666 resultados para Early healing
Resumo:
There is increasing evidence that parenting and feeding interact to influence children’s eating behaviour and weight status. Interpretation of existing research is complicated by the lack of consensus in the conceptualisation and measurement of both ‘parenting’ and ‘feeding’, particularly the distinction between ‘styles’, ‘dimensions’ and ‘practices’. In addition, the lack of validated tools to concurrently assess feeding practices in infancy limits the capacity to examine the relationships between parenting and feeding in infancy and their short- and long-term influence on weight status. In this paper we provide an overview of the constructs examined in this emerging area of research, highlight the conceptual, definitional and measurement challenges and propose a unifying model to aid design and the interpretation of intervention studies. Progress on these methodological issues will contribute to the robust evidence required to justify investment in interventions that focus on parenting and feeding in the context of child obesity prevention.
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Hypertrophic scars arise when there is an overproduction of collagen during wound healing. These are often associated with poor regulation of the rate of programmed cell death(apoptosis) of the cells synthesizing the collagen or by an exuberant inflammatory response that prolongs collagen production and increases wound contraction. Severe contractures that occur, for example, after a deep burn can cause loss of function especially if the wound is over a joint such as the elbow or knee. Recently, we have developed a morphoelastic mathematical model for dermal repair that incorporates the chemical, cellular and mechanical aspects of dermal wound healing. Using this model, we examine pathological scarring in dermal repair by first assuming a smaller than usual apoptotic rate for myofibroblasts, and then considering a prolonged inflammatory response, in an attempt to determine a possible optimal intervention strategy to promote normal repair, or terminate the fibrotic scarring response. Our model predicts that in both cases it is best to apply the intervention strategy early in the wound healing response. Further, the earlier an intervention is made, the less aggressive the intervention required. Finally, if intervention is conducted at a late time during healing, a significant intervention is required; however, there is a threshold concentration of the drug or therapy applied, above which minimal further improvement to wound repair is obtained.
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There is a continued need to consider ways to prevent early adolescent engagement in a variety of harmful risk-taking behaviours for example, violence, road-related risks and alcohol use. The current prospective study examined adolescents’ reports of intervening to try and stop friends’ engagement in such behaviours among 207 early adolescents (mean age = 13.51 years, 50.1% females). Findings showed that intervening behaviour after three months was predicted by the confidence to intervene which in turn was predicted by student and teacher support although not parental support. The findings suggest that the benefits of positive relationship experiences might extend to the safety of early adolescent friendship groups particularly through the development of confidence to try and stop friends’ risky and dangerous behaviours. Findings from the study support the important role of the school in creating a culture of positive adolescent behaviour whereby young people take social responsibility.
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This chapter examines the changing landscape of literacy in the early years and considers how the diverse spaces and places in which early literacy learning is promoted and takes place can be conceptualised and researched. We argue that early literacy research needs to extend beyond a language focus to become attentive to the embodied, material dimensions of learning environments. The discussion is organised in terms of three kinds of spaces within which children encounter opportunities to participate in communication and representational practices. These are domestic spaces, commercial spaces and spaces of formal education. Theories of spatiality and material semiotics provide the conceptual tools for interpreting research studies located in these spaces. Implications for educators are considered.
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Young children are the most vulnerable and most at risk of environmental challenges, current and future. Yet, early learning around environment and sustainability issues and topics has been neglected and underrated in early childhood education even though there is an expanding body of research literature – from economics, neuroscience, sociology and health – that shows that early investments in human capital offer substantial returns for individuals and for communities and have a long reach into the future. Early childhood education for sustainability (ECEfS) - a synthesis of early childhood education (ECE) and education for sustainability (EfS) - builds on groundings in play, outdoor learning and nature education, but takes a stronger focus on learning about, and engagement with, environmental and sustainability issues. Child participation and agency is central to ECEfS and can relate, for example, to local environmental problem-solving such as water and energy conservation or waste reduction in a childcare centre, kindergarten or preschool, or young children’s social learning for Indigenous Reconciliation and cultural inclusivity. While the ECE field has been much slower than other educational sectors in taking up the challenges of sustainability, this situation is rapidly changing as early childhood practitioners begin to engage – it is fast moving from the margins of early childhood curriculum and pedagogic decision-making into the mainstream. This presents challenges, however, as ECEfS is somewhat misunderstood and misrepresented and, as a new field, is under-researched and under-theorised.
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Purpose: Colorectal cancer patients diagnosed with stage I or II disease are not routinely offered adjuvant chemotherapy following resection of the primary tumor. However, up to 10% of stage I and 30% of stage II patients relapse within 5 years of surgery from recurrent or metastatic disease. The aim of this study was to determine if tumor-associated markers could detect disseminated malignant cells and so identify a subgroup of patients with early-stage colorectal cancer that were at risk of relapse. Experimental Design: We recruited consecutive patients undergoing curative resection for early-stage colorectal cancer. Immunobead reverse transcription-PCR of five tumor-associated markers (carcinoembryonic antigen, laminin γ2, ephrin B4, matrilysin, and cytokeratin 20) was used to detect the presence of colon tumor cells in peripheral blood and within the peritoneal cavity of colon cancer patients perioperatively. Clinicopathologic variables were tested for their effect on survival outcomes in univariate analyses using the Kaplan-Meier method. A multivariate Cox proportional hazards regression analysis was done to determine whether detection of tumor cells was an independent prognostic marker for disease relapse. Results: Overall, 41 of 125 (32.8%) early-stage patients were positive for disseminated tumor cells. Patients who were marker positive for disseminated cells in post-resection lavage samples showed a significantly poorer prognosis (hazard ratio, 6.2; 95% confidence interval, 1.9-19.6; P = 0.002), and this was independent of other risk factors. Conclusion: The markers used in this study identified a subgroup of early-stage patients at increased risk of relapse post-resection for primary colorectal cancer. This method may be considered as a new diagnostic tool to improve the staging and management of colorectal cancer. © 2006 American Association for Cancer Research.
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While there is strong interest in teaching values in Australia and internationally there is little focus on young children’s moral values learning in the classroom. Research shows that personal epistemology influences teaching and learning in a range of education contexts, including moral education. This study examines relationships between personal epistemologies (children’s and teachers’), pedagogies, and school contexts for moral learning in two early years classrooms. Interviews with teachers and children and analysis of school policy revealed clear patterns of personal epistemologies and pedagogies within each school. A whole school approach to understanding personal epistemologies and practice for moral values learning is suggested.
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The intention of the analysis in this paper was to determine, from interviews with 11 early years’ teachers, what informed their knowledge of children’s learning and teaching strategies regarding moral development. Overall, the analysis revealed four main categories: definitions of moral behaviour, understanding of children’s learning, pedagogy for moral learning, and the source of knowledge for moral pedagogy. Children’s learning was attributed by five of the teachers to incidental/contextual issues. Nine of the teachers reported using pedagogies that involved discussion of issues, in various contexts, as a way of teaching about social and moral issues. The majority of the teachers (n = 7) described the source of their knowledge of pedagogy as practical/observed as opposed to being theoretically informed. There was no clear relationship between teachers’ definitions, understanding of children’s learning, pedagogy or source of knowledge. These results suggests a strong need for the teaching of moral development to be given more prominence and addressed directly in in-service courses so that teachers are clear about their intentions and the most effective ways of achieving them.
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Purpose: To measure renal adenosine triphosphate (ATP) (bioenergetics) during hypotensive sepsis with or without angiotensin II (Ang II) infusion. Methods: In anaesthetised sheep implanted with a renal artery flow probe and a magnetic resonance coil around one kidney, we induced hypotensive sepsis with intravenous Escherichia coli injection. We measured mean arterial pressure (MAP), heart rate, renal blood flow RBF and renal ATP levels using magnetic resonance spectroscopy. After 2 h of sepsis, we randomly assigned sheep to receive an infusion of Ang II or vehicle intravenously and studied the effect of treatment on the same variables. Results: After E. coli administration, the experimental animals developed hypotensive sepsis (MAP from 92 ± 9 at baseline to 58 ± 4 mmHg at 4 h). Initially, RBF increased, then, after 4 h, it decreased below control levels (from 175 ± 28 at baseline to 138 ± 27 mL/min). Despite decreased RBF and hypotension, renal ATP was unchanged (total ATP to inorganic phosphate ratio from 0.69 ± 0.02 to 0.70 ± 0.02). Ang II infusion restored MAP but caused significant renal vasoconstriction. However, it induced no changes in renal ATP (total ATP to inorganic phosphate ratio from 0.79 ± 0.03 to 0.80 ± 0.02). Conclusions:During early hypotensive experimental Gram-negative sepsis, there was no evidence of renal bioenergetic failure despite decreased RBF. In this setting, the addition of a powerful renal vasoconstrictor does not lead to deterioration in renal bioenergetics.
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Education might be conceptualized as a swarm of signs. Deleuze, in Proust and Signs (1964/2000) suggests that “Everything that teaches us something emits signs” (p. 4). Such conceptualizations regard education as fluid, multiple and temporal; a young child can display great skill in decoding some signs but not others. Regarding education as temporal and complex operates at some distance to the sociocultural concepts suggested by Vygotsky (1978) which focus on linear sequences of gaining managed, culturally-loaded knowledge from more experienced others. Despite differing theorizations around apprenticeship, during early years education a child becomes sensitive to signs that collectively prioritize conventionalized knowledge acquisition and communication practices. Drawing for learning and communicating exemplifies apprenticeship as a creative process rather than as sequential or culturally driven, and serves to exemplify Deleuzian concepts around the relationships between time and learning, rather than age or development stage and learning.
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Chronic venous leg ulcers are a detrimental health issue plaguing our society, resulting in long term pain, immobility and decreased quality of life for a large proportion of sufferers. The frequency of these chronic wounds has led current research to focus on the wound environment to provide important information regarding the prolonged, fluctuated or static healing patterns of these wounds. Disruption to the normal wound healing process results in release of multiple factors in the wound environment that could correlate to wound chronicity. These biochemical factors can often be detected through non-invasively sampling chronic wound fluid (CWF) from the site of injury. Of note, whilst there are numerous studies comparing acute and chronic wound fluids, there have not been any reports in the literature employing a longitudinal study in order to track biochemical changes in wound fluid as patients transition from a non-healing to healed state. Initially the objective of this study was to identify biochemical changes in CWF associated with wound healing using a proteomic approach. The proteomic approach incorporated a multi-dimensional liquid chromatography fractionation technique coupled with mass spectrometry (MS) to enable identification of proteins present in lower concentrations in CWF. Not surprisingly, many of the proteins identified in wound fluid were acute phase proteins normally expressed during the inflammatory phase of healing. However, the number of proteins positively identified by MS was quite low. This was attributed to the diverse range in concentration of protein species in CWF making it challenging to detect the diagnostically relevant low molecular weight proteins. In view of this, SELDI-TOF MS was also explored as a means to target low molecular weight proteins in sequential patient CWF samples during the course of healing. Unfortunately, the results generated did not yield any peaks of interest that were altered as wounds transitioned to a healed state. During the course of proteomic assessment of CWF, it became evident that a fraction of non-proteinaceous compounds strongly absorbed at 280 nm. Subsequent analyses confirmed that most of these compounds were in fact part of the purine catabolic pathway, possessing distinctive aromatic rings and which results in high absorbance at 254 nm. The accumulation of these purinogenic compounds in CWF suggests that the wound bed is poorly oxygenated resulting in a switch to anaerobic metabolism and consequently ATP breakdown. In addition, the presence of the terminal purine catabolite, uric acid (UA), indicates that the enzyme xanthine oxidoreductase (XOR) catalyses the reaction of hypoxanthine to xanthine and finally to UA. More importantly, the studies provide evidence for the first time of the exogenous presence of XOR in CWF. XOR is the only enzyme in humans capable of catalysing the production of UA in conjunction with a burst of the highly reactive superoxide radical and other oxidants like H2O2. Excessive release of these free radicals in the wound environment can cause cellular damage disrupting the normal wound healing process. In view of this, a sensitive and specific assay was established for monitoring low concentrations of these catabolites in CWF. This procedure involved combining high performance liquid chromatography (HPLC) with tandem mass spectrometry and multiple reaction monitoring (MRM). This application was selective, using specific MRM transitions and HPLC separations for each analyte, making it ideal for the detection and quantitation of purine catabolites in CWF. The results demonstrated that elevated levels of UA were detected in wound fluid obtained from patients with clinically worse ulcers. This suggests that XOR is active in the wound site generating significant amounts of reactive oxygen species (ROS). In addition, analysis of the amount of purine precursors in wound fluid revealed elevated levels of purine precursors in wound fluid from patients with less severe ulcers. Taken together, the results generated in this thesis suggest that monitoring changes of purine catabolites in CWF is likely to provide valuable information regarding the healing patterns of chronic venous leg ulcers. XOR catalysis of purine precursors not only provides a method for monitoring the onset, prognosis and progress of chronic venous leg ulcers, but also provides a potential therapeutic target by inhibiting XOR, thus blocking UA and ROS production. Targeting a combination of these purinogenic compounds and XOR could lead to the development of novel point of care diagnostic tests. Therefore, further investigation of these processes during wound healing will be worthwhile and may assist in elucidating the pathogenesis of this disease state, which in turn may lead to the development of new diagnostics and therapies that target these processes.
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Nonhealing wounds are a major burden for health care systems worldwide. In addition, a patient who suffers from this type of wound usually has a reduced quality of life. While the wound healing process is undoubtedly complex, in this paper we develop a deterministic mathematical model, formulated as a system of partial differential equations, that focusses on an important aspect of successful healing: oxygen supply to the wound bed by a combination of diffusion from the surrounding unwounded tissue and delivery from newly formed blood vessels. While the model equations can be solved numerically, the emphasis here is on the use of asymptotic methods to establish conditions under which new blood vessel growth can be initiated and wound-bed angiogenesis can progress. These conditions are given in terms of key model parameters including the rate of oxygen supply and its rate of consumption in the wound. We use our model to discuss the clinical use of treatments such as hyperbaric oxygen therapy, wound bed debridement, and revascularisation therapy that have the potential to initiate healing in chronic, stalled wounds.
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This paper examines social change following the recent introduction of mobile telephony into rural communities in Papua New Guinea (PNG). It presents the findings of substantial fieldwork conducted in 2009, and suggests ways in which the new technology is already changing people’s lives and relationships. The paper identifies the roles of mobile telephones in two communities, the changes taking place, and how villagers are responding to them. Comparison of the two villages is strategic as it highlights similarities in perceptions of mobile phones in these two very different settings. An ethnographic approach is adopted, situated within an interpretative methodology. Data collection methods include semi-structured interviews, orally-administered surveys and participant observation. The theoretical lens is focused on the ‘communicative ecology’ concept, which stems from the communication research tradition. This research is significant as it addresses changes currently occurring in the communication methods of whole communities.
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The authors provide a theoretically generative definition of cyberinfrastructure (CI) by drawing from existing definitions and literature in social sciences, law, and policy studies. They propose two models of domestic and international influencers on CI emergence, development, and implementation in the early 21st century. Based on its historical emergence and computational power, they argue that cyberinfrastructure is built on, and yet distinct from the current notion of the internet. The authors seek to answer two research questions: firstly, what is cyberinfrastructure? And secondly, what national and international influencers shape its emergence, development and implementation (in e-science) in the early 21st century? Additionally, consideration will be given to the implications of the proposed definition and models, and future directions on CI research in Internet studies will be suggested.
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Purpose: The construction industry is well known for its high accident rate and many practitioners consider a preventative approach to be the most important means of bringing about improvements. This paper addresses previous research and the weaknesses of existing preventative approaches and a new application is described and illustrated involving the use of a multi-dimensional simulation tool - Construction Virtual Prototyping (CVP). Methodology: A literature review was conducted to investigate previous studies of hazard identification and safety management and to develop the new approach. Due to weaknesses in current practice, the research study explored the use of computer simulation techniques to create virtual environments where users can explore and identify construction hazards. Specifically, virtual prototyping technology was deployed to develop typical construction scenarios in which unsafe or hazardous incidents occur. In a case study, the users’ performance was evaluated their responses to incidents within the virtual environment and the effectiveness of the computer simulation system established though interviews with the safety project management team. Findings: The opinions and suggestions provided by the interviewees led to the initial conclusion that the simulation tool was useful in assisting the safety management team’s hazard identification process during the early design stage. Originality: The research introduces an innovative method to support the management teams’ reviews of construction site safety. The system utilises three-dimensional modelling and four-dimensional simulation of worker behaviour, a configuration that has previously not been employed in construction simulations. An illustration of the method’s use is also provided, together with a consideration of its strengths and weaknesses.