31 resultados para Medicine--Early works to 1800


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Driven by Western companies' requirements for efficiency and effectiveness, a trend towards outsourcing of business activities to India and other low-cost countries commenced in the early 1990s and has continued to grow at a surprisingly fast pace. In a relatively short timeframe India has become a global hub for back-office services, although the effect on the urban cities is yet to be fully comprehended. As American and European companies continue to relocate their information technology services and other back office works to the subcontinent, there has been a considerable flow-on effect on Indian corporate real estate. This paper addresses two key questions. Firstly, the factors important for Western companies' outsourcing of organisational activities to India, and secondly, the effect of business outsourcing on corporate real estate locational requirements in India. A survey of corporate real estate representatives in India and the UK was conducted with the results providing an insight into the present state and possible future direction of outsourcing for India. This research presents a unique insight into the impacts of Western business outsourcing on corporate real estate in India, and presents findings that are useful to both organisations seeking to relocate business activities to India and for property market analysts looking to understand drivers behind this sustained demand for Indian corporate real estate.

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Drawing on interviews about the drinking trajectories of sixty young Victorian drinkers (aged 20-24), this paper outlines patterns of change over time and explores two drinking biographies in depth. For most research participants, drinking alcohol was an enjoyable and integral part of their social lives, but its role changed as they made other transitions in their lives. Most participants considered their early twenties to be a time for heavy alcohol consumption, and most imagined that they would drink less when they were middle-aged.

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My study examines the subjective nature of artistic interpretation through the notion of mimesis as process or transformation of material. Influential factors that mediate in the artistic process, such as memory, reflection and an awareness of cultural analogy and metaphor, are examined and related to a specific project in the studio, where the mediation process is further influenced by the materials used to produce the images. My studies of the concept of mimesis have revealed an intermediary realm that exists in the space between empirical reality and its interpretation. Throughout history the process of mimesis has been integral to all forms of the arts. In Plato's time the production of an image that simulated things as they appeared to the eye was considered a desired ideal. Aristotle later introduced developments which extended this concept to include a refiguring or reforming of material derived from the original source, making new connections between existing factors and in this transformation bringing new meanings to a symbolically constituted world. This discussion of the representation of reality, the influence of a dialogue between notions of imitation and the recreation of material continues throughout the exegesis. My study emphasises the interpretive stage of the mimetic process where a consideration of these themes is most relevant and some of the factors that can influence its outcome. It is my opinion that the production of images in response to the particularities of place can be defined in three stages. Firstly, the experience of the place; secondly, the beginning and maturation of the idea or concept; where mimesis takes place, and thirdly, the production of the art work in response. This process is illustrated in Part 2 of the exegesis, where the development of the studio work is documented and linked with the themes discussed in Part 1. The geographic site or place I selected to study is adjacent to Mt. Noorat, a volcanic site in the Western district of Victoria; the surrounding plains are littered with scoria that has been thrown out of the volcano thousands of years ago. Early British, Scottish and Irish settlers to this region used the stone to construct fences reminiscent of their homeland, through this activity they cleared the land and confined and protected their stock. My interests are in factors that include - the material of the stone, notions of enclosure and safety, of boundaries and circumscribed space, and of the cultural reflection that has taken place in this reconstruction of Eurocentric vision. These walls also represent the means by which land was enclosed and property defined, moving from a situation of public access to notions of ownership and the annexation of land for individual gain. Around each point of eruption, the craggy volcanic scoria has been used to create a constructed landscape which both symbolises and mirrors the Anglo - Celtic origins of the people. I have used the legend of Narcissus to illustrate the self-reflective and introspective processes that the settlers invoked in their attempts to come to terms with a strange land. I consider that the story of Narcissus, who fell in love with his own reflection, finds a parellel in the creation of the walls. The re-creation of artifacts from their own cultural environment provided the settlers with a familiar 'face' in an alien world; a reassurance of the familiar in an unfamiliar terrain. Part of this study is an investigation of this notion of landscape as cultural reflection. Geographers have long known that landscape is a cultural construct, an historically evolving ideal manifested in painting, prints and drawings as well as poetry, gardens and parks. One can view these constructions as illustrations or images of meaning which constitute representations of cultural ideals. The neo-classical influence reflected in the paintings of artists who accompanied the early expeditions to Australia demonstrates these themes. The medium of the mirror provides the opportunity to suggest aspects of a cultural reflection and an awareness of identity that has relevance to contemporary Australian culture, therefore, I have allowed it to play a major role throughout this study. Its role in mimesis, firstly, as a reflection in an imitative sense is established, then in its refigurative role, in which the similarities between the original and the reformed rely more on correlative factors than representation. I have used examples from the history of art to illustrate this potential. The formation and development of a narrative involving reflection threads throughout the thesis, both in the visual presentation and in the exegesis. The production of a body of paintings, drawings and sculpture reflect my interpretation and response to the particular site. The correspondences between these works and my theoretical concerns is articulated in the exegesis. The metaphor implied by the use of the walls as agents of enclosure also refers to the capacity of the individual to be confined by notional boundaries and restrictive practices where totalising systems of thought dominate theoretical debate and restrict its freedom. I have used images where gaps in the walls represent the potential implicit to the concept of liminal space, where the spectator moves from one physical space to another and from one stage of development to another. The threshold of this opening in the walls becomes the site where transformation can take place, a metaphor for the mimetic process where the initial experience is translated and transformed into the final product. The paintings, drawings and other works in this series fulfil the role of marks on the surface of the mirror, separating the initial experience from the processes of memory, reflection and speculation. The works draw attention to the materiality that they represent and yet provide the opportunity for new insights and experiences, allowing the subjective nature of artistic activity to combine symbolic elements relating to the site, resulting in the production of meaning.

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Objective: The Early Psychosis Prevention and Intervention Centre (EPPIC) provides a comprehensive 'real-world' model of early intervention to young people experiencing an emerging psychotic disorder. A prospective study has already provided evidence of improved clinical outcome at 12 months after entry. The present study examined whether the service was also cost-effective.

Method: A cost-effectiveness analysis compared EPPIC with its immediate precursor service, from the perspective of the government funding agency. Only direct costs were included.

Results: EPPIC proved to be more cost-effective. The weighted average cost per patient for the first 12 months was cheaper (by äD 7110 per patient), while treatment outcomes were superior. The savings were due to the marked reduction in in-patient costs outweighing substantial increases in the costs of community care.

Conclusion: These results, while encouraging in terms of the further development of integrated, phase-specific intervention programmes for early psychosis, are not conclusive, and further research is required.

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Background: There is insufficient evidence for the efficacy of comprehensive multiple risk factor interventions by pharmacists in the primary prevention of cardiovascular disease (CVD). Given the proven benefits of pharmacist interventions for individual risk factors, it is essential that evidence for a comprehensive approach to care be generated so that pharmacists remain key members of the health care team for individuals at risk of initial onset of CVD. Objective: To establish the feasibility of an intervention delivered by community pharmacists to reduce the risk of primary onset of CVD.
Methods: A single-cohort intervention study was undertaken in 2008-2009. Twelve community pharmacists from 10 pharmacies who were trained to provide lifestyle and medicine management support to reduce CVD risk recruited 70 at-risk participants aged 50-74 years who were free from diabetes or CVD. Participants received a baseline assessment to establish CVD risk and health behaviors. An assessment report provided to patients and pharmacists was used to collaboratively establish treatment goals and, over 5 sessions, implement treatment strategies. Follow-up assessment at 6 months measured changes in baseline parameters. The primary outcome was the average change to overall 5-year risk of CVD onset.
Results:
Sixty-seven participants were included in the analysis. The mean participant age was 60 years and 73% were female. We observed a 25% (95% CI 17 to 33) proportional risk reduction in overall CVD risk. Significant reductions also occurred in mean blood pressure (-11/-5 mm Hg) and waist circumference (-1.3 cm), with trends toward improvement for most other observed risk factors.
Conclusions: Findings support previous evidence of positive cardiovascular health outcomes following pharmacist intervention in other patient groups; we recommend generating randomized controlled trial evidence for a primary prevention population.

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Cultural heritage should not be seen merely as a technical matter or from a narrow visitor management point of view but rather as cultural practice—a form of cultural politics dominated by ruling regimes and social groups in which decisions are made about the future of and access to scarce resources. Several scholars have sought to push this approach further by arguing that heritage studies should take on the protection of human rights as a core consideration in the processes of identifying, inscribing, conserving and interpreting cultural heritage. This paper builds on these previous works to explore what the shift to a rights-based management approach in the World Heritage system might mean for various stakeholders in the heritage protection enterprise as they learn to meet this challenge and to find ways to support people’s right to access, enjoy and maintain cultural heritage. Reaffirming the need to maintain a strong relationship between theory and praxis, the paper draws into the discussion heritage practitioners, decision makers in governments and government agencies, scholars and educators. Of these, the principal emphasis in this paper is on educators who are seen to have a fundamentally important role in developing a critical understanding of the cultural heritage concept, how heritage is created, used and misused and how conservation approaches and programs sit within the broader context of community attitudes and aspirations and governmental responsibilities. A distinction is made between teachers in universities and trainers offering short courses more focused on specific employer needs. The paper focuses on World Heritage but refers to both tangible and intangible aspects. It shows how current moves to establish a rights-based approach to the management of World Heritage sites connects with moves elsewhere in global governance, most notably in the United Nations Permanent Forum on Indigenous Issues and the United Nations Human Rights Commission.

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The history of children’s popular culture in Australia is still to be written. This article examines Australian print publication for children from the mid-nineteenth to the early twentieth centuries, together with radio and children’s television programming from the 1950s to the 1970s. It presents new scholarship on the history of children’s magazines and newspapers, sourced from digital archives such as Trove, and documents new sources for early works by Australian children’s writers. The discussion covers early television production for children, mobilising digital resources that have hitherto not informed scholarship in the field.

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This article explores three NGO projects that assemble and distribute clean birthing kits in Ethiopia. It contrasts the government's health strategy that aims to increase skilled birth attendance, with local realities as most women in rural and remote settings give birth at home, often in unhygienic conditions, and without skilled assistance. Many health facilities are also unable to provide hygienic conditions for birthing women. The findings indicate that clean birth kits have assisted the NGOs to effectively promote clean delivery at home or in health facilities, and to encourage antenatal care, and early referral to emergency obstetric and new-born care.

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As mobile devices have become the personal information-processing interface of choice, many individuals seem to swiftly follow fashion. Yet, the literature is silent on how early adopters of mobile devices overcome uncertainties related to shifts in technology. Based on purposive sampling, this paper presents detailed insights into why and how five closely related individuals made the decision to adopt the iPhone before it was available through traditional supply chains. Focusing on the role played by social networks, we analyze how adoption threshold, opinion leaders, social contagion, and social learning shaped adoption behaviors and outcomes. The analyses confirm that network structures impact the early decision to accept the iPhone; they show that when facing uncertainty, adoption decisions emerged as a combined result of individual adoption reflections and major influences from the social network as well as behaviors observed within the network, and, they reveal interesting behaviors that differed from expectations. In conclusion, we discuss implications for both theory and practice.

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As mobile devices have become the personal information-processing interface of choice, many individuals seem to swiftly follow fashion. Yet, the literature is silent on how early adopters of mobile devices overcome uncertainties related to shifts in technology. Based on purposive sampling, this paper presents detailed insights into why and how five closely related individuals made the decision to adopt the iPhone before it was available through traditional supply chains. Focusing on the role played by social networks, we analyze how adoption threshold, opinion leaders, social contagion, and social learning shaped adoption behaviors and outcomes. The analyses confirm that network structures impacted the early decision to accept the iPhone; they show that when facing uncertainty, adoption decisions emerged as a combined result of individual adoption reflections and major influences from the social network as well as behaviors observed within the network; and, they reveal interesting behaviors that differed from expectations. In conclusion, we discuss implications for both theory and practice.

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Children and adolescents mature at different rates such that individuals competing in the same competition may differ in physical and biological maturity despite being of similar chronological age. Whether or not differences translate into on-field performance in competition is relatively unknown. This study investigated the influence of biological maturity on fitness and match running performance in junior Australian football. Eighty-seven under-15 years players were categorised into early (n = 20), average (n = 45) and late (n = 22) maturity groups based on self-reported and anthropometric assessment of biological maturity. Running movements during competition were collected using GPS (5 Hz) technology. Early maturers were heavier and taller than all other boys (P < 0.05), while biological maturity was significantly correlated to 20 m sprint (r = 0.53, P < 0.01). Total distance, high-intensity (>14.4 km · h−1) running distance and number of high-intensity efforts were significantly greater (20.8%, 53.6%, 31.7%, respectively; P < 0.01) in early compared to late maturers. Number of sprints and peak speed in competition were not different. Pubertal development and maturity status partially explained the differences between players in physical size, functional running fitness and match running performance. Late maturing players in this Australian football under-15 age group were at a physical and performance disadvantage to their earlier maturing peers.

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Adaptive developmental plasticity allows individuals experiencing poor environmental conditions in early life to adjust their life-history strategy in order to prioritize short-term fitness benefits and maximize reproductive output in challenging environments. Much research has been conducted to test whether such adoption of a "faster" life-history strategy is accompanied by concordant changes in behavior and physiology, with mixed results. As research in this field has focused on comparison of mean-level responses of treatment groups, few studies include repeated measures of response variables and the effect that developmental stress may have on repeatability per se. We investigated how early-developmental stress affects the mean expression of (and repeatability in) a variety of behavioral and physiological traits in female zebra finches. We predicted that: (1) individuals subjected to nutritional restriction in the nestling phase would have higher feeding and activity rates, with associated increases in hematocrit and basal metabolic rates (BMRs), (2) nutritional restriction in early life would alter adults' stress-induced corticosterone level, and (3) developmental stress would, respectively, influence the amount of among-individual and within-individual variation in behavioral and physiological traits, hence affecting the repeatability of these traits. In comparison to control females, stressed females did not differ in activity rate or stress-induced corticosterone level, but they did have higher levels of feeding, hematocrit, and BMR. Among-individual variance and repeatability were generally higher in stressed females than in controls. Finally, we found that developmental dietary restriction significantly reduced the amount of within-individual variance both in activity rate in the novel environment and in stress-induced corticosterone level. Our results not only confirm previous findings on the effect of early-developmental stress on BMR, but also extend its effect to feeding rate and hematocrit, suggesting that developmental plasticity in these traits is ontogenetically linked. Early-developmental stress may disable particular genetic canalizing processes, which would release cryptic genetic variation and explain why repeatability and among-individual variance were generally higher in the stressed groups than in controls. For activity rate in the novel environment and with stress-induced corticosterone level, however, early-developmental stress significantly reduced within-individual variance, which may be a consequence of increased canalization of these traits at the micro-environmental level.

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BACKGROUND: Aloe vera supports a substantial global trade yet its wild origins, and explanations for its popularity over 500 related Aloe species in one of the world's largest succulent groups, have remained uncertain. We developed an explicit phylogenetic framework to explore links between the rich traditions of medicinal use and leaf succulence in aloes. RESULTS: The phylogenetic hypothesis clarifies the origins of Aloe vera to the Arabian Peninsula at the northernmost limits of the range for aloes. The genus Aloe originated in southern Africa ~16 million years ago and underwent two major radiations driven by different speciation processes, giving rise to the extraordinary diversity known today. Large, succulent leaves typical of medicinal aloes arose during the most recent diversification ~10 million years ago and are strongly correlated to the phylogeny and to the likelihood of a species being used for medicine. A significant, albeit weak, phylogenetic signal is evident in the medicinal uses of aloes, suggesting that the properties for which they are valued do not occur randomly across the branches of the phylogenetic tree. CONCLUSIONS: Phylogenetic investigation of plant use and leaf succulence among aloes has yielded new explanations for the extraordinary market dominance of Aloe vera. The industry preference for Aloe vera appears to be due to its proximity to important historic trade routes, and early introduction to trade and cultivation. Well-developed succulent leaf mesophyll tissue, an adaptive feature that likely contributed to the ecological success of the genus Aloe, is the main predictor for medicinal use among Aloe species, whereas evolutionary loss of succulence tends to be associated with losses of medicinal use. Phylogenetic analyses of plant use offer potential to understand patterns in the value of global plant diversity.

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Early timing of adrenarche, associated with relatively high levels of Dehydroepiandrosterone (DHEA) in children, has been associated with mental health and behavioral problems. However, little is known about effects of adreneracheal timing on brain function. The aim of this study was to investigate the effects of early adrenarche (defined by high DHEA levels independent of age) on affective brain function and symptoms of psychopathology in late childhood (N = 83, 43 females, M age 9.53 years, s.d. 0.34 years). Results showed that higher DHEA levels were associated with decreased affect-related brain activity (i) in the mid-cingulate cortex in the whole sample, and (ii) in a number of cortical and subcortical regions in female but not male children. Higher DHEA levels were also associated with increased externalizing symptoms in females, an association that was partly mediated by posterior insula activation to happy facial expressions. These results suggest that timing of adrenarche is an important moderator of affect-related brain function, and that this may be one mechanism linking early adrenarche to psychopathology.