214 resultados para Autosomal-dominant Hemochromatosis


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The significant challenge faced by government in demonstrating value for money in the delivery of major infrastructure resolves around estimating costs and benefits of alternative modes of procurement. Faced with this challenge, one approach is to focus on a dominant performance outcome visible on the opening day of the asset, as the means to select the procurement approach. In this case, value for money becomes a largely nominal concept and determined by selected procurement mode delivering, or not delivering, the selected performance outcome, and notwithstanding possible under delivery on other desirable performance outcomes, as well as possibly incurring excessive transaction costs. This paper proposes a mind-set change in this particular practice, to an approach in which the analysis commences with the conditions pertaining to the project and proceeds to deploy transaction cost and production cost theory to indicate a procurement approach that can claim superior value for money relative to other competing procurement modes. This approach to delivering value for money in relative terms is developed in a first-order procurement decision making model outlined in this paper. The model developed could be complementary to the Public Sector Comparator (PSC) in terms of cross validation and the model more readily lends itself to public dissemination. As a possible alternative to the PSC, the model could save time and money in preparation of project details to lesser extent than that required in the reference project and may send a stronger signal to the market that may encourage more innovation and competition.

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Purpose. The objective of this study was to explore the discriminative capacity of non-contact corneal esthesiometry (NCCE) when compared with the neuropathy disability score (NDS) score—a validated, standard method of diagnosing clinically significant diabetic neuropathy. Methods. Eighty-one participants with type 2 diabetes, no history of ocular disease, trauma, or surgery and no history of systemic disease that may affect the cornea were enrolled. Participants were ineligible if there was history of neuropathy due to non-diabetic cause or current diabetic foot ulcer or infection. Corneal sensitivity threshold was measured on the eye of dominant hand side at a distance of 10 mm from the center of the cornea using a stimulus duration of 0.9 s. The NDS was measured producing a score ranging from 0 to 10. To determine the optimal cutoff point of corneal sensitivity that identified the presence of neuropathy (diagnosed by NDS), the Youden index and “closest-to-(0,1)” criteria were used. Results. The receiver-operator characteristic curve for NCCE for the presence of neuropathy (NDS ≥3) had an area under the curve of 0.73 (p = 0.001) and, for the presence of moderate neuropathy (NDS ≥6), area of 0.71 (p = 0.003). By using the Youden index, for an NDS ≥3, the sensitivity of NCCE was 70% and specificity was 75%, and a corneal sensitivity threshold of 0.66 mbar or higher indicated the presence of neuropathy. When NDS ≥6 (indicating risk of foot ulceration) was applied, the sensitivity was 52% with a specificity of 85%. Conclusions. NCCE is a sensitive test for the diagnosis of minimal and more advanced diabetic neuropathy and may serve as a useful surrogate marker for diabetic and perhaps other neuropathies.

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In this paper I analyse UK artist Alison Jones’ sonic interventions Portrait of the Artist by Proxy (2008), Voyeurism by Proxy (2008) and Art, Lies and Audio Tapes (2009). In Portrait of the Artist by Proxy, Jones – who, due to deteriorating vision, has not seen her reflection in a mirror in years – asks and trusts participants to audio-describe her own image back to her. In Voyeurism by Proxy, Jones asks participants to audio-describe erotic drawings by Gustav Klimt. In Art, Lies and Audio Tapes, Jones asks participants to audio-describe other artworks, such as W.F. Yeames’ And When Did You Last see Your Father?. In these portraits by proxy, Jones opens her image, and other images, to interpretation. In doing so, Jones draws attention to the way sight is privileged as a mode of access to fixed, fundamental truths in Western culture – a mode assumed to be untainted by filters that skew perception of the object. “In a culture where vision is by far the dominant sense,” Jones says, “and as a visual artist with a visual impairment, I am reliant on audio-description …Inevitably, there are limitations imposed by language, time and the interpreter’s background knowledge of the subject viewed, as well as their personal bias of what is deemed important to impart in their description” . In these works, Jones strips these background knowledges, biases and assumptions bare. She reveals different perceptions, as well as tendencies or censor, edit or exaggerate descriptions. In this paper, I investigate how, by revealing unconscious biases, Jones’ works renders herself and her participants vulnerable to a change of perception. I also examine how Jones’ later editing of the audio-descriptions allows her to show the instabilities of sight, and, in Portrait of the Artist by Proxy, to reclaim authorship of her own image.

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Recently, the numerical modelling and simulation for fractional partial differential equations (FPDE), which have been found with widely applications in modern engineering and sciences, are attracting increased attentions. The current dominant numerical method for modelling of FPDE is the explicit Finite Difference Method (FDM), which is based on a pre-defined grid leading to inherited issues or shortcomings. This paper aims to develop an implicit meshless approach based on the radial basis functions (RBF) for numerical simulation of time fractional diffusion equations. The discrete system of equations is obtained by using the RBF meshless shape functions and the strong-forms. The stability and convergence of this meshless approach are then discussed and theoretically proven. Several numerical examples with different problem domains are used to validate and investigate accuracy and efficiency of the newly developed meshless formulation. The results obtained by the meshless formations are also compared with those obtained by FDM in terms of their accuracy and efficiency. It is concluded that the present meshless formulation is very effective for the modelling and simulation for FPDE.

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The Granadilla eruption at 600 ka was one of the largest phonolitic explosive eruptions from the Las Cañadas volcano on Tenerife, producing a classical plinian eruptive sequence of a widespread pumice fall deposit overlain by an ignimbrite. The eruption resulted in a major phase of caldera collapse that probably destroyed the shallow-level magma chamber system. Granadilla pumices contain a diverse phenocryst assemblage of alkali feldspar + biotite + sodian diopside to aegirine–augite + titanomagnetite + ilmenite + nosean/haüyne + titanite + apatite; alkali feldspar is the dominant phenocryst and biotite is the main ferromagnesian phase. Kaersutite and partially resorbed plagioclase (oligoclase to sodic andesine) are present in some eruptive units, particularly in pumice erupted during the early plinian phase, and in the Granadilla ignimbrite at the top of the sequence. Associated with the kaersutite and plagioclase are small clots of microlitic plagioclase and kaersutite interpreted as quenched blebs of tephriphonolitic magma within the phonolite pumice. The Granadilla Member has previously been recognized as an example of reverse-then-normal compositional zonation, where the zonation is primarily expressed in terms of substantial variations in trace element abundances with limited major element variation (cryptic zonation). Evidence for cryptic zonation is also provided by the chemistry of the phenocryst phases, and corresponding changes in intensive parameters (e.g. T, f O2, f  H2O). Geothermometry estimates indicate that the main body of phonolite magma had a temperature gradient from 860 °C to ∼790 °C, with hotter magma (≥900 °C) tapped at the onset and terminal phases of the eruption. The reverse-then-normal chemical and thermal zonation reflects the initial tapping of a partially hybridized magma (mixing of phonolite and tephriphonolite), followed by the more sequential tapping of a zoned and relatively large body of highly evolved phonolite at a new vent and during the main plinian phase. This suggests that the different magma types within the main holding chamber could have been laterally juxtaposed, as well as in a density-stratified arrangement. Correlations between the presence of mixed phenocryst populations (i.e. presence of plagioclase and kaersutite) and coarser pumice fall layers suggest that increased eruption vigour led to the tapping of hybridized and/or less evolved magma probably from greater depths in the chamber. New oxygen isotope data for glass and mineral separates preclude syn-eruptive interaction between the vesiculating magma and hydrothermal fluids as the cause of the Sr isotope disequilibrium identified previously for the deposit. Enrichment in radiogenic Sr in the pumice glass has more likely been due to low-temperature exchange with meteoric water that was enriched in 87Sr by sea spray, which may be a common process affecting porous and glassy pyroclastic deposits on oceanic islands.

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"The Politics of Media Policy opens with a highly insightful analysis of how to do media policy studies in original and significant ways. Unfortunately, by anchoring its empirical analysis closely to a desire to expose the hidden machinations of neo-liberal ideology, it loses focus the more that it moves out of the dominant terrain of political economy in the study of media ownership. Des Freedman has pointed to important new directions in media policy studies, but has unfortunately only got half way to developing a new synthesis for understanding the relationship between policy institutions and broader ideas." -- from author's personal website

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Mycobacterium lentiflavum, a slow-growing nontuberculous mycobacterium, is a rare cause of human disease. It has been isolated from environmental samples worldwide. To assess the clinical significance of M. lentiflavum isolates reported to the Queensland Tuberculosis Control Centre, Australia, during 2001-2008, we explored the genotypic similarity and geographic relationship between isolates from humans and potable water in the Brisbane metropolitan area. A total of 47 isolates from 36 patients were reported; 4 patients had clinically significant disease. M. lentiflavum was cultured from 13 of 206 drinking water sites. These sites overlapped geographically with home addresses of the patients who had clinically significant disease. Automated repetitive sequence-based PCR genotyping showed a dominant environmental clone closely related to clinical strains. This finding suggests potable water as a possible source of M. lentiflavum infection in humans.

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The queer studies field works to deconstruct dominant western discourses which cast gay men as hedonistic partygoers. Concurrently it examines the real social ramifications for some gay men for whom partying, illegal drugs and casual sex is an everyday reality. Another reality of gay male culture is HIV/AIDS and the legal prescribed medicines which accompany these conditions. Pleasure Consuming Medicine: The Queer Politics of Drugs explores these realities and the discourses surrounding them. Exploring the embodiments of illegal and prescription drug users, this book problematises the binary between prescription medicine use, where drug use is configured as a matter of consumer choice, and 'illicit' drug use which is heavily policed and condemned. Returning to the gay community it reviews community approaches to safe sex and drug use, and individual practices, to demonstrate alternative approaches to condemning drug usage.

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The queer studies field works to deconstruct dominant western discourses which cast gay men as hedonistic partygoers. Concurrently it examines the real social ramifications for some gay men for whom partying, illegal drugs and casual sex is an everyday reality. Another reality of gay male culture is HIV/AIDS and the legal prescribed medicines which accompany these conditions. Pleasure Consuming Medicine: The Queer Politics of Drugs explores these realities and the discourses surrounding them. Exploring the embodiments of illegal and prescription drug users, this book problematises the binary between prescription medicine use, where drug use is configured as a matter of consumer choice, and 'illicit' drug use which is heavily policed and condemned. Returning to the gay community it reviews community approaches to safe sex and drug use, and individual practices, to demonstrate alternative approaches to condemning drug usage.

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Although relatively few studies have been undertaken analyzing the drivers of performance for construction companies in producing and delivering satisfactory quality of project works, findings from previous research reveal that there is a significant correlation between the company’s organisational culture and the quality performance of contractors. It has also been noted that the nature of organisational culture is a major determinant factor for quality improvement. This paper presents a summary of the results of a pilot study investigating the organisational culture profiles of five Indonesian construction companies. The survey utilizes the Organisational Culture Assessment Instrument (OCAI), which is based on the Competing Values Framework (CVF). This instrument assesses six important and significant traits of organisational culture: dominant characteristics, organisational leadership, management of employees, organisational ‘glue’, strategic emphasis, and criteria of success. These assessed cultural dimensions identify the most close-fitting perspective of a company’s inherent culture drawn from four possible types: clan, adhocracy, market, or hierarchy culture. Further discussion is presented, which describes the companies’ dominant cultural profiles in terms of strength and congruence and how an effective quality management system operates within the dominant culture type. This analysis contributes to the finding that a suitably ‘strong’ organisational culture impacts positively on construction organisation success within its own specific sector.

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The field of literacy studies has always been challenged by the changing technologies that humans have used to express, represent and communicate their feelings, ideas, understandings and knowledge. However, while the written word has remained central to literacy processes over a long period, it is generally accepted that there have been significant changes to what constitutes ‘literate’ practice. In particular, the status of the printed word has been challenged by the increasing dominance of the image, along with the multimodal meaning-making systems facilitated by digital media. For example, Gunther Kress and other members of the New London Group have argued that the second half of the twentieth century saw a significant cultural shift from the linguistic to the visual as the dominant semiotic mode. This in turn, they suggest, was accompanied by a cultural shift ‘from page to screen’ as a dominant space of representation (e.g. Cope & Kalantzis, 2000; Kress, 2003; New London Group, 1996). In a similar vein, Bill Green has noted that we have witnessed a shift from the regime of the print apparatus to a regime of the digital electronic apparatus (Lankshear, Snyder and Green, 2000). For these reasons, the field of literacy education has been challenged to find new ways to conceptualise what is meant by ‘literacy’ in the twenty first century and to rethink the conditions under which children might best be taught to be fully literate so that they can operate with agency in today’s world.

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The terms ‘literacy’ and ‘technology’ remain highly contentious within the field of education. What is meant by ‘literacy’ and the methods used to measure it vary quite markedly in educational and historical contexts across the world. Similarly, while there is a shared concern to research the potential impact of new information and communication technologies (ICTs) on patterns of teaching and learning, there are major discrepancies about which aspects and uses of these technologies should be incorporated into formal learning environments and how this can be accomplished. While government policy makers tend to regard ICTs in relation to ideas of ‘smartness’, efficiency, and the ‘knowledge’ (or ‘new’) economy, educators and educational researchers promote them as offering new tools for learning and critical thinking and the development of new literacies and socio-cultural identities. This clearly has ramifications for the ways literacy is taught and conceptualised throughout the years of schooling, K-12. Outside school, meanwhile, students engage with ICTs on another level entirely, as tools for the maintenance of social networks, for leisure, and for learning and participating in the cultures of their peers. Whatever the differences in perspective, it remains the case that a society’s dominant understandings about literacy and technology will have significant implications for the development of school curriculum.

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The author, a teacher of television and film from a cultural studies perspective, endeavours to persuade his students to give up snobbery when they judge culture. The author has found that most students enter university with a series of middle class value judgements very strongly in place. Essentially, the judgements are that commercial culture is 'bad' and non-commercial culture is 'good'.

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When managers of entrepreneurial companies typically talk about strategies, they first consider what products to make and secondly where to locate the business. The entrepreneurial companies locate in rural areas because of a wish to maintain a certain lifestyle, or because they can combine a resource available there with certain knowledge or interest that they have (Getz and Nilsson, 2004). In addition, many managers of entrepreneurial companies are confident in locating in a rural area, because there often is economic and social structure supportive of local corporate governance. The most central part of corporate governance is the board of directors. In an entrepreneurial company in a rural area, such members of boards are most likely to be individuals in dominant positions influential in the local economy.

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Australia’s efforts to transition to a low-emissions economy have stagnated following the successive defeats of the Carbon Pollution Reduction Scheme. This failure should not, however, be regarded as the end of Australia’s efforts to make this transition. In fact, the opportunity now exists for Australia to refine its existing arrangements to enable this transition to occur more effectively. The starting point for this analysis is the legal arrangements applying to the electricity generation sector, which is the largest sectoral emitter of anthropogenic greenhouse gas emissions in Australia. Without an effective strategy to mitigate this sector’s contribution to anthropogenic climate change, it is unlikely that Australia will be able to transition towards a low-emissions economy. It is on this basis that this article assesses the dominant national legal arrangement – the Renewable Energy Target – underpinning the electricity generation sector's efforts to become a low-emissions sector.