131 resultados para Communication in medicine.


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Areal bone mineral density (aBMD) is the most common surrogate measurement for assessing the bone strength of the proximal femur associated with osteoporosis. Additional factors, however, contribute to the overall strength of the proximal femur, primarily the anatomical geometry. Finite element analysis (FEA) is an effective and widely used computerbased simulation technique for modeling mechanical loading of various engineering structures, providing predictions of displacement and induced stress distribution due to the applied load. FEA is therefore inherently dependent upon both density and anatomical geometry. FEA may be performed on both three-dimensional and two-dimensional models of the proximal femur derived from radiographic images, from which the mechanical stiffness may be redicted. It is examined whether the outcome measures of two-dimensional FEA, two-dimensional, finite element analysis of X-ray images (FEXI), and three-dimensional FEA computed stiffness of the proximal femur were more sensitive than aBMD to changes in trabecular bone density and femur geometry. It is assumed that if an outcome measure follows known trends with changes in density and geometric parameters, then an increased sensitivity will be indicative of an improved prediction of bone strength. All three outcome measures increased non-linearly with trabecular bone density, increased linearly with cortical shell thickness and neck width, decreased linearly with neck length, and were relatively insensitive to neck-shaft angle. For femoral head radius, aBMD was relatively insensitive, with two-dimensional FEXI and threedimensional FEA demonstrating a non-linear increase and decrease in sensitivity, respectively. For neck anteversion, aBMD decreased non-linearly, whereas both two-dimensional FEXI and three dimensional FEA demonstrated a parabolic-type relationship, with maximum stiffness achieved at an angle of approximately 15o. Multi-parameter analysis showed that all three outcome measures demonstrated their highest sensitivity to a change in cortical thickness. When changes in all input parameters were considered simultaneously, three and twodimensional FEA had statistically equal sensitivities (0.41±0.20 and 0.42±0.16 respectively, p = ns) that were significantly higher than the sensitivity of aBMD (0.24±0.07; p = 0.014 and 0.002 for three-dimensional and two-dimensional FEA respectively). This simulation study suggests that since mechanical integrity and FEA are inherently dependent upon anatomical geometry, FEXI stiffness, being derived from conventional two-dimensional radiographic images, may provide an improvement in the prediction of bone strength of the proximal femur than currently provided by aBMD.

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The purpose of this paper is threefold. First, we propose a systemic view of communication based in autopoiesis, the theory of living systems formulated by Maturana & Varela (1980, 1987). Second, we show the links between the underpinning assumptions of autopoiesis and the sociolinguistic approaches of Halliday (1978), Fairclough (1989, 1992, 1995) and Lemke (1995, 1994). Third, we propose a theoretical and analytical synthesis of autopoiesis and sociolinguistics for the study of organisational communication. In proposing a systemic theory for organisational communication, we argue that traditional approaches to communication, information, and the role of language in human organisations have, to date, been placed in teleological constraints because of an inverted focus on organisational purpose-the generally perceived role of an organisation within society-that obscure, rather than clarify, the role of language within human organisations. We argue that human social systems are, according to the criteria defined by Maturana and Varela, third-order, non-organismic living systems constituted in language. We further propose that sociolinguistics provides an appropriate analytical tool which is both compatible and penetrating in synthesis with the systemic framework provided by an autopoietic understanding of social organisation.

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The effects of radiation backscattered from the secondary collimators into the monitor chamber in an Elekta linac (producing 6 and 10 MV photon beams) are investigated using BEAMnrc Monte Carlo simulations. The degree and effects of this backscattered radiation are assessed by evaluating the changes to the calculated dose in the monitor chamber, and by determining a correction factor for those changes. Additionally, the fluency and energy characteristics of particles entering the monitor chamber from the downstream direction are evaluated by examining BEAMnrc phase-space data. It is shown that the proportion of particles backscattered into the monitor chamber is small (<0.35 %), for all field sizes studied. However, when the backscatter plate is removed from the model linac, these backscattered particles generate a noticeable increase in dose to the monitor chamber (up to approximate to 2.4 % for the 6 MV beam and up to 4.4 % for the 10 MV beam). With its backscatter plate in place, the Elekta linac (operating at 6 and 10 MV) is subject to negligible variation of monitor chamber dose with field size. At these energies, output variations in photon beams produced by the clinical Elekta linear accelerator can be attributed to head scatter alone. Corrections for field-size-dependence of monitor chamber dose are not necessary when running Monte Carlo simulations of the Elekta linac operating at 6 and 10 MV.

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Non-Western practitioners across the globe instinctively attempt to implement Western-based public relations models and theories, often unsuccessfully, regardless of their surrounding environment. This paper reviews business practices and reveals that in Europe, company interests are a main priority, while in Asia, the line between business and personal relationships is extremely blurred. Cultural dimensions and topois were even more varied between the three regions. Implications for the adoption of Western models of public relations practice are discussed.

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This paper investigates the possibility of power sharing improvements amongst distributed generators with low cost, low bandwidth communications. Decentralized power sharing or power management can be improved significantly with low bandwidth communication. Utility intranet or a dedicated web based communication can serve the purpose. The effect of network parameter such line impedance, R/X ratio on decentralized power sharing can be compensated with correction in the decentralized control reference quantities through the low bandwidth communication. In this paper, the possible improvement is demonstrated in weak system condition, where the micro sources and the loads are not symmetrical along the rural microgrid with high R/X ratio line, creates challenge for decentralized control. In those cases the web based low bandwidth communication is economic and justified than costly advance high bandwidth communication.

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Throughout history, developments in medicine have aimed to improve patient quality of life, and reduce the trauma associated with surgical treatment. Surgical access to internal organs and bodily structures has been traditionally via large incisions. Endoscopic surgery presents a technique for surgical access via small (1 Omm) incisions by utilising a scope and camera for visualisation of the operative site. Endoscopy presents enormous benefits for patients in terms of lower post operative discomfort, and reduced recovery and hospitalisation time. Since the first gall bladder extraction operation was performed in France in 1987, endoscopic surgery has been embraced by the international medical community. With the adoption of the new technique, new problems never previously encountered in open surgery, were revealed. One such problem is that the removal of large tissue specimens and organs is restricted by the small incision size. Instruments have been developed to address this problem however none of the devices provide a totally satisfactory solution. They have a number of critical weaknesses: -The size of the access incision has to be enlarged, thereby compromising the entire endoscopic approach to surgery. - The physical quality of the specimen extracted is very poor and is not suitable to conduct the necessary post operative pathological examinations. -The safety of both the patient and the physician is jeopardised. The problem of tissue and organ extraction at endoscopy is investigated and addressed. In addition to background information covering endoscopic surgery, this thesis describes the entire approach to the design problem, and the steps taken before arriving at the final solution. This thesis contributes to the body of knowledge associated with the development of endoscopic surgical instruments. A new product capable of extracting large tissue specimens and organs in endoscopy is the final outcome of the research.

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This study focused on a group of primary school teachers as they implemented a variety of intervention actions within their class programs aimed towards supporting the reduction of high levels of communication apprehension (CA) among students.Six teachers and nine students, located across three primary schools, four year levels,and six classes, participated in this study. For reasons of confidentiality the schools,principals, parents, teachers, teacher assistants, and students who were involved in this study were given fictitious names. The following research question was explored in this study: What intervention actions can primary school teachers implement within their class programs that support the reduction of high CA levels among students? Throughout this study the term CA referred to "an individual's level of fear or anxiety associated with either real or anticipated (oral) communication with another person or persons" (McCroskey, 1984, p. 13). The sources of CA were explained with reference to McCroskey's state-trait continuum. The distinctions between high and appropriate levels of CA were determined conceptually and empirically. The education system within which this study was conducted promoted the philosophy of inclusion and the practices of inclusive schooling. Teachers employed in this system were encouraged to create class programs inclusive of and successful for all students. Consequently the conceptual framework within which this study was conducted was based around the notion of inclusion. Action research and case study research were the methodologies used in the study. Case studies described teachers' action research as they responded to the challenge of executing intervention actions within their class programs directed towards supporting the reduction of high CA levels among students. Consequently the teachers and not the researcher were the central characters in each of the case studies. Three principal data collection instruments were used in this study: Personal Report of Communication Fear (PRCF) scale, semistructured interviews, and dialogue journals. The PRCF scale was the screening tool used to identify a pool of students eligible for the study. Data relevant to the students involved in the study were gathered during semistructured interviews and throughout the dialogue journaling process. Dialogue journaling provided the opportunity for regular contact between teachers and the researcher, a sequence to teacher and student intervention behaviours, and a permanent record of teacher and student growth and development. The majority of teachers involved in this study endeavoured to develop class programs inclusive of all students.These teachers acknowledged the importance of modifying aspects of their class programs in response to the diverse and often multiple needs of individual students with high levels of CA. Numerous conclusions were drawn regarding practical ways that the teachers in this study supported the reduction of high CA levels among students. What this study has shown is that teachers can incorporate intervention actions within their class programs aimed towards supporting students lower their high levels of CA. Whilst no teacher developed an identical approach to intervention, similarities and differences were evident among teachers regarding their selection, interpretation, and implementation of intervention actions. Actions that teachers enacted within their class programs emerged from numerous fields of research including CA, inclusion, social skills, behaviour teaching, co-operative learning, and quality schools. Each teacher's knowledge of and familiarity with these research fields influenced their preference for and commitment to particular intervention actions. Additional factors including each teacher's paradigm of inclusion and exclusion contributed towards their choice of intervention actions. Possible implications of these conclusions were noted with reference to teachers,school administrators, support personnel, system personnel, teacher educators, parents, and researchers.

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wenty-eight international scholars contribute 11 chapters on the key role of communication in intergroup relations. Following an introductory essay on intergroup theory and communication processes, the text focuses on specific intergroup contexts, examining communication within and between cultural, disability, age, sex and sexuality, and language groups. The remaining chapters explore the communicating of identity across communication contexts, including small group, organizational, mass, and Internet communications. The text is designed for scholars in the fields of communication and intergroup social psychology, and is also suited for use in upper- division undergraduate and introductory graduate courses in those areas. Annotation ©2004 Book News, Inc., Portland, OR

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There are a number of gel dosimeter calibration methods in contemporary usage. The present study is a detailed Monte Carlo investigation into the accuracy of several calibration techniques. Results show that for most arrangements the dose to gel accurately reflects the dose to water, with the most accurate method involving the use of a large diameter flask of gel into which multiple small fields of varying dose are directed. The least accurate method was found to be that of a long test tube in a water phantom, coaxial with the beam. The large flask method is also the most straightforward and least likely to introduce errors during setup, though, to its detriment, the volume of gel required is much more than other methods.

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This paper investigates the current turbulent state of copyright in the digital age, and explores the viability of alternative compensation systems that aim to achieve the same goals with fewer negative consequences for consumers and artists. To sustain existing business models associated with creative content, increased recourse to DRM (Digital Rights Management) technologies, designed to restrict access to and usage of digital content, is well underway. Considerable technical challenges associated with DRM systems necessitate increasingly aggressive recourse to the law. A number of controversial aspects of copyright enforcement are discussed and contrasted with those inherent in levy based compensation systems. Lateral exploration of the copyright dilemma may help prevent some undesirable societal impacts, but with powerful coalitions of creative, consumer electronics and information technology industries having enormous vested interest in current models, alternative schemes are frequently treated dismissively. This paper focuses on consideration of alternative models that better suit the digital era whilst achieving a more even balance in the copyright bargain.