249 resultados para Referral patterns


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Studies of individual nutrients or foods have revealed much about dietary influences on bone. Multiple food or nutrient approaches, such as dietary pattern analysis, could offer further insight but research is limited and largely confined to older adults. We examined the relationship between dietary patterns, obtained by a posteriori and a priori methods, and bone mineral status (BMS; collective term for bone mineral content (BMC) and bone mineral density (BMD)) in young adults (20-25 years; n 489). Diet was assessed by 7 d diet history and BMD and BMC were determined at the lumbar spine and femoral neck (FN). A posteriori dietary patterns were derived using principal component analysis (PCA) and three a priori dietary quality scores were applied (dietary diversity score (DDS), nutritional risk score and Mediterranean diet score). For the PCA-derived dietary patterns, women in the top compared to the bottom fifth of the 'Nuts and Meat' pattern had greater FN BMD by 0.074 g/cm(2) (P=0.049) and FN BMC by 0.40 g (P=0.034) after adjustment for confounders. Similarly, men in the top compared to the bottom fifth of the 'Refined' pattern had lower FN BMC by 0.41 g (P-0.049). For the a priori DDS, women in the top compared to the bottom third had lower FN BMD by 0.05 g/cm(2) after adjustments (P=0.052), but no other relationships with BMS were identified. In conclusion, adherence to a 'Nuts and Meat' dietary pattern may be associated with greater BMS in young women and a 'Refined' dietary pattern may be detrimental for bone health in young men.

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K-alpha x-ray emission, extreme ultraviolet emission, and plasma imaging techniques have been used to diagnose energy transport patterns in copper foils ranging in thickness from 5 to 75 mu m for intensities up to 5x10(20) Wcm(-20). The K-alpha emission and shadowgrams both indicate a larger divergence angle than that reported in the literature at lower intensities [R. Stephens , Phys. Rev. E 69, 066414 (2004)]. Foils 5 mu m thick show triple-humped plasma expansion patterns at the back and front surfaces. Hybrid code modeling shows that this can be attributed to an increase in the mean energy of the fast electrons emitted at large radii, which only have sufficient energy to form a plasma in such thin targets.

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Many studies have shown that the effectiveness of radiations of varying LET is similar when yields of dsb have been measured, despite large differences in biological response. Recent evidence has suggested however, that current techniques underestimate the yields of dsb. By monitoring the fragmentation of DNA over a wide range of fragment sizes ( 6 Mbp) by pulsed field electrophoresis, RBE values greater than 1.0 for radiations of around 100 keV/mm have been determined. The data provide evidence for the production of correlated breaks produced within cells as particle tracks traverse the nucleus. The highly ordered structure of DNA within mammalian cells may lead to clustering of breaks over distances related to the repeating unit structures of the chromatin. As well as these regionally damaged sites, a major contributor to radiation effectiveness will be the localised clustering of damage in the 1 - 20 bp region. A major effort is required to elucidate the relative importance of these levels of clustering and their importance in biological response.

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In September 1999 the Independent Commission on Policing in Northern Ireland, chaired by Chris Patten, published its recommendations. This article examines the political context of policing reform, the contents of the report and the rejection of its core ideas in the Police (Northern Ireland) Bill published in May 2000. The central argument of the paper is that the Commission's radical model of policing - a network of regulating mechanisms in which policing becomes everyone's business - failed, because it gave insufficient attention, like much modern writing on policing, to the role of the state and the vested interests within policing.

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Revealing the consequences of species extinctions for ecosystem function has been a chief research goal(1-7) and has been accompanied by enthusiastic debate(8-11). Studies carried out predominantly in terrestrial grassland and soil ecosystems have demonstrated that as the number of species in assembled communities increases, so too do certain ecosystem processes, such as productivity, whereas others such as decomposition can remain unaffected(12). Diversity can influence aspects of ecosystem function, but questions remain as to how generic the patterns observed are, and whether they are the product of diversity, as such, or of the functional roles and traits that characterize species in ecological systems. Here we demonstrate variable diversity effects for species representative of marine coastal systems at both global and regional scales. We provide evidence for an increase in complementary resource use as diversity increases and show strong evidence for diversity effects in naturally assembled com-munities at a regional scale. The variability among individual species responses is consistent with a positive but idiosyncratic pattern of ecosystem function with increased diversity.

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In a recent study, we reported that the accurate perception of beat structure in music ('perception of musical meter') accounted for over 40% of the variance in single word reading in children with and without dyslexia (Huss et al., 2011). Performance in the musical task was most strongly associated with the auditory processing of rise time, even though beat structure was varied by manipulating the duration of the musical notes.

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Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice.