195 resultados para 171-1051


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Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.

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This paper provides an outline of the work undertaken by nurses who participated in the relief effort as members of Australian medical teams during the Sumatra-Andaman earthquake and tsunami response. This profile is contrasted with the information provided by nurses who registered their interest in volunteering to help via the Australian Tsunami Hotline. The paper provides an overview of the skills and background of the nurses who provided information to the hotline and describes the range and extent of experience among this cohort of potential volunteers. This data is compared to nursing workforce data and internal rates of volunteering in Australia. The paper concludes that further research is necessary to examine the motivations of and disincentives for nurses to volunteer for overseas (disaster) work and, to develop an improved understanding within the discipline of the skills and experience required of volunteer responders. Further, it is argued that the development of standards for the collection of disaster health volunteer data would assist future responses and provide better tools for developing an improved understanding of disaster volunteering.

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Immigration to Australia has long been the focus of negative political interest. In recent times, the proposal of exclusionary policies such as the Malaysia Deal in 2011 has fuelled further debate. In these debates, Federal politicians often describe asylum seekers and refugees as ‘illegal’, ‘queue jumpers’, and ‘boat people’. This article examines the political construction of asylum seekers and refugees during debates surrounding the Malaysia Deal in the Federal Parliament of Australia. Hansard parliamentary debates were analysed to identify the underlying themes and constructions that permeate political discourse about asylum seekers and refugees. We argue that asylum seekers arriving in Australia by boat were constructed as threatening to Australia’s national identity and border security, and were labelled as ‘illegitimate’. A dichotomous characterisation of legitimacy pervades the discourse about asylum seekers, with this group constructed either as legitimate humanitarian refugees or as illegitimate ‘boat arrivals’. Parliamentarians apply the label of legitimacy based on implicit criteria concerning the mode of arrival of asylum seekers, their respect for the so-called ‘queue’, and their ability to pay to travel to Australia. These constructions result in the misrepresentation of asylum seekers as illegitimate, undermining their right to protection under Australia’s laws and international obligations.

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The Sydney rock oyster (Saccostrea glomerata) (SRO) is an oyster species that only occurs in estuaries along Australia's east coast. The SRO industry evolved from commercial gathering of oyster in the 1790s to a high production volume aquaculture industry in the 1970s. However, since the late 1970s the SRO industry has experienced a significant and continuous decline in production quantities and the industry's future commercial viably appears to be uncertain. The aim of this study was to review the history and the status of the SRO industry and to discuss the potential future prospects of this industry. This study summarised findings of the existing literature about the industry and defined development stages of the industry. Particular focus was put on the more recent development within the industry (1980s-present) which has not been covered adequately in the existing literature. The finding from this study revealed that major issues of the industry are linked to the management of prevailing diseases, the handling of water quality impairments from increasing coastal development, increasing competition from Australia's Pacific oyster (Crassostrea gigas) industry and the current socio-economic profile of the industry. The study also found that policy makers are currently confronted by the dilemma of saving a "dying art". Findings from this industry review may be vital for current and future fisheries managers and stakeholders as a basis for reviewing industry management and development strategies. This review may also be of interest for other aquaculture industries and fisheries who are dealing with similar challenges as the SRO industry.

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Socio-economic characteristics such as age, gender, educational attainment, employment status, and income contain vital information about how an industry may respond to changing circumstances, and hence are of importance to decision makers. While some socio-economic studies exist, relatively little attention has been given to fishery and aquaculture industries in regards to their socio-economic profiles and their role in the development prospects of these industries. In this study, by way of example, we focus on Australia’s Sydney rock oyster (Saccostrea glomerata) (SRO) industry. The aim of this study was identify the socio-economic profile of the SRO industry and to illustrate the value of such information for an industry management assessment. The SRO industry has experienced a major decrease in production volume since the late 1970 and continues to be affected by prevailing diseases and increasing market competition from Australia’s Pacific oyster (Crassostrea gigas) industry. It is likely that socio-economic aspects have influenced this development within the SRO industry. The socio-economic profile was developed using data from a SRO industry farm survey which was undertaken in 2012. Findings suggested that this industry is characterised by a mature aged oyster farmer population and a part-time oyster farming approach. These characteristics may affect the farmers’ ability to drive innovation and growth. The results also suggested that there may be potential industry entry barriers present in the SRO industry which may prevent younger people taking up oyster farming. Given the results, the study concluded that the current socio-economic profile of the industry has likely contributed to the present economic status quo of the industry.

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Childhood obesity is a leading public health concern globally. This study aimed to extend research applying the principle of market segmentation to gain insight into changing the physical activity behaviour of children, particularly their walk to/from school behaviour. It further examined the utility of employing theory, specifically the Theory of Planned Behaviour (TPB), for this purpose. The study demonstrates the usefulness of behavioural, geographic and psychographic variables, as measured by the TPB, in distinguishing segments, offering an important contrast to prior segmentation studies emphasising demographic variables. This result provides empirical evidence of the value of employing the four segmentation bases, extending beyond a demographic focus, and the importance of incorporating behavioural theory in market segmentation. In so doing, this research provides key insights into changing children’s walking behaviour.

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The purpose of this article is to assess the viability of blanket sustainability policies, such as Building Rating Systems in achieving energy efficiency in university campus buildings. We analyzed the energy consumption trends of 10 LEED-certified buildings and 14 non-LEED certified buildings at a major university in the US. Energy Use Intensity (EUI) of the LEED buildings was significantly higher (EUILEED= 331.20 kBtu/sf/yr) than non-LEED buildings (EUInon-LEED=222.70 kBtu/sf/yr); however, the median EUI values were comparable (EUILEED= 172.64 and EUInon-LEED= 178.16). Because the distributions of EUI values were non-symmetrical in this dataset, both measures can be used for energy comparisons—this was also evident when EUI computations exclude outliers, EUILEED=171.82 and EUInon-LEED=195.41. Additional analyses were conducted to further explore the impact of LEED certification on university campus buildings energy performance. No statistically significant differences were observed between certified and non-certified buildings through a range of robust comparison criteria. These findings were then leveraged to devise strategies to achieve sustainable energy policies for university campus buildings and to identify potential issues with portfolio level building energy performance comparisons.

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Background The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual’s quality of life and healthcare costs. Objectives This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Design Secondary analysis of combined data collected from three previous prospective longitudinal studies. Setting The contributing studies’ participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Participants Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3 to 36 months). Methods Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. Results The median time to recurrence was 42 weeks (95% CI 31.9–52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07–2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84–10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003–1.01, p<0.001); while the protective factors were elevating legs for at least 30 minutes per day (HR 0.33, 95% CI 0.19–0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92–0.99, p=0.016), and walking around for at least three hours/day (HR 0.66, 95% CI 0.44–0.98, p=0.040). Conclusions Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence.

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This paper aims to provide a contextualised and embedded exploration of how the notions of "practice" and "participation", key concepts in the study of culture and media, are manifest in an example of a complex creative project. This project aimed to engage with refugees and asylum seekers through the co-creation of cultural material and is an outcome of an? ethnographic action research (Tacchi et al. 2003) partnership involving a community development worker in a settlement support agency and a storytelling/community media researcher (the author), along with other project collaborators. The discussion of this project focuses on the role of the facilitator and illustrates the processes of orchestrating a complex project involving a series of linked stages with cumulative effect. As practitioners at this site we are working in the space where personal narratives, participatory arts and media, and the staging of intercultural, civic dialogue events, intersect. Co-creative media facilitation in these contexts involves both managing hybrid communicative spaces and (re)combining the "integrative practices" (Schatzki 1996) of a range of professional approaches and creative roles. This is liminal work, located on the boundaries of several disciplines and practices. Drawing on reflections gathered from collaborative ethnographic descriptions (Bhattacharya 2008), this paper traces moments of practitioner uncertainty that can be linked to the way "practice" and “participation” is problematised within the community cultural development field in a way that is at times an uneasy fit with conventional ways of operating in social service roles. These moments of tension also indicate where this project pushed practitioners into spaces of improvisation and new learning. Keywords: Youth, refugees, community cultural development, co-creative media facilitation, ethnographic action research, intercultural dialogue.

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Abstract - English Multiple literacies refers to reading, reading the world and self. This article proposes an understanding of reading that goes beyond its definition in psychology and applied linguistics. This longitudinal project is interested in a conceptualisation of what reading is, how it functions and what it produces in becoming multilingual. Reading is explored through the lens of an empirical study involving five female pupils from senior Kindergarten to Grade 3 observed and interviewed in relation to activities at school and at home. The study took place in Ottawa schools where French is the sole language of instruction. Reading in the context of multiple literacies is conceptualised to disrupt /deterritorialise and to be immanent, offering the potentiality to go beyond what is to what could be. Becoming multilingual is a continuous movement involving networks of rhizomatic connections and reading the world and self. Résumé - Francais Les littératies multiples se réfèrent à la lecture, la lecture du monde et la lecture de soi. Cet article propose une compréhension de la lecture qui dépasse sa définition usuelle en psychologie et en linguistique appliquée. Ce projet longitudinal porte sur la conceptualisation de la lecture, son fonctionnement et ce qu’elle produit dans le devenir plurilingue. La lecture est examinée selon l’optique d’une étude empirique durant laquelle cinq écolières du jardin d’enfants à la 3e année étaient observées et interviewées par rapport à des activités à l’école et à la maison. L’étude a eu lieu dans des écoles d’Ottawa dont la seule langue d’enseignement est le français. Dans le contexte des littératies multiples, la lecture est conceptualisée comme étant perturbatrice/déterritorialisante et immanente. Elle offre la potentialité d’aller au-delà de ce qui est vers ce qui pourrait être. Devenir plurilingue est un mouvement continu faisant appel à des réseaux de connexions rhizomatiques et à la lecture du monde et de soi.

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We have studied the mineral kornerupine, a borosilicate mineral, by using a combination of scanning electron microscopy with energy-dispersive analysis and Raman and infrared spectroscopy. Qualitative chemical analysis of kornerupine shows a magnesium–aluminum silicate. Strong Raman bands at 925, 995, and 1051 cm−1 with bands of lesser intensity at 1035 and 1084 cm−1 are assigned to the silicon–oxygen stretching vibrations of the siloxane units. Raman bands at 923 and 947 cm−1 are attributed to the symmetrical stretching vibrations of trigonal boron. Infrared spectra show greater complexity and the infrared bands are more difficult to assign. Two intense Raman bands at 3547 and 3612 cm−1 are assigned to the stretching vibrations of hydroxyl units. The infrared bands are observed at 3544 and 3610 cm−1. Water is also identified in the spectra of kornerupine.

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Many researchers in the field of civil structural health monitoring (SHM) have developed and tested their methods on simple to moderately complex laboratory structures such as beams, plates, frames, and trusses. Fieldwork has also been conducted by many researchers and practitioners on more complex operating bridges. Most laboratory structures do not adequately replicate the complexity of truss bridges. Informed by a brief review of the literature, this paper documents the design and proposed test plan of a structurally complex laboratory bridge model that has been specifically designed for the purpose of SHM research. Preliminary results have been presented in the companion paper.

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The literature on alcohol consumption among university and residential college students in Australia and comparable countries shows a high incidence of heavy and/or frequent drinking. In this article, we report the findings from a study on alcohol consumption among undergraduate university students living in residential colleges in Australia. The aim of the study was to examine residents’ alcohol use as part of a broader set of institutional practices in higher education that are constructed as central to the student experience. The data were collected through in-depth semistructured interviews with 29 students from seven residential colleges. We found that inclusion of alcohol in many students’ social and extracurricular activities while residing in college is associated with heavy and/or frequent drinking. We suggest that the use of alcohol among students is shaped by the colleges’ institutional micro-processes, leading to a tension between college managements’ aim to foster alcohol citizenship and students’ liberty to engage in frequent and/or heavy drinking.

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We have studied the phosphate mineral vantasselite Al4(PO4)3(OH)3·9H2O using a combination of SEM with EDX and Raman and infrared spectroscopy. Qualitative chemical analysis shows Al, Fe and P. Raman bands at 1013 and 1027cm−1 are assigned to the PO43−ν1 symmetric stretching mode. The observation of two bands suggests the non-equivalence of the phosphate units in the vantasselite structure. Raman bands at 1051, 1076 and 1090cm−1 are attributed to the PO43−ν3 antisymmetric stretching vibration. A comparison is made with the spectroscopy of wardite. Strong infrared bands at 1044, 1078, 1092, 1112, 1133, 1180 and 1210cm−1 are attributed to the PO43−ν3 antisymmetric stretching mode. Some of these bands may be due to δAl2OH deformation modes. Vibrational spectroscopy offers a mechanism for the study of the molecular structure of vantasselite.

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Directly after the horrific events of September 11, 2001, many Americans were saying the same thing: the world has changed forever. They were overwhelmed with a sense that “the party was over.” It was clear that America had lost its innocence; it now had to “grow up.” Much of the fiction produced since 9/11 and with 9/11 at its core provides evidence of the larger cultural belief that September 11 was a turning point (much like adolescence) from which there is no turning back. In this chapter, I examine how three post-9/11 novels—Lorrie Moore’s A Gate at the Stairs, Joyce Maynard’s The Usual Rules, and John Updike’s Terrorist—position readers to understand September 11 as a moment that changed how young Americans come of age.