10 resultados para Below-Knee Amputee
em CentAUR: Central Archive University of Reading - UK
Resumo:
In this review, we consider three possible criteria by which knowledge might be regarded as implicit or inaccessible: It might be implicit only in the sense that it is difficult to articulate freely, or it might be implicit according to either an objective threshold or a subjective threshold. We evaluate evidence for these criteria in relation to artificial grammar learning, the control of complex systems, and sequence learning, respectively. We argue that the convincing evidence is not yet in, but construing the implicit nature of implicit learning in terms of a subjective threshold is most likely to prove fruitful for future research. Furthermore, the subjective threshold criterion may demarcate qualitatively different types of knowledge. We argue that (1) implicit, rather than explicit, knowledge is often relatively inflexible in transfer to different domains, (2) implicit, rather than explicit, learning occurs when attention is focused on specific items and not underlying rules, and (3) implicit learning and the resulting knowledge are often relatively robust.
Resumo:
Although practitioner-prescribed 'western' herbal medicine (phytotherapy) is a popular complementary therapy in the UK, no clinical studies have been reported on patient-orientated outcomes. The objective of this pilot study was to investigate the effects of phytotherapy on symptoms of osteoarthritis of the knee. A previous study of Chinese herbal medicine for the treatment of irritable bowel syndrome, published in the Journal of the American Medical Association,(1) acted as a model in the development of the protocol of this investigation. Twenty adults, previously diagnosed with osteoarthritis of the knee, were recruited from two Inner London GP practices into this randomized, double-blind, placebo-controlled, pilot study carried out in a primary-care setting. All subjects were seen in consultation three times by a herbal practitioner who was blinded to the randomization coding. Each subject was prescribed treatment and given lifestyle advice according to usual practice: continuation of conventional medication where applicable, healthy-eating advice and nutrient supplementation, Individualized herbal medicine was prescribed for each patient, but only dispensed for those randomized to active treatment - the remainder were supplied with a placebo. At baseline and outcome (after ten weeks of treatment), subjects completed a food frequency questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee health and Measure Yourself Outcome Profile (MYMOP) wellbeing questionnaires. Subjects completing the study per protocol (n = 14) reported an increased intake of wholegrain foods (p = 0.045) and oily fish (p = 0.039) compared to baseline, but no increase in fruit and vegetables and dairy products intakes. There was no difference in the primary outcome measure of knee health assessed as the difference in the mean response (baseline-week 10) in WOMAC score between the two treatment groups. However, there was, compared with baseline, improvement in the active group (n = 9) for the mean WOMAC stiffness sub-score at week 5 (p = 0.035) and week 10 (p = 0.060) but not in the placebo group (n = 5). Furthermore, for the active, but not the placebo group, the mean WOMAC total and sub-scores all showed clinically significant improvement (>= 20%) in knee symptoms at weeks 5 and 10 compared with baseline. Moreover, the mean MYMOP symptom 2 sub-score, mostly relating to osteoarthritis (OA), showed significant improvement at week 5 (p = 0.02) and week 10 (p = 0.008) compared with baseline for the active, but not for the placebo group. This pilot study showed that herbal medicine prescribed for the individual by a herbal practitioner resulted in improvement of symptoms of OA of the knee.
Resumo:
Background: Osteoarthritis (OA) of the knee is the most prevalent joint disorder. Previous studies suggest that bromelain, a pineapple extract, may be a safer alternative/adjunctive treatment for knee OA than current conventional treatment. Aim: To assess the efficacy of bromelain in treating OA of the knee. Design: Randomized, double-blind placebo-controlled trial. Methods: Subjects (n=47) with a confirmed diagnosis of moderate to severe knee OA were randomized to 12 weeks of bromelain 800 mg/day or placebo, with a 4-week follow-up. Knee (pain, stiffness and function) and quality-of-life symptoms were reported monthly in the WOMAC and SF36 questionnaires, respectively. Adverse events were also recorded. The primary outcome measure was the change in total WOMAC score from baseline to the end of treatment at week 12. Longitudinal models were used to evaluate outcome. Results: Thirty-one patients completed the trial (14 bromelain, 17 placebo). No statistically significant differences were observed between groups for the primary outcome (coefficient 11.16, p=0.27, 95%CI-8.86 to 31.18), nor the WOMAC subscales or SF36. Both treatment groups showed clinically relevant improvement in the WOMAC disability subscale only. Adverse events were generally mild in nature. Discussion: This study suggests that bromelain is not efficacious as an adjunctive treatment of moderate to severe OA, but its limitations support the need for a follow-up study.
Resumo:
An increasing importance is assigned to the estimation and verification of carbon stocks in forests. Forestry practice has several long-established and reliable methods for the assessment of aboveground biomass; however we still miss accurate predictors of belowground biomass. A major windthrow event exposing the coarse root systems of Norway spruce trees allowed us to assess the effects of contrasting soil stone and water content on belowground allocation. Increasing stone content decreases root/shoot ratio, while soil waterlogging leads to an increase in this ratio. We constructed allometric relationships for belowground biomass prediction and were able to show that only soil waterlogging significantly impacts model parameters. We showed that diameter at breast height is a reliable predictor of belowground biomass and, once site-specific parameters have been developed, it is possible to accurately estimate belowground biomass in Norway spruce.
Resumo:
This study describes the turbulent processes in the upper ocean boundary layer forced by a constant surface stress in the absence of the Coriolis force using large-eddy simulation. The boundary layer that develops has a two-layer structure, a well-mixed layer above a stratified shear layer. The depth of the mixed layer is approximately constant, whereas the depth of the shear layer increases with time. The turbulent momentum flux varies approximately linearly from the surface to the base of the shear layer. There is a maximum in the production of turbulence through shear at the base of the mixed layer. The magnitude of the shear production increases with time. The increase is mainly a result of the increase in the turbulent momentum flux at the base of the mixed layer due to the increase in the depth of the boundary layer. The length scale for the shear turbulence is the boundary layer depth. A simple scaling is proposed for the magnitude of the shear production that depends on the surface forcing and the average mixed layer current. The scaling can be interpreted in terms of the divergence of a mean kinetic energy flux. A simple bulk model of the boundary layer is developed to obtain equations describing the variation of the mixed layer and boundary layer depths with time. The model shows that the rate at which the boundary layer deepens does not depend on the stratification of the thermocline. The bulk model shows that the variation in the mixed layer depth is small as long as the surface buoyancy flux is small.
Resumo:
Local, tacit and normally unspoken OHS (occupational health and safety) knowledge and practices can too easily be excluded from or remain below the industry horizon of notice, meaning that they remain unaccounted for in formal OHS policy and practice. In this article we stress the need to more systematically and routinely tap into these otherwise ‘hidden’ communication channels, which are central to how everyday safe working practices are achieved. To demonstrate this approach this paper will draw on our ethnographic research with a gang of migrant curtain wall installers on a large office development project in the north of England. In doing so we reflect on the practice-based nature of learning and sharing OHS knowledge through examples of how workers’ own patterns of successful communication help avoid health and safety problems. These understandings, we argue, can be advanced as a basis for the development of improved OHS measures, and of organizational knowing and learning.
Resumo:
Nocturnal cooling of air within a forest canopy and the resulting temperature profile may drive local thermally driven motions, such as drainage flows, which are believed to impact measurements of ecosystem–atmosphere exchange. To model such flows, it is necessary to accurately predict the rate of cooling. Cooling occurs primarily due to radiative heat loss. However, much of the radiative loss occurs at the surface of canopy elements (leaves, branches, and boles of trees), while radiative divergence in the canopy air space is small due to high transmissivity of air. Furthermore, sensible heat exchange between the canopy elements and the air space is slow relative to radiative fluxes. Therefore, canopy elements initially cool much more quickly than the canopy air space after the switch from radiative gain during the day to radiative loss during the night. Thus in modeling air cooling within a canopy, it is not appropriate to neglect the storage change of heat in the canopy elements or even to assume equal rates of cooling of the canopy air and canopy elements. Here a simple parameterization of radiatively driven cooling of air within the canopy is presented, which accounts implicitly for radiative cooling of the canopy volume, heat storage in the canopy elements, and heat transfer between the canopy elements and the air. Simulations using this parameterization are compared to temperature data from the Morgan–Monroe State Forest (IN, USA) FLUXNET site. While the model does not perfectly reproduce the measured rates of cooling, particularly near the top of the canopy, the simulated cooling rates are of the correct order of magnitude.
Resumo:
It is well known that atmospheric concentrations of carbon dioxide (CO2) (and other greenhouse gases) have increased markedly as a result of human activity since the industrial revolution. It is perhaps less appreciated that natural and managed soils are an important source and sink for atmospheric CO2 and that, primarily as a result of the activities of soil microorganisms, there is a soil-derived respiratory flux of CO2 to the atmosphere that overshadows by tenfold the annual CO2 flux from fossil fuel emissions. Therefore small changes in the soil carbon cycle could have large impacts on atmospheric CO2 concentrations. Here we discuss the role of soil microbes in the global carbon cycle and review the main methods that have been used to identify the microorganisms responsible for the processing of plant photosynthetic carbon inputs to soil. We discuss whether application of these techniques can provide the information required to underpin the management of agro-ecosystems for carbon sequestration and increased agricultural sustainability. We conclude that, although crucial in enabling the identification of plant-derived carbon-utilising microbes, current technologies lack the high-throughput ability to quantitatively apportion carbon use by phylogentic groups and its use efficiency and destination within the microbial metabolome. It is this information that is required to inform rational manipulation of the plant–soil system to favour organisms or physiologies most important for promoting soil carbon storage in agricultural soil.