528 resultados para peak accelerations
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The focus of this thesis is discretionary work effort, that is, work effort that is voluntary, is above and beyond what is minimally required or normally expected to avoid reprimand or dismissal, and is organisationally functional. Discretionary work effort is an important construct because it is known to affect individual performance as well as organisational efficiency and effectiveness. To optimise organisational performance and ensure their long term competitiveness and sustainability, firms need to be able to induce their employees to work at or near their peak level. To work at or near their peak level, individuals must be willing to supply discretionary work effort. Thus, managers need to understand the determinants of discretionary work effort. Nonetheless, despite many years of scholarly investigation across multiple disciplines, considerable debate still exists concerning why some individuals supply only minimal work effort whilst others expend effort well above and beyond what is minimally required of them (Le. they supply discretionary work effort). Even though it is well recognised that discretionary work effort is important for promoting organisational performance and effectiveness, many authors claim that too little is being done by managers to increase the discretionary work effort of their employees. In this research, I have adopted a multi-disciplinary approach towards investigating the role of monetary and non-monetary work environment characteristics in determining discretionary work effort. My central research questions were "What non-monetary work environment characteristics do employees perceive as perks (perquisites) and irks (irksome work environment characteristics)?" and "How do perks, irks and monetary rewards relate to an employee's level of discretionary work effort?" My research took a unique approach in addressing these research questions. By bringing together the economics and organisational behaviour (OB) literatures, I identified problems with the current definition and conceptualisations of the discretionary work effort construct. I then developed and empirically tested a more concise and theoretically-based definition and conceptualisation of this construct. In doing so, I disaggregated discretionary work effort to include three facets - time, intensity and direction - and empirically assessed if different classes of work environment characteristics have a differential pattern of relationships with these facets. This analysis involved a new application of a multi-disciplinary framework of human behaviour as a tool for classifying work environment characteristics and the facets of discretionary work effort. To test my model of discretionary work effort, I used a public sector context in which there has been limited systematic empirical research into work motivation. The program of research undertaken involved three separate but interrelated studies using mixed methods. Data on perks, irks, monetary rewards and discretionary work effort were gathered from employees in 12 organisations in the local government sector in Western Australia. Non-monetary work environment characteristics that should be associated with discretionary work effort were initially identified through a review of the literature. Then, a qualitative study explored what work behaviours public sector employees perceive as discretionary and what perks and irks were associated with high and low levels of discretionary work effort. Next, a quantitative study developed measures of these perks and irks. A Q-sorttype procedure and exploratory factor analysis were used to develop the perks and irks measures. Finally, a second quantitative study tested the relationships amongst perks, irks, monetary rewards and discretionary work effort. Confirmatory factor analysis was firstly used to confirm the factor structure of the measurement models. Correlation analysis, regression analysis and effect-size correlation analysis were used to test the hypothesised relationships in the proposed model of discretionary work effort. The findings confirmed five hypothesised non-monetary work environment characteristics as common perks and two of three hypothesised non-monetary work environment characteristics as common irks. Importantly, they showed that perks, irks and monetary rewards are differentially related to the different facets of discretionary work effort. The convergent and discriminant validities of the perks and irks constructs as well as the time, intensity and direction facets of discretionary work effort were generally confirmed by the research findings. This research advances the literature in several ways: (i) it draws on the Economics and OB literatures to redefine and reconceptualise the discretionary work effort construct to provide greater definitional clarity and a more complete conceptualisation of this important construct; (ii) it builds on prior research to create a more comprehensive set of perks and irks for which measures are developed; (iii) it develops and empirically tests a new motivational model of discretionary work effort that enhances our understanding of the nature and functioning of perks and irks and advances our ability to predict discretionary work effort; and (iv) it fills a substantial gap in the literature on public sector work motivation by revealing what work behaviours public sector employees perceive as discretionary and what work environment characteristics are associated with their supply of discretionary work effort. Importantly, by disaggregating discretionary work effort this research provides greater detail on how perks, irks and monetary rewards are related to the different facets of discretionary work effort. Thus, from a theoretical perspective this research also demonstrates the conceptual meaningfulness and empirical utility of investigating the different facets of discretionary work effort separately. From a practical perspective, identifying work environment factors that are associated with discretionary work effort enhances managers' capacity to tap this valuable resource. This research indicates that to maximise the potential of their human resources, managers need to address perks, irks and monetary rewards. It suggests three different mechanisms through which managers might influence discretionary work effort and points to the importance of training for both managers and non-managers in cultivating positive interpersonal relationships.
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Foam-filled conical tubes have recently emerged as efficient energy absorbing devices to mitigate the adverse effects of impacts. The primary aim of this thesis was to generate research and design information on the impact and energy absorption response of empty and foam-filled conical tubes, and to facilitate their application in energy absorbing systems under axial and oblique loading conditions representative of those typically encountered in crashworthiness and impact applications. Finite element techniques supported by experiments and existing results were used in the investigation. Major findings show that the energy absorption response can be effectively controlled by varying geometry and material parameters. A useful empirical formula was developed for providing engineering designers with an initial estimate of the load ratio and hence energy absorption performances of these devices. It was evident that foam-filled conical tubes enhance the energy absorption capacity and stabilise the crush response for both axial and oblique impact loading without a significant increase in the initial peak load. This is practically beneficial when higher kinetic energy needs to be absorbed, thus reducing the impact force transmitted to the protected structure and occupants. Such tubes also increase and maintain the energy absorption capacity under global bending as well as minimise the reduction of energy absorption capacity with increasing load angle. Furthermore, the results also highlight the feasibility of adding a foam-filled conical tube as a supplementary device in energy absorbing systems, since the overall energy absorption performance of such systems can be favourably enhanced by only including a relatively small energy absorbing device. Above all, the results demonstrate the superior performance of foam-filled conical tube for mitigating impact energy in impact and crashworthiness applications.
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Objective: To determine whether differences existed in lower-extremity joint biomechanics during self-selected walking cadence (SW) and fast walking cadence (FW) in overweight- and normal-weight children.---------- Design: Survey.---------- Setting: Institutional gait study center.---------- Participants: Participants (N=20; mean age ± SD, 10.4±1.6y) from referred and volunteer samples were classified based on body mass index percentiles and stratified by age and sex. Exclusion criteria were a history of diabetes, neuromuscular disorder, or recent lower-extremity injury.---------- Main Outcome Measures: Sagittal, frontal, and transverse plane angular displacements (degrees) and peak moments (newton meters) at the hip, knee, and ankle joints.---------- Results: The level of significance was set at P less than .008. Compared with normal-weight children, overweight children had greater absolute peak joint moments at the hip (flexor, extensor, abductor, external rotator), the knee (flexor, extensor, abductor, adductor, internal rotator), and the ankle (plantarflexor, inverter, external/internal rotators). After including body weight as a covariate, overweight children had greater peak ankle dorsiflexor moments than normal-weight children. No kinematic differences existed between groups. Greater peak hip extensor moments and less peak ankle inverter moments occurred during FW than SW. There was greater angular displacement during hip flexion as well as less angular displacement at the hip (extension, abduction), knee (flexion, extension), and ankle (plantarflexion, inversion) during FW than SW.---------- Conclusions: Overweight children experienced increased joint moments, which can have long-term orthopedic implications and suggest a need for more nonweight-bearing activities within exercise prescription. The percent of increase in joint moments from SW to FW was not different for overweight and normal-weight children. These findings can be used in developing an exercise prescription that must involve weight-bearing activity.
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BACKGROUND:Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance.METHODS:Usual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated.RESULTS:GL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable.CONCLUSION:A dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.
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Background: Altered mechanical properties of the heel pad have been implicated in the development of plantar heel pain. However, the in vivo properties of the heel pad during gait remain largely unexplored in this cohort. The aim of the current study was to characterise the bulk compressive properties of the heel pad in individuals with and without plantar heel pain while walking. ---------- Methods: The sagittal thickness and axial compressive strain of the heel pad were estimated in vivo from dynamic lateral foot radiographs acquired from nine subjects with unilateral plantar heel pain and an equivalent number of matched controls, while walking at their preferred speed. Compressive stress was derived from simultaneously acquired plantar pressure data. Principal viscoelastic parameters of the heel pad, including peak strain, secant modulus and energy dissipation (hysteresis), were estimated from subsequent stress–strain curves.---------- Findings: There was no significant difference in loaded and unloaded heel pad thickness, peak stress, peak strain, or secant and tangent modulus in subjects with and without heel pain. However, the fat pad of symptomatic feet had a significantly lower energy dissipation ratio (0.55 ± 0.17 vs. 0.69 ± 0.08) when compared to asymptomatic feet (P < .05).---------- Interpretation: Plantar heel pain is characterised by reduced energy dissipation ratio of the heel pad when measured in vivo and under physiologically relevant strain rates.
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Principal Topic: ''In less than ten years music labels will not exist anymore.'' Michael Smelli, former Global COO Sony/BMG MCA/QUT IMP Business Lab Digital Music Think Thanks 9 May 2009, Brisbane Big music labels such as EMI, Sony BMG and UMG have been responsible for promoting and producing a myriad of stars in the music industry over the last decades. However, the industry structure is under enormous threat with the emergence of a new innovative era of digital music. Recent years have seen a dramatic shift in industry power with the emergence of Napster and other file sharing sites, iTunes and other online stores, iPod and the MP3 revolution. Myspace.com and other social networking sites are connecting entrepreneurial artists with fans and creating online music communities independent of music labels. In 2008 the digital music business internationally grew by around 25% to 3.7 Billion US-Dollar. Digital platforms now account for around 20% of recorded music sales, up from 15 % in 2007 (IFPI Digital music report 2009). CD sales have fallen by 40% since their peak levels. Global digital music sales totalled an estimated US$ 3 Billion in 2007, an increase of 40% on 2006 figures. Digital sales account for an estimated 15% of global market, up from 11% in 2006 and zero in 2003. The music industry is more advanced in terms of digital revenues than any other creative or entertainment industry (except games). Its digital share is more than twice that of newspapers (7%), films (35) or books (2%). All these shifts present new possibilities for music entrepreneurs to act entrepreneurially and promote their music independently of the major music labels. Diffusion of innovations has a long tradition in both sociology (e.g. Rogers 1962, 2003) and marketing (Bass 1969, Mahajan et al., 1990). The context of the current project is theoretically interesting in two respects. First, the role of online social networks replaces traditional face-to-face word of mouth communications. Second, as music is a hedonistic product, this strongly influences the nature of interpersonal communications and their diffusion patterns. Both of these have received very little attention in the diffusion literature to date, and no studies have investigated the influence of both simultaneously. This research project is concerned with the role of social networks in this new music industry landscape, and how this may be leveraged by musicians willing to act entrepreneurially. Our key research question we intend to address is: How do online social network communities impact the nature, pattern and speed that music diffuses? Methodology/Key Propositions : We expect the nature/ character of diffusion of popular, generic music genres to be different from specialized, niche music. To date, only Moe & Fader (2002) and Lee et al. (2003) investigated diffusion patterns of music and these focus on forecast weekly sales of music CDs based on the advance purchase orders before the launch, rather than taking a detailed look at diffusion patterns. Consequently, our first research questions are concerned with understanding the nature of online communications within the context of diffusion of music and artists. Hence, we have the following research questions: RQ1: What is the nature of fan-to-fan ''word of mouth'' online communications for music? Do these vary by type of artist and genre of music? RQ2: What is the nature of artist-to-fan online communications for music? Do these vary by type of artist and genre of music? What types of communication are effective? Two outcomes from research social network theory are particularly relevant to understanding how music might diffuse through social networks. Weak tie theory (Granovetter, 1973), argues that casual or infrequent contacts within a social network (or weak ties) act as a link to unique information which is not normally contained within an entrepreneurs inner circle (or strong tie) social network. A related argument, structural hole theory (Burt, 1992), posits that it is the absence of direct links (or structural holes) between members of a social network which offers similar informational benefits. Although these two theories argue for the information benefits of casual linkages, and diversity within a social network, others acknowledge that a balanced network which consists of a mix of strong ties, weak ties is perhaps more important overall (Uzzi, 1996). It is anticipated that the network structure of the fan base for different types of artists and genres of music will vary considerably. This leads to our third research question: RQ3: How does the network structure of online social network communities impact the pattern and speed that music diffuses? The current paper is best described as theory elaboration. It will report the first exploratory phase designed to develop and elaborate relevant theory (the second phase will be a quantitative study of network structure and diffusion). We intend to develop specific research propositions or hypotheses from the above research questions. To do so we will conduct three focus group discussions of independent musicians and three focus group discussions of fans active in online music communication on social network sites. We will also conduct five case studies of bands that have successfully built fan bases through social networking sites (e.g. myspace.com, facebook.com). The idea is to identify which communication channels they employ and the characteristics of the fan interactions for different genres of music. We intend to conduct interviews with each of the artists and analyse their online interaction with their fans. Results and Implications : At the current stage, we have just begun to conduct focus group discussions. An analysis of the themes from these focus groups will enable us to further refine our research questions into testable hypotheses. Ultimately, our research will provide a better understanding of how social networks promote the diffusion of music, and how this varies for different genres of music. Hence, some music entrepreneurs will be able to promote their music more effectively. The results may be further generalised to other industries where online peer-to-peer communication is common, such as other forms of entertainment and consumer technologies.
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The global financial crisis, global pandemics, global warming and peak oil are indicative of a world facing major environmental, social and economic problems. At the same time, world population continues to rise and global inequalities deepen. Children are the most vulnerable to the impacts of unsustainable living with specific harms arising because of their physical and cognitive vulnerabilities. Nevertheless, children do not have to be victims in the face of these challenges. Education, including early childhood education, has an important role to in building resilience and capabilities in children that equip them as active and informed citizens now and in the future and who are capable of contributing to healthy and sustainable ways of living. Drawing on educational change literature, action research, education for sustainability, health promotion and systems theory, this paper outlines three strategies that can help reorient early childhood education towards sustainability. One strategy is the adoption of whole centre approaches to sustainability and education for sustainability. This means working across the whole of a centre’s operations – curriculum and pedagogy, physical and social environments, its partnerships and community connections. The second strategy – applied in conjunction with the first – is the use of action research to investigate the early childhood setting and to create the desired changes. The third strategy is the adoption of systems thinking as a way of leveraging support and momentum for change so that education for sustainability goes beyond the initiatives of individual teachers and centres, and becomes a systems-wide imperative.
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Several brain imaging studies have assumed that response conflict is present in Stroop tasks. However, this has not been demonstrated directly. We examined the time-course of stimulus and response conflict resolution in a numerical Stroop task by combining single-trial electro-myography (EMG) and event-related brain potentials (ERP). EMG enabled the direct tracking of response conflict and the peak latency of the P300 ERP wave was used to index stimulus conflict. In correctly responded trials of the incongruent condition EMG detected robust incorrect response hand activation which appeared consistently in single trials. In 50–80% of the trials correct and incorrect response hand activation coincided temporally, while in 20–50% of the trials incorrect hand activation preceded correct hand activation. EMG data provides robust direct evidence for response conflict. However, congruency effects also appeared in the peak latency of the P300 wave which suggests that stimulus conflict also played a role in the Stroop paradigm. Findings are explained by the continuous flow model of information processing: Partially processed task-irrelevant stimulus information can result in stimulus conflict and can prepare incorrect response activity. A robust congruency effect appeared in the amplitude of incongruent vs. congruent ERPs between 330–400 ms, this effect may be related to the activity of the anterior cingulate cortex.
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This paper aims to present a preliminary benefit analysis for airborne GPS occultation technique for the Australian region. The simulation studies are based on current domestic commercial flights between major Australian airports. With the knowledge of GPS satellite ephemeris data, occultation events for for any particular flight can be determined. Preliminary analysis shows a high resolution occultation observations can be achieved with this approach, for instance, about 15 occultation events for a Perth-to-Sydney flight. The simulation result agrees to the results published by other researchers for a different region. Of course, occultation observation during off-peak hours might be affected due to the limited flight activities. --------- High resolution occultation observations obtainable from airborne GPS occultation system provides an opportunity to improve the current global numerical weather prediction (NWP) models and ultimately improves the accuracy in weather forecasting. More intensive research efforts and experimental demonstrations are required in order to demonstrate the technical feasibility of the airborne GPS technology.
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Near-infrared (NIR) and Fourier transform infrared (FTIR) spectroscopy have been used to determine the mineralogical character of isomorphic substitutions for Mg2+ by divalent transition metals Fe, Mn, Co and Ni in natural halotrichite series. The minerals are characterised by d-d transitions in NIR region 12000-7500 cm-1. NIR spectrum of halotrichite reveals broad feature from 12000 to 7500 cm-1 with a splitting of two bands resulting from ferrous ion transition 5T2g ® 5Eg. The presence of overtones of OH- fundamentals near 7000 cm-1 confirms molecular water in the mineral structure of the halotrichite series. The appearance of the most intense peak at around 5132 cm-1 is a common feature in the three minerals and is derived from combination of OH- vibrations of water molecules and 2 water bending modes. The influence of cations like Mg2+, Fe2+, Mn2+, Co2+, Ni2+ shows on the spectra of halotrichites. Especially wupatkiite-OH stretching vibrations in which bands are distorted conspicuously to low wave numbers at 3270, 2904 and 2454 cm-1. The observation of high frequency 2 mode in the infrared spectrum at 1640 cm-1 indicates coordination of water molecules is strongly hydrogen bonded in natural halotrichites. The splittings of bands in 3 and 4 (SO4)2- stretching regions may be attributed to the reduction of symmetry from Td to C2v for sulphate ion. This work has shown the usefulness of NIR spectroscopy for the rapid identification and classification of the halotrichite minerals.
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The macerals in bituminous coals with varying organic sulfur content from the Early Permian Greta Coal Measures at three locations (Southland Colliery, Drayton Colliery and the Cranky Corner Basin), in and around the Sydney Basin (Australia), have been studied using light-element electron microprobe (EMP) analysis and micro-ATR–FTIR. Electron microprobe analysis of individual macerals reveals that the vitrinite in both the Cranky Corner Basin and Drayton Colliery (Puxtrees seam) samples have similar carbon contents (ca. 78% C in telocollinite), suggesting that they are of equivalent rank. However, the Cranky Corner coals have anomalously low vitrinite reflectance (down to 0.45%) vs. the Drayton materials (ca. 0.7%). They also have very high organic S content (3–6.5%) and lower O content (ca. 10%) than the equivalent macerals in the Drayton sample (0.7% S and 15.6% O). A study was carried out to investigate the impacts of the high organic S on the functional groups of the macerals in these two otherwise iso-rank, stratigraphically-equivalent seams. An iso-rank low-S coal from the overlying Wittingham Coal Measures near Muswellbrook and coals of slightly higher rank from the Greta Coal Measures at Southland Colliery near Cessnock were also evaluated using the same techniques to extend the data set. Although the telocollinite in the Drayton and Cranky Corner coals have very similar carbon content (ca.78% C), the ATR–FTIR spectra of the vitrinite and inertinite macerals in these respectively low S and high S coals show some distinct differences in IR absorbance from various aliphatic and aromatic functional groups. The differences in absorbance of the aliphatic stretching bands (2800–3000 cm−1) and the aromatic carbon (CC) peak at 1606 cm−1 are very obvious. Compared to that of the Drayton sample (0.7% S and 15% O), the telocollinite of the Cranky Corner coal (6% S and 10% O) clearly shows: (i) less absorbance from OH groups, represented by a broad region around 3553 cm−1, (ii) much stronger aliphatic C–H absorbance (stretching modes around 3000–2800 cm−1 and bending modes around 1442 cm−1) and (iii) less absorbance from aromatic carbon functional groups (peaking at 1606 cm−1). Evaluation of the iso-rank Drayton and Cranky Corner coals shows that: (i) the aliphatic C–H absorbances decrease with increasing oxygen content but increase with increasing organic S content and (ii) the aromatic H to aliphatic H ratio (Har/Hali) for the telocollinite increases with (organic) O%, but decreases progressively with increasing organic S. The high organic S content in the maceral appears to be accompanied by a greater proportion of aliphatic functional groups, possibly as a result of some of the O within maceral ring structures in the high S coal samples being replaced.
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When classifying a signal, ideally we want our classifier to trigger a large response when it encounters a positive example and have little to no response for all other examples. Unfortunately in practice this does not occur with responses fluctuating, often causing false alarms. There exists a myriad of reasons why this is the case, most notably not incorporating the dynamics of the signal into the classification. In facial expression recognition, this has been highlighted as one major research question. In this paper we present a novel technique which incorporates the dynamics of the signal which can produce a strong response when the peak expression is found and essentially suppresses all other responses as much as possible. We conducted preliminary experiments on the extended Cohn-Kanade (CK+) database which shows its benefits. The ability to automatically and accurately recognize facial expressions of drivers is highly relevant to the automobile. For example, the early recognition of “surprise” could indicate that an accident is about to occur; and various safeguards could immediately be deployed to avoid or minimize injury and damage. In this paper, we conducted initial experiments on the extended Cohn-Kanade (CK+) database which shows its benefits.
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Water Sensitive Urban Design (WSUD) systems have the potential mitigate the hydrologic disturbance and water quality concerns associated with stormwater runoff from urban development. In the last few years WSUD has been strongly promoted in South East Queensland (SEQ) and new developments are now required to use WSUD systems to manage stormwater runoff. However, there has been limited field evaluation of WSUD systems in SEQ and consequently knowledge of their effectiveness in the field, under storm events, is limited. The objective of this research project was to assess the effectiveness of WSUD systems installed in a residential development, under real storm events. To achieve this objective, a constructed wetland, bioretention swale and a bioretention basin were evaluated for their ability to improve the hydrologic and water quality characteristics of stormwater runoff from urban development. The monitoring focused on storm events, with sophisticated event monitoring stations measuring the inflow and outflow from WSUD systems. Data analysis undertaken confirmed that the constructed wetland, bioretention basin and bioretention swale improved the hydrologic characteristics by reducing peak flow. The bioretention systems, particularly the bioretention basin also reduced the runoff volume and frequency of flow, meeting key objectives of current urban stormwater management. The pollutant loads were reduced by the WSUD systems to above or just below the regional guidelines, showing significant reductions to TSS (70-85%), TN (40-50%) and TP (50%). The load reduction of NOx and PO4 3- by the bioretention basin was poor (<20%), whilst the constructed wetland effectively reduced the load of these pollutants in the outflow by approximately 90%. The primary reason for the load reduction in the wetland was due to a reduction in concentration in the outflow, showing efficient treatment of stormwater by the system. In contrast, the concentration of key pollutants exiting the bioretention basin were higher than the inflow. However, as the volume of stormwater exiting the bioretention basin was significantly lower than the inflow, a load reduction was still achieved. Calibrated MUSIC modelling showed that the bioretention basin, and in particular, the constructed wetland were undersized, with 34% and 62% of stormwater bypassing the treatment zones in the devices. Over the long term, a large proportion of runoff would not receive treatment, considerably reducing the effectiveness of the WSUD systems.
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Background We have used serial visual analogue scores to demonstrate disturbances of the appetite profile in dialysis patients. This is potentially important as dialysis patients are prone to malnutrition yet have a lower nutrient intake than controls. Appetite disturbance may be influenced by accumulation of appetite inhibitors such as leptin and cholecystokinin (CCK) in dialysis patients. Methods Fasting blood samples were drawn from 43 controls, 50 haemodialysis (HD) and 39 peritoneal dialysis (PD) patients to measure leptin and CCK. Hunger and fullness scores were derived from profiles compiled using hourly visual analogue scores. Nutrient intake was derived from 3 day dietary records. Results Fasting CCK was elevated for PD (6.73 ± 4.42 ng/l vs control 4.99 ± 2.23 ng/l, P < 0.05; vs HD 4.43 ± 2.15 ng/l, P < 0.01). Fasting CCK correlated with the variability of the hunger (r = 0.426, P = 0.01) and fullness (r = 0.52, P = 0.002) scores for PD. There was a notable relationship with the increase in fullness after lunch for PD (r = 0.455, P = 0.006). When well nourished PD patients were compared with their malnourished counterparts, CCK was higher in the malnourished group (P = 0.004). Leptin levels were higher for the dialysis patients than controls (HD and PD, P < 0.001) with pronounced hyperleptinaemia evident in some PD patients. Control leptin levels demonstrated correlation with fullness scores (e.g. peak fullness, r = 0.45, P = 0.007) but the dialysis patients did not. PD nutrient intake (energy and protein intake, r = -0.56, P < 0.0001) demonstrated significant negative correlation with leptin. Conclusion Increased CCK levels appear to influence fullness and hunger perception in PD patients and thus may contribute to malnutrition. Leptin does not appear to affect perceived appetite in dialysis patients but it may influence nutrient intake in PD patients via central feeding centres.
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OBJECTIVE Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. DESIGN Prospective, cross-sectional comparison of PD patients versus controls. SETTING Teaching hospital dialysis unit. PATIENTS 39 PD patients and 42 healthy controls. INTERVENTION Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. MAIN OUTCOME MEASURES Hunger and fullness profiles. Derived hunger and fullness scores. RESULTS Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. CONCLUSION The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.