimulant effects of (-)-CGP12177 at human β1ARs was verified with recombinant receptors (Kaumann and Molenaar, 2008). However, in a recent report it was proposed that the positive inotropic effects of CGP12177 are mediated through 3ARs in human right atrium (Skeberdis et al 2008). This proposal was not consistent with the lack of blockade of (-)-CGP12177 inotropic effects or increases in L-type Ca2+ current (ICa-L ) by the β3AR blocker 1 μM LY748,337 (Christ et al, 2010). On the otherhand, (-)-CGP12177 increases in inotropic effects and ICa-L were blocked by (-)-bupranolol 1-10 μM (Christ et al, 2010). Chronic infusion of (-)-CGP 12177 (10 mg/Kg/24 hours) for four weeks in an aortic constriction mouse model of heart failure caused an increase in left ventricular wall thickness, fibrosis and inflammation-related left ventricular gene expression levels. Christ T et al (2010) Br J Pharmacol, In press Kaumann A and Molenaar P (2008) Pharmacol Ther 118, 303-336 Skeberdis VA et al (2008) J Clin Invest, 118, 3219-3227

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This chapter outlines issues of excessive anxiety in Indigenous youth. It describes what an anxiety disorder is and its consequences and how Indigenous youth seem to be at risk for developing such disorders. Issues concerning the delivery of traditional prevention and intervention programs are discussed and possible interventions are provided.

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This chapter explores the ‘creative pedagogies’ of imaginative teaching and learning and the development of creative capacities in formal schooling. It considers how educational policies enable and constrain creative thinking as students learn through play and experimentation. The chapter outlines two classroom based case studies involving creative media technologies in Queensland, Australia. It argues that Queensland’s ‘open’ system of curriculum development enabled the two schools to implement transdisciplinary ‘rich tasks’ for the students. However, there are constraints related to the social mediation of creativity and the influence of high stakes testing in foregrounding ‘value’ and ‘purpose’ in learning.

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Commentary on : Carey JV. Literature review : should antipyretic therapies routinely be administered to patients with [corrected] fever? J Clin Nurs 2010;19:2377–93.

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The development and implementation of the Australian Curriculum together with national testing of students and the publication of school results place new demands on teachers. In this article we address the importance of teachers becoming attuned to the silent assessors in assessment generally and in the National Literacy and Numeracy Program (NAPLAN) more specifically. Using the concept of literacies, we develop a method to conduct a literacy audit of assessment tasks that teachers can use to help both themselves and their students. Providing assistance to students as a consequence of such an audit is imperative to improve the outcomes for students and to address issues of equity.

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This chapter reports on a project in which university researchers’ expertise in architecture, literacy and communications enabled two teachers in one school to expand the forms of literacy that primary school children engaged in. Starting from the school community’s concerns about an urban renewal project in their neighbourhood, participants collaborated to develop a curriculum of spatial literacies with real-world goals and outcomes. We describe how the creative re-design of curriculum and pedagogy by classroom teachers, in collaboration with university academics and students, allowed students aged 8 to 12 years to appropriate semiotic resources from their local neighbourhood, home communities, and popular culture to make a difference to their material surrounds. We argue that there are productive possibilities for educators who integrate critical and place-based approaches to the design and teaching of the literacy curriculum with work in other learning areas such as society and environment, technology and design and the arts. The student production of expansive and socially significant texts enabled by such approaches may be especially necessary in contemporary neoconservative policy contexts that tend to limit and constrain what is possible in schools.

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Objectives:  Comparatively few people with severe mental illness are employed despite evidence that many people within this group wish to obtain, can obtain and sustain employment, and that employment can contribute to recovery. This investigation aimed to: (i) describe the current policy and service environment within which people with severe mental illness receive employment services; (ii) identify evidence-based practices that improve employment outcomes for people with severe mental illness; (iii) determine the extent to which the current Australian policy environment is consistent with the implementation of evidence-based employment services for people with severe mental illness; and (iv) identify methods and priorities for enhancing employment services for Australians with severe mental illness through implementation of evidence-based practices. Method:  Current Australian practices were identified, having reference to policy and legal documents, funding body requirements and anecdotal reports. Evidence-based employment services for people with severe mental illness were identified through examination of published reviews and the results of recent controlled trials. Results:  Current policy settings support the provision of employment services for people with severe mental illness separate from clinical services. Recent studies have identified integration of clinical and employment services as a major factor in the effectiveness of employment services. This is usually achieved through co-location of employment and mental health services. Conclusions:  Optimal evidence-based employment services are needed by Australians with severe mental illness. Providing optimal services is a challenge in the current policy environment. Service integration may be achieved through enhanced intersectoral links between employment and mental health service providers as well as by co-locating employment specialists within a mental health care setting.

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The field of research is contemporary theatre practice with a community focus. In 2007, La Boite Theatre Company partnered with the Queensland Music Festival to produce an operatic representation of the 1964 Mt Isa industrial dispute, focussed on the charismatic figure of Pat Mackie. “Community theatre” is often criticised on grounds that the work aims only to satisfy community outcomes. This work explored whether a story from a specific location, which is very much an embedded story in the culture of the Mt Isa community, could be told in such a way as to appeal to, resonate with, and have relevance for, broader national and international audiences. To address this question required rigorous interrogation of both content and form. The play was researched through interviews with members of the Mt Isa community, political leadership at the time of the dispute, and participants of the dispute, including Pat Mackie himself. The production was then framed as an oratorio. Uniquely, the play had two back-to-back seasons; the first in Mount Isa (3 shows: 1500 people including a significant number of school children) and a 4-week season at the Roundhouse Theatre, Brisbane (over 5,000 attendances). In each location, a chorale was formed of community participants who, alongside the professional cast, performed the work. The production and its complementary exhibition had a significant local and national profile. The project was featured in The Australian newspaper’s Queensland Music Festival wrap-up as an exemplar of successful community engagement and creative adventure. Playlab Press has since published the script.

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The use of “Day in Prison” programs to deter young adult offenders is a concept which originated in the United States and was replicated in Australia during the late 1970s. After almost a decade of uncertainty this model of ‘crime prevention’ re-emerged in Victoria with the introduction of a pilot “Day in Prison” program. This article traces the development and operation of the Victorian experience and provides evaluation research findings which conclude that coercive, intimidatory and degrading aversion techniques should not be utilised by the criminal justice system for the purposes of individual deterrence.

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Introduction:  Smoking status in outpatients with chronic obstructive pulmonary disease (COPD) has been associated with a low body mass index (BMI) and reduced mid-arm muscle circumference (Cochrane & Afolabi, 2004). Individuals with COPD identified as malnourished have also been found to be twice as likely to die within 1 year compared to non-malnourished patients (Collins et al., 2010). Although malnutrition is both preventable and treatable, it is not clear what influence current smoking status, another modifiable risk factor, has on malnutrition risk. The current study aimed to establish the influence of smoking status on malnutrition risk and 1-year mortality in outpatients with COPD. Methods:  A prospective nutritional screening survey was carried out between July 2008 and May 2009 at a large teaching hospital (Southampton General Hospital) and a smaller community hospital within Hampshire (Lymington New Forest Hospital). In total, 424 outpatients with a diagnosis of COPD were routinely screened using the ‘Malnutrition Universal Screening Tool’, ‘MUST’ (Elia, 2003); 222 males, 202 females; mean (SD) age 73 (9.9) years; mean (SD) BMI 25.9 (6.4) kg m−2. Smoking status on the date of screening was obtained for 401 of the outpatients. Severity of COPD was assessed using the GOLD criteria, and social deprivation determined using the Index of Multiple Deprivation (Nobel et al., 2008). Results:  The overall prevalence of malnutrition (medium + high risk) was 22%, with 32% of current smokers at risk (who accounted for 19% of the total COPD population). In comparison, 19% of nonsmokers and ex-smokers were likely to be malnourished [odds ratio, 1.965; 95% confidence interval (CI), 1.133–3.394; P = 0.015]. Smoking status remained an independent risk factor for malnutrition even after adjustment for age, social deprivation and disease-severity (odds ratio, 2.048; 95% CI, 1.085–3.866; P = 0.027) using binary logistic regression. After adjusting for age, disease severity, social deprivation, smoking status, malnutrition remained a significant predictor of 1-year mortality [odds ratio (medium + high risk versus low risk), 2.161; 95% CI, 1.021–4.573; P = 0.044], whereas smoking status did not (odds ratio for smokers versus ex-smokers + nonsmokers was 1.968; 95% CI, 0.788–4.913; P = 0.147). Discussion:  This study highlights the potential importance of combined nutritional support and smoking cessation in order to treat malnutrition. The close association between smoking status and malnutrition risk in COPD suggests that smoking is an important consideration in the nutritional management of malnourished COPD outpatients. Conclusions:  Smoking status in COPD outpatients is a significant independent risk factor for malnutrition and a weaker (nonsignificant) predictor of 1-year mortality. Malnutrition significantly predicted 1 year mortality. References:  Cochrane, W.J. & Afolabi, O.A. (2004) Investigation into the nutritional status, dietary intake and smoking habits of patients with chronic obstructive pulmonary disease. J. Hum. Nutr. Diet.17, 3–11. Collins, P.F., Stratton, R.J., Kurukulaaratchym R., Warwick, H. Cawood, A.L. & Elia, M. (2010) ‘MUST’ predicts 1-year survival in outpatients with chronic obstructive pulmonary disease. Clin. Nutr.5, 17. Elia, M. (Ed) (2003) The ‘MUST’ Report. BAPEN. http://www.bapen.org.uk (accessed on March 30 2011). Nobel, M., McLennan, D., Wilkinson, K., Whitworth, A. & Barnes, H. (2008) The English Indices of Deprivation 2007. http://www.communities.gov.uk (accessed on March 30 2011).