110 resultados para Deterioration


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Numerous mathematical models have been developed to evaluate both initial and transient stage removal efficiency of deep bed filters. Microscopic models either using trajectory analysis or convective-diffusion equations were used to compute the initial removal efficiency. These models predicted the removal efficiency under favorable filtration conditions quantitatively, but failed to predict the removal efficiency under unfavorable conditions. They underestimated the removal efficiency under unfavorable conditions. Thus, semi-empirical formulations were developed to compute initial removal efficiencies under unfavorable conditions. Also, correction for the adhesion of particles onto filter grains improved the results obtained for removal efficiency from the trajectory analysis. Macroscopic models were used to predict the transient stage removal efficiency of deep bed filters. O’Melia and Ali’s model assumed that the particle removal is due to filter grains as well as the particles that are already deposited onto the filter grain. Thus, semi-empirical models were used to predict the ripening of filtration. Several modifications were made to the model developed by O’Melia and Ali to predict the deterioration of particle removal during the transient stages of filtration. Models considering the removal of particles under favorable conditions and the accumulation of charges on the filter grains during the transient stages were also developed. This paper evaluates those models and their applicability under different operating conditions of filtration.

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Numerous mathematical models have been developed to evaluate both initial and transient stage removal efficiency of deep bed filters. Microscopic models either using trajectory analysis or convective diffusion equations were used to compute the initial removal efficiency. These models predicted the removal efficiency under favorable filtration conditions quantitatively, but failed to predict the removal efficiency under unfavorable conditions. They underestimated the removal efficiency under unfavorable conditions. Thus, semi-empirical formulations were developed to compute initial removal efficiencies under unfavorable conditions. Also, correction for the adhesion of particles onto filter grains improved the results obtained for removal efficiency from the trajectory analysis. Macroscopic models were used to predict the transient stage removal efficiency of deep bed filters. The O’Melia and Ali1 model assumed that the particle removal is due to filter grains as well as the particles that are already deposited onto the filter grain. Thus, semi-empirical models were used to predict the ripening of filtration. Several modifications were made to the model developed by O’Melia and Ali to predict the deterioration of particle removal during the transient stages of filtration. Models considering the removal of particles under favorable conditions and the accumulation of charges on the filter grains during the transient stages were also developed. This article evaluates those models and their applicability under different operating conditions of filtration.

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Background: Canola oil shortens the life span of stroke-prone spontaneously hypertensive (SHRSP) rats compared with rats fed soybean oil when given as the sole dietary lipid source. One possible mechanism leading to the damage and deterioration of organs due to canola oil ingestion is oxidative stress. This study investigated the effect of canola oil intake on oxidative stress in this animal model.
Method: Male SHRSP rats, were fed a defatted control diet containing 10% wt/wt soybean oil or a defatted treatment diet containing 10% wt/wt canola oil, and given water containing 1% NaCl. Blood pressure was measured weekly. Blood was collected prior to beginning the diets and at the end of completion of the study for analysis of red blood cell (RBC) antioxidant enzymes, RBC and plasma malondialdehyde (MDA), plasma 8- isoprostane and plasma lipids.
Results: Canola oil ingestion significantly decreased the life span of SHRSP rats compared with soybean oil, 85.8 ± 1.1 and 98.3 ± 3.4 days, respectively. Systolic blood pressure increased over time with a significant difference between the diets at the 6th week of feeding. Canola oil ingestion significantly reduced RBC superoxide dismutase, glutathione peroxidase and catalase activities, total cholesterol and low-density lipoprotein cholesterol compared with soybean oil. There were no significant differences in RBC MDA concentration between canola oil fed and soybean oil fed rats. In contrast, plasma MDA and 8-isoprostane concentration was significantly lower in the canola oil group compared to the soybean oil group.
Conclusion: In conclusion, canola oil ingestion shortens the life span of SHRSP rats and leads to changes in oxidative status, despite an improvement in the plasma lipids.

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Objectives: To evaluate the uptake of an emergency department early warning system (ED EWS) for recognition of, and response to, clinical deterioration.

Design, setting and participants: A descriptive exploratory study conducted in an urban district hospital in Melbourne, Australia. Systematic sampling was used to identify every 10th patient for whom the ED EWS was activated from May 2009 to May 2011.

Main outcome measures:
Patient characteristics, ED system data and ED EWS activation characteristics.

Results: ED EWS activation occurred in 1.5% of ED patients; 204 patients were included in this pilot study. The median age was 65.1 years (interquartile range [IQR], 47.8-77.5 years), 89.2% of patients were classified as triage category 2 or 3, and 82.4% of patients were seen by medical staff before ED EWS activation. Hypotension (27.7%) and tachycardia (23.7%) were the most common reasons for ED EWS activation. Median duration of clinical instability was 39 minutes (IQR, 5- 129 minutes). Nurses made 93.1% of ED EWS activations. Median time between documenting physiological abnormalities and ED EWS activation was 5 minutes (IQR, 0- 20). Most patients (57.8%) required hospital admission: 4.4% of patients required intensive care unit admission.

Conclusions: The ED EWS resulted in at least two formal reports of clinical deterioration in ED patients per day, indicating reasonable uptake by clinicians. A greater understanding of clinical deterioration in ED patients is warranted to inform an evidence-based approach to recognition of, and response to, clinical deterioration in ED patients.

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Objective: To assess the prospective relationship between obesity and health-related quality of life, including a novel assessment of the impact of health-related quality of life on weight gain.

Design and setting:
Longitudinal, national, population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study, with surveys conducted in 1999/2000 and 2004/2005.

Participants:
A total of 5985 men and women aged 25 years at study entry.

Main outcome measure(s):
At both time points, height, weight and waist circumference were measured and self-report data on health-related quality of life from the SF-36 questionnaire were obtained. Cross-sectional and bi-directional, prospective associations between obesity categories and health-related quality of life were assessed.

Results:
Higher body mass index (BMI) at baseline was associated with deterioration in health-related quality of life over 5 years for seven of the eight health-related quality of life domains in women (all P0.01, with the exception of mental health, P>0.05), and six out of eight in men (all P<0.05, with the exception of role-emotional, P=0.055, and mental health, P>0.05). Each of the quality-of-life domains related to mental health as well as the mental component summary were inversely associated with BMI change (all P<0.0001 for women and P0.01 for men), with the exception of vitality, which was significant in women only (P=0.008). For the physical domains, change in BMI was inversely associated with baseline general health in women only (P=0.023).

Conclusions:
Obesity was associated with a deterioration in health-related quality of life (including both physical and mental health domains) in this cohort of Australian adults followed over 5 years. Health-related quality of life was also a predictor of weight gain over 5 years, indicating a bi-directional association between obesity and health-related quality of life. The identification of those with poor health-related quality of life may be important in assessing the risk of future weight gain, and a focus on health-related quality of life may be beneficial in weight management strategies.

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Type 2 diabetes is associated with insulin resistance and reduced insulin secretion, which results in hyperglycaemia. This can then lead to diabetic complications such as retinopathy, neuropathy, nephropathy and cardiovascular disease. Although insulin resistance may be present earlier in the progression of the disease, it is now generally accepted that it is the deterioration in insulin-secretory function that leads to hyperglycaemia. This reduction in insulin secretion in Type 2 diabetes is due to both islet β-cell dysfunction and death. Therefore, interventions that maintain the normal function and protect the pancreatic islet β-cells from death are crucial in the treatment of Type 2 diabetes so that plasma glucose levels may be maintained within the normal range. Recently, a number of compounds have been shown to protect β-cells from failure. This review examines the evidence that the existing therapies for Type 2 diabetes that were developed to lower plasma glucose (metformin) or improve insulin sensitivity (thiazolidinediones) may also have islet-protective function. Newer emerging therapeutic agents that are designed to increase the levels of glucagon-like peptide-1 not only stimulate insulin secretion but also appear to increase islet β-cell mass. Evidence will also be presented that the future of drug therapy designed to prevent β-cell failure should target the formation of advanced glycation end products and alleviate oxidative and endoplasmic reticulum stress.

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Type 2 diabetes is characterized by islet dysfunction resulting in hyperglycemia, which can then lead to further deterioration in islet function. A possible mechanism for hyperglycemia-induced islet dysfunction is the accumulation of advanced glycation end products (AGE). The DBA/2 mouse develops pancreatic islet dysfunction when exposed to a high glucose environment and/or obesity-induced insulin resistance. To determine the biochemical cause of dysfunction, DBA/2 and C57BL/6 control islets were incubated in 11.1 mM or 40 mM glucose in the absence or presence of the AGE inhibitor aminoguanidine (AG) for 10 days. Basal (2.8 mM glucose) insulin release was increased in both DBA/2 and C57BL/6 islets incubated with 40 mM vs 11.1 mM glucose for 10 days. Chronic exposure to hyperglycemia decreased glucose (20 mM)-stimulated insulin secretion in DBA/2 but not in C57BL/6 islets. AG significantly increased fold-induced insulin release in high glucose cultured DBA/2 mouse islets, but did not affect C57BL/6 islet function. DBA/2 islet glucokinase was significantly reduced following 40 mM glucose culture, compared with 11.1 mM glucose cultured DBA/2 islets and 40 mM glucose cultured C57BL/6 islets. Incubation of islets with AG resulted in a normalization of DBA/2 islet glucokinase levels. In conclusion, chronic high glucose-induced increases in AGE can result in islet dysfunction and this is associated with reduced glucokinase levels in a mouse model with susceptibility to islet failure.

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Electrochemical impedance spectroscopy (EIS) was used to study and evaluate commercial batch treatment inhibitors which are used for protecting oil wells, gas wells, and pipelines from CO2 corrosion, focusing on the evaluation of inhibitor film persistency. It was found that theformation and deterioration of batch treatment inhibitor films were accompanied by typical impedance spectral changes. During the formation of inhibitor films, electrode impedance showed a rapid increase and the Bode phase angle plots also showed a sudden change. Thus, the formation of inhibitor film was a very fast process. During the deterioration of inhibitor films, electrode impedance showed a gradual decrease and the Bode phase angle plots showed changes which characterised the three stages of the inhibitor film deterioration process. The relationships between EIS and corrosion rate are discussed, including comparisons with weight loss measurements. Based on the experimental findings in the present work, a method is suggested for estimating the persistency of inhibitor films by monitoring the characteristic changes in the Bode phase angle plots and by measuring electrochemical charge transfer resistance at the second and third stages of the inhibitor film deterioration process.

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Electrochemical noise analysis (ENA) was used to monitor continuously the formation and deterioration processes of a commercial batch treatment inhibitor film of the type used for protecting against CO2 corrosion in oilfields; ENA was shown to be able to follow effectively the formation and deterioration processes of batch treatment inhibitor films. As an inhibitor film formed, the current noise amplitude decreased rapidly and the noise resistance Rn, which is deducible from the voltage and current noise records, was found to increase sharply. Conversely, as the inhibitor film deteriorated, the current noise amplitude increased rapidly and Rn decreased rapidly. In the corrosion inhibition system studied, the noise resistance was confirmed to be similar to the linear polarisation resistance. Based on the calculation of Rn on a continuous basis, a technique is proposed to study fast corrosion processes.

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It has been proposed that a sense of control (primary control) is critical to maintaining positive and stable subjective wellbeing (SWB). As people age and control capacity presumably declines (due to physical and cognitive deterioration and increased sociocultural challenges), it is argued that the influence of secondary perceived control (or acceptance) increases to help maintain normative levels of SWB. While previous studies have typically investigated the relationship between perceived control and global estimates of satisfaction (i.e., overall life satisfaction), the present study evaluated the link between perceived control and seven key domains of satisfaction in order to obtain a more comprehensive understanding of the control-satisfaction relationship. A community-based sample of 1,317 individuals (age range: 17–92 years) was utilised to examine potential age-related differences in perceived control (primary and secondary) and satisfaction. Findings revealed that primary and secondary perceived control both increased across age, with secondary perceived control increasing at a higher rate. Primary perceived control had predictive primacy for satisfaction over secondary perceived control (consistent with theory). A moderated mediation effect was also found, suggesting that, in later life, secondary perceived control influences primary perceived control and, in turn, influences satisfaction with various domains. Therefore, while primary control is important to wellbeing, it should be acknowledged that secondary perceived control may have unique significance to the wellbeing of older adults.

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The last 400 years has witnessed Western colonialism spread across the Asian communities and landscape transforming and re-defining their identity, culture, landscape patterns and meanings, as well as their land ethic. Whilst independence has brought forth robust attempts at nationalism it has been at the deference of regionalism and cultural identity. Instead, modernism, economic regeneration and growth, and attempts to define a nationalist image out of the newly created nations that are often a patchwork quilt of pre-colonial empires, are signalling the demise of critical regionalism and Indigenous knowledge systems. This paper considers the changes and cultural transformations over the last 400 years pointing to key dilemmas in regionalist growth, deterioration and stabilisation that are causing a loss of environmental and cultural values, morals and codes. These are the cultural and planning ‘rules’ that originally structured and guided the sustainable life and spirit of community, land and culture as an integrated whole. Particular attention will be drawn to the Indigenous communities of Malaysia, Indonesia and Australia that are struggling to maintain identity and environmental ethic in the shadow of major disjointed and multi-objectival national and international economic growth and digital transformation advances. Several possible answers or mediated strategies are offered, through a cultural heritage and planning lens, that could afford a respect and creative integration of these Indigenous knowledge systems to better inform regional growth and land management strategies so that it was regionally relevant.

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The study aims to identify the reasons for, and outcomes from, unplanned transfers from subacute care to acute care. A retrospective patient record review of patients requiring unplanned transfer from subacute to an acute care emergency department (ED) from 1 July 2008 to 30 June 2009 was undertaken. Data collected included patient demographics, clinical characteristics in preceding transfer, and on ED arrival and outcome data. There were 136 patients included in the study with a median age of 81 years. The most common reasons for transfer were respiratory problems and altered conscious state. In the 24 h preceding transfer, 92.6% of patients had ≥ 1 physiological abnormality and 10.3% of patients had no physiological parameters documented. On ED arrival, 75% of patients had physiological abnormalities. Hospital admission occurred in 75% of patients and the inpatient mortality rate was 14.7%. Factors associated with inpatient mortality were tachypnoea and severe hypoxaemia in 24 h preceding transfer and tachypnoea, hypoxaemia, hypoxaemia, severe hypoxaemia and hypothermia on ED arrival. Patients requiring unplanned transfer had higher inpatient mortality than older hospital users. Reasons for unplanned transfer reflect known predictors of in-hospital adverse events so predictive use of physiological data and patient characteristics might optimize patient safety.

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While the social work literature is broader and more holistic than many disciplines, we undoubtedly still limit the knowledge we draw upon in ways that stifle our creativity in conceptualising and attempting to facilitate wellbeing, which flows on to limit our teaching. In particular, the significance to wellbeing of place and social space, the value of informal networks to generate support and opportunities for reciprocity, and the inherent therapeutic value of creative activity appears to be neglected. In this paper we draw upon a small Australian research study around older women and craftmaking to explore how learning from diverse disciplines, such as critical gerontology and textile making, can illuminate our understanding of wellbeing. We relate this discussion to examining notions of ageing that go beyond a focus on illness and deterioration, to enhance positive and diverse concepts of health in the context of everyday life. We then discuss the implications for social work education, with particular emphasis on ageing, and argue that by engaging with a diverse range of disciplines, we are able to think about, teach and advocate for wellbeing in more expansive and useful ways.

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Objectives: 

The aim of this paper, is to present a case to develop and test emergency department (ED)-specific approaches to improve the sequential detection, recognition and timely escalation of care for ED patients who have deteriorated after their initial triage and assessment.

Results:
Managing the risk of clinical deterioration is a key feature of emergency care and underpins practice. However, although the epidemiology of deterioration in hospitalized ward patients has been well studied, the epidemiology of deterioration in ED patients is less understood. As ED workloads continue to increase, an emerging challenge for ED clinicians is how best to recognize and rapidly respond to deteriorating ED patients following triage and/or medical assessment. Rapid response systems for such patients exist in hospital wards; however, the use of rapid response systems in EDs is variable and largely unknown outside the UK.

Conclusion:
A systematic approach to the early recognition of, and response to, deteriorating ED patients across the entire ED trajectory of care remains untested. Given the complexities of the ED environment, ward-based models of recognizing and responding to deteriorating patients may not meet the specific needs of the ED.

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Background

Age-related losses in bone mineral density (BMD), muscle strength, balance, and gait have been linked to an increased risk of falls, fractures and disability, but few prospective studies have compared the timing, rate and pattern of changes in each of these measures in middle-aged and older men and women. This is important so that targeted strategies can be developed to optimise specific musculoskeletal and functional performance measures in older adults. Thus, the aim of this 10-year prospective study was to: 1) characterize and compare age- and gender-specific changes in BMD, grip strength, balance and gait in adults aged 50 years and over, and 2) compare the relative rates of changes between each of these musculoskeletal and functional parameters with ageing.

Methods:
Men (n = 152) and women (n = 206) aged 50, 60, 70 and 80 years recruited for a population-based study had forearm BMD, grip strength, balance and gait velocity re-assessed after 10-years.

Results:
The annual loss in BMD was 0.5-0.7% greater in women compared to men aged 60 years and older (p < 0.05- < 0.001), but there were no gender differences in the rate of loss in grip strength, balance or gait. From the age of 50 years there was a consistent pattern of loss in grip strength, while the greatest deterioration in balance and gait occurred from 60 and 70 years onwards, respectively. Comparison of the changes between the different measures revealed that the annual loss in grip strength in men and women aged <70 years was 1-3% greater than the decline in BMD, balance and gait velocity.

Conclusion:
There were no gender differences in the timing (age) and rate (magnitude) of decline in grip strength, balance or gait in Swedish adults aged 50 years and older, but forearm BMD decreased at a greater rate in women than in men. Furthermore, there was heterogeneity in the rate of loss between the different musculoskeletal and function parameters, especially prior to the age of 70 years, with grip strength deteriorating at a greater rate than BMD, balance and gait.