674 resultados para intellectual life


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Background: Improved survivorship has led to increased recognition of the need to manage the side effects of cancer and its treatment. Exercise and psychological interventions benefit survivors; however, it is unknown if additional benefits can be gained by combining these two modalities. Objective: Our purpose was to examine the feasibility of delivering an exercise and counseling intervention to 43 breast cancer survivors, to determine if counseling can add value to an exercise intervention for improving quality of life (QOL) in terms of physical and psychological function. Methods: We compared exercise only (Ex), counseling only (C), exercise and counseling (ExC), and usual care (UsC) over an 8 week intervention. Results: In all, 93% of participants completed the interventions, with no adverse effects documented. There were significant improvements in VO2max as well as upper body and lower body strength in the ExC and Ex groups compared to the C and UsC groups (P < .05). Significant improvements on the Beck Depression Inventory were observed in the ExC and Ex groups, compared with UsC (P < .04), with significant reduction in fatigue for the ExC group, compared with UsC, and no significant differences in QOL change between groups, although the ExC group had significant clinical improvement. Limitations: Limitations included small subject number and study of only breast cancer survivors. Conclusions: These preliminary results suggest that a combined exercise and psychological counseling program is both feasible and acceptable for breast cancer survivors and may improve QOL more than would a single-entity intervention.

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Current educational reform, policy and public discourse emphasise standardisation of testing, curricula and professional practice, yet the landscape of literacy practices today is fluid, interactive, multimodal, ever-changing, adaptive and collaborative. How then can English and literacy educators negotiate these conflicting terrains? The nature of today’s literacy practices is reflected in a concept of living texts which refers to experienced events and encounters that offer meaning-making that is fluid, interactive and changing. Literacy learning possibilities with living texts are described and discussed by the authors who independently investigated the place of living texts across two distinctly different learning contexts: a young people’s community arts project and a co-taught multiliteracies project in a high school. In the community arts project, young people created living texts as guided walks of urban spaces that adapt and change to varying audiences. In the multiliteracies project, two parents and a teacher created interactive spaces through co-teaching and cogenerative dialoguing. These spaces generate living texts that yield a purposefully connected curriculum rich in community-relevant and culturally significant texts. These two studies are shared with a view of bringing living texts into literacy education to loosen rigidity in standardisation.

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Background Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL. Methods The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations. Conclusions This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

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Background Over half of the residents in long-term care have a diagnosis of dementia. Maintaining quality of life is important, as there is no cure for dementia. Quality of life may be used as a benchmark for caregiving, and can help to enhance respect for the person with dementia and to improve care provision. The purpose of this study was to describe quality of life as reported by people living with dementia in long-term care in terms of the influencers of, as well as the strategies needed, to improve quality of life. Methods A descriptive exploratory approach. A subsample of twelve residents across two Australian states from a national quantitative study on quality of life was interviewed. Data were analysed thematically from a realist perspective. The approach to the thematic analysis was inductive and data-driven. Results Three themes emerged in relation to influencers and strategies related to quality of life: (a) maintaining independence; (b) having something to do, and; (c) the importance of social interaction. Conclusions The findings highlight the importance of understanding individual resident needs and consideration of the complexity of living in large group living situations, in particular in regard to resident decision-making.

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The American Association of Australasian Literary Studies (AAALS) Annual Conference, Forth Worth, Texas, 9–11 April 2015. The dark fluidity of Melbourne suburbia in Sonya Hartnett’s Butterfly Sonya Hartnett’s Butterfly (2009) is a fictional account of the suburban family life of the Coyles in 1980’s outer suburban Melbourne written from the perspective of teenager Plum Coyle. The Coyle family at first glance appear to be living a textbook example of the suburban lifestyle developed from the 19th century and sustained well into the twentieth century, in which housing design and gender roles were clearly defined and “connected with a normative heterosexuality” (Johnson 2000: 94). The Australian suburban space is also well documented as a place where people often have to contend with oppressive rigid social and cultural ideals (ie Rowse 1978, Johnson 1993, Turnbull 2008, and Flew 2011). There is a tendency to group “suburb” as one monolithic space but this paper will argue that Hartnett exposes the dark fluidity and the complexity of the term, just as she reveals that despite or perhaps because of the planned nature of suburbia, the lives that people live are often just as complex.

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The ability to estimate the expected Remaining Useful Life (RUL) is critical to reduce maintenance costs, operational downtime and safety hazards. In most industries, reliability analysis is based on the Reliability Centred Maintenance (RCM) and lifetime distribution models. In these models, the lifetime of an asset is estimated using failure time data; however, statistically sufficient failure time data are often difficult to attain in practice due to the fixed time-based replacement and the small population of identical assets. When condition indicator data are available in addition to failure time data, one of the alternate approaches to the traditional reliability models is the Condition-Based Maintenance (CBM). The covariate-based hazard modelling is one of CBM approaches. There are a number of covariate-based hazard models; however, little study has been conducted to evaluate the performance of these models in asset life prediction using various condition indicators and data availability. This paper reviews two covariate-based hazard models, Proportional Hazard Model (PHM) and Proportional Covariate Model (PCM). To assess these models’ performance, the expected RUL is compared to the actual RUL. Outcomes demonstrate that both models achieve convincingly good results in RUL prediction; however, PCM has smaller absolute prediction error. In addition, PHM shows over-smoothing tendency compared to PCM in sudden changes of condition data. Moreover, the case studies show PCM is not being biased in the case of small sample size.

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Purpose Improved survival for men with prostate cancer has led to increased attention to factors influencing quality of life (QOL). As protein levels of vascular endothelial growth factor (VEGF) and insulin-like growth factor 1 (IGF-1) have been reported to be associated with QOL in people with cancer, we sought to identify whether single-nucleotide polymorphisms (SNPs) of these genes were associated with QOL in men with prostate cancer. Methods Multiple linear regression of two data sets (including approximately 750 men newly diagnosed with prostate cancer and 550 men from the general population) was used to investigate SNPs of VEGF and IGF-1 (10 SNPs in total) for associations with QOL (measured by the SF-36v2 health survey). Results Men with prostate cancer who carried the minor ‘T’ allele for IGF-1 SNP rs35767 had higher mean Role-Physical scale scores (≥0.3 SD) compared to non-carriers (p < 0.05). While this association was not identified in men from the general population, one IGF-1 SNP rs7965399 was associated with higher mean Bodily Pain scale scores in men from the general population that was not found in men with prostate cancer. Men from the general population who carried the rare ‘C’ allele had higher mean Bodily Pain scale scores (≥0.3 SD) than non-carriers (p < 0.05). Conclusions Through identifying SNPs that are associated with QOL in men with prostate cancer and men from the general population, this study adds to the mapping of complex interrelationships that influence QOL and suggests a role for IGF-I in physical QOL outcomes. Future research may identify biomarkers associated with increased risk of poor QOL that could assist in the provision of pre-emptive support for those identified at risk.

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The objective of this study was to identify symptom clusters and their effect on quality of life (QOL) of adults with chronic leg ulcers of mixed venous and arterial aetiology. A secondary analysis of data from four existing prospective longitudinal studies conducted by a wound healing research group in Australia was undertaken. A total of 110 patients who met the inclusion criteria were selected for this study. Exploratory factor analysis (EFA) was used to identify symptom clusters and correlational analyses to examine relationships between the identified symptom clusters and QOL. The EFA identified two distinct symptom clusters: a 'systemic symptom cluster' consisting of pain, fatigue and depressive symptoms; and a 'localised-leg symptom cluster' including pain, fatigue, oedema, lower limb inflammation and exudate. Physical QOL correlated significantly with the systemic symptom cluster (r = -0·055, P < 0·0001) and the localised-leg symptom cluster (r = -0·054, P < 0·0001), whereas mental QOL was associated only with the systemic symptom cluster (r = -0·038, P = 0·01). The results suggest that appropriate intervention strategies targeting specific symptom clusters should be developed. Targeting patients with symptom clusters is particularly important because they are at high risk and the most vulnerable for reduced QOL.

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This article discusses the experience of economic inequality of badli workers in the state-owned jute mills of the postcolonial state of Bangladesh, and how this inequality is constituted and perpetuated. Nominally appointed to fill posts during the temporary absence of permanent workers, the reality of badli workers’ employment is very different. They define themselves as ‘a different category of workers’, with limited economic entitlements. We undertake content analysis of the badli workers’ narratives to identify elements that they themselves consider constitute these economic entitlements. We consider their perceptions of discrimination and exclusion and explain how, in response to these feelings, they construct their survival strategy. From this, through the writings of Armatya Sen, we discuss the badli workers’ contextual experience and understanding of economic inequality in relation to extant theoretical understandings, seeking to contribute to the field and to empirical studies in the subaltern context.

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Background: To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning (ACP) in their jurisdiction of practice. This includes the use of advance directives/living wills (ADs) and substitute decision-makers (SDMs) who can legally consent to or refuse treatment if there is no valid AD. Aim: The study aimed to investigate the knowledge, attitudes and practices of medical specialists most often involved in end-of-life care in relation to the law on withholding/ withdrawing life-sustaining treatment (WWLST) from adults without decision-making capacity. Design/participants: A pre-piloted survey was posted to specialists in palliative, emergency, geriatric, renal and respiratory medicine, intensive care and medical oncology in three Australian States. Surveys were analysed using SPSS20 and SAS 9.3. Results: The overall response rate was 32% (867/2702); 52% from palliative care specialists. Palliative Care specialists and Geriatricians had significantly more positive attitudes towards the law (χ242 = 94.352; p < 0.001) and higher levels of knowledge about the WWLST law (χ27 = 30.033; p < 0.001), than did the other specialists, while still having critical gaps in their knowledge. Conclusions: A high level of knowledge of the law is essential to ensure that patients’ wishes and decisions, expressed through ACP, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or removal of treatment.

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This PhD playfully employs visual arts as a means through which to explore concepts of gender, normative behaviour, play, humour, collecting and an intimate and idiosyncratic relationship with domestic space. This PhD seeks to: represent certain complexities of individual experience through theoretical frameworks of Gaston Bachelard, Michel de Certeau, Pierre Bourdieu and selected visual artists; use my art to elucidate the humour that exists in the mundane; and illustrate the construction of particular life-worlds using auto-ethnography and visual documentation. This is represented in a 50,000 word exegesis (50%) and a practice comprising of eight artist books (50%).

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We argue that safeguards are necessary to ensure human rights are adequately protected. All systems of blocking access to online content necessarily raise difficult and problematic issues of infringement of freedom of speech and access to information. Given the importance of access to information across the breadth of modern life, great care must be taken to ensure that any measures designed to protect copyright by blocking access to online locations are proportionate. Any measures to block access to online content must be carefully tailored to avoid serious and disproportionate impact on human rights. This means first that the measures must be effective and adapted to achieve a legitimate purpose. The experience of foreign jurisdictions suggests that this legislation is unlikely to be effective. Unless and until there is clear evidence that the proposed scheme is likely to increase effective returns to Australian creators, this legislation should not be introduced. Second, the principle of proportionality requires ensuring that the proposed legislation does not unnecessarily burden legitimate speech or access to information. As currently worded, the draft legislation may result in online locations being blocked even though they would, if operated in Australia, not contravene Australian law. This is unacceptable, and if introduced, the law should be drafted so that it is clearly limited only to foreign locations where there is clear and compelling evidence that the location would authorise copyright infringement if it were in Australia. Third, proportionality requires that measures are reasonable and strike an appropriate balance between competing interests. This draft legislation provides few safeguards for the public interest or the interests of private actors who would access legitimate information. New safeguards should be introduced to ensure that the public interest is well represented at both the stage of the primary application and at any applications to rescind or vary injunctions. We recommend that: The legislation not be introduced unless and until there is compelling evidence that it will have a real and significant positive impact on the effective incomes of Australian creators. The ‘facilitates an infringement’ test in s 115A(1)(b) should be replaced with ‘authorises infringement’. The ‘primary purpose’ test in s 115A(1)(c) should be replaced with: “the online location has no substantial non-infringing uses”. An explicit role for public interest groups as amici curiae should be introduced. Costs of successful applications should be borne by applicants. Injunctions should be valid only for renewable two year terms. Section 115A(5) should be clarified, and cl (b) and (c) be removed. The effectiveness of the scheme should be evaluated in two years.

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AIMS The aim of this narrative review of the literature was to examine the current state of knowledge regarding the impact of aggressive surgical interventions for severe stroke on patient and caregiver quality of life and caregiver outcomes. BACKGROUND Decompressive hemicraniectomy (DHC) is a surgical therapeutic option for treatment of massive middle cerebral artery infarction (MCA), lobar intracerebral hemorrhage (ICH), and severe aneurysmal subarachnoid hemorrhage (aSAH). Decompressive hemicraniectomy has been shown to be effective in reducing mortality in these three life-threatening conditions. Significant functional impairment is an experience common to many severe stroke survivors worldwide and close relatives experience decision-making difficulty when confronted with making life or death choices related to surgical intervention for severe stroke. DATA SOURCES Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PsychInfo. REVIEW METHODS A narrative review methodology was utilized in this review of the literature related to long-term outcomes following decompressive hemicraniectomy for stroke. The key words decompressive hemicraniectomy, severe stroke, middle cerebral artery stroke, subarachnoid hemorrhage, lobar ICH, intracerebral hemorrhage, quality of life, and caregivers, literature review were combined to search the databases. RESULTS Good functional outcomes following DHC for life-threatening stroke have been shown to be associated with younger age and few co-morbid conditions. It was also apparent that quality of life was reduced for many stroke survivors, although not assessed routinely in studies. Caregiver burden has not been systematically studied in this population. CONCLUSION Most patients and caregivers in the studies reviewed agreed with the original decision to undergo DHC and would make the same decision again. However, little is known about quality of life for both patients and caregivers and caregiver burden over the long-term post-surgery. Further research is needed to generate information and interventions for the management of ongoing patient and carer recovery following DHC for severe stroke.

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In The Climate Change Review, Ross Garnaut emphasised that ‘Climate change and climate change mitigation will bring about major structural change in the agriculture, forestry and other land use sectors’. He provides this overview of the effects of climate change on food demand and supply: ‘Domestic food production in many developing countries will be at immediate risk of reductions in agricultural productivity due to crop failure, livestock loss, severe weather events and new patterns of pests and diseases.’ He observes that ‘Changes to local climate and water availability will be key determinants of where agricultural production occurs and what is produced.’ Gert Würtenberger has commented that modern plant breeding is particularly concerned with addressing larger issues about nutrition, food security and climate change: ‘Modern plant breeding has an increasing importance with regard to the continuously growing demand for plants for nutritional and feeding purposes as well as with regard to renewal energy sources and the challenges caused by climate changes.’ Moreover, he notes that there is a wide array of scientific and technological means of breeding new plant varieties: ‘Apart from classical breeding, technologies have an important role in the development of plants that satisfy the various requirements that industrial and agricultural challenges expect to be fulfilled.’ He comments: ‘Plant variety rights, as well as patents which protect such results, are of increasingly high importance to the breeders and enterprises involved in plant development programmes.’ There has been larger interest in the intersections between sustainable agriculture, environmental protection and food security. The debate over agricultural intellectual property is a polarised one, particularly between plant breeders, agricultural biotechnology companies and a range of environmentalist groups. Susan Sell comments that there are complex intellectual property battles surrounding agriculture: 'Seeds are at the centre of a complex political dynamic between stakeholders. Access to seeds concerns the balance between private rights and public obligations, private ownership and the public domain, and commercial versus humanitarian objectives.' Part I of this chapter considers debates in respect of plant breeders’ rights, food security and climate change in relation to the UPOV Convention 1991. Part II explores efforts by agricultural biotechnology companies to patent climate-ready crops. Part III considers the report of the Special Rapporteur for Food, Olivier De Schutter. It looks at a variety of options to encourage access to plant varieties with climate adaptive or mitigating properties.

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Engaging in a close analysis of legal and political discourse, this chapter considers conflicts over intellectual property and climate change in three key arenas: climate law; trade law; and intellectual property law. In this chapter, it is argued that there is a need to overcome the political stalemates and deadlocks over intellectual property and climate change. It is essential that intellectual property law engage in a substantive fashion with the matrix of issues surrounding fossil fuels, clean technologies, and climate change at an international level. First, this chapter examines the debate over intellectual property and climate change under the auspices of the United Nations Framework Convention on Climate Change 1992, and the establishment of the UNFCCC Climate Technology Centre and Network. It recommends that the technology mechanism should address and deal with matters of intellectual property management and policy. Second, the piece examines the discussion of global issues in the World Intellectual Property Organization, WIPO GREEN. It supports the proposal for a Global Green Patent Highway to allow for the fast-tracking of intellectual property applications in respect of green technologies. Third, the chapter investigates the dispute in the TRIPS Council at the World Trade Organization over intellectual property, climate change, and development. This section focuses upon the TRIPS Agreement 1994. This chapter calls for a Joint Declaration on Intellectual Property and Climate Change from the UNFCCC, WIPO, and the WTO. The paper concludes that intellectual property should be reformed as part of a larger effort to promote climate justice. Rather than adopt a fragmented, piecemeal approach in various international institutions, there is a need for a co-ordinated and cohesive response to intellectual property in an age of runaway, global climate change. Patent law should be fossil fuel free. Intellectual property should encourage research, development, and diffusion of renewable energy and clean technologies. It is submitted that intellectual property law reform should promote climate justice in line with Mary Robinson’s Declaration on Climate Justice 2013.