A combined strength and balance exercise program to decrease falls risk in dialysis patients : a feasibility study

People suffering end-stage kidney disease receiving hemodialysis have a greater risk of falling and suffering debilitating injuries. The purpose of this study was to examine the feasibility and impact of a combined strength and balance exercise intervention on falls risk in hemodialysis patients. Twenty-four adults (mean age = 67.8 yrs) from two Australian outpatient hemodialysis clinics completed the intervention. Falls risk was measured using the Physiological Profile Assessment (PPA). There was a significant reduction in the median overall falls risk z-score from 1.67 to .52 (z = -3.11, P<.008; r = .45). Median reaction time improved from .30 to .26 sec (z = -2.86, P<.008; r = .41). A strength and balance intervention to reduce the falls risk for dialysis patients is feasible and may reduce falls risk for at risk patients.

An agile IT security model for project risk assessment

There are two fundamental challenges in effectively performing security risk assessment in today's IT projects.The first is the project manager's need to know what IT security risks face the project before the project begins. At this stage IT security staff are unable to answer this question without first knowing the system requirements for the project which are yet to be defined. Second organisations that deal with a large project throughput each year find the current IT security risk assessment process to be tedious and expensive, especially when the same process has to be repeated for each individual project. This also makes it difficult for an organisation to prioritise which projects require more investment in IT security in order to fit within budget constraints. This paper presents a conceptual model that is based on an agile approach to alleviate these challenges. We do this by first analysing two online database resources of vulnerabilities by comparing them to each other, and then compare them to the agile criteria of the conceptual model which we define. The conceptual model is then presented and an example is given of how it can be applied to an actual project. We then briefly discuss what further work needs to be done to implement the conceptual model and validate it against an existing IT project.

Development of a new best practice model for building projects

Time, cost and quality are the traditional determinants of project success. The level of client satisfaction is a newly defined measurement of project success. Often the satisfaction level of construction clients is not high. The reasons for this situation are twofold, firstly due to the temporary organizational structure of construction team and secondly, the inefficient construction process. The traditional procurement route, whilst still the most popular in the building sector, is probably subject to most criticism. The primary aim of this research is to develop a new best practice model for building projects. This will enable the client’s project manager to identify best practice under the traditional procurement route before the work is executed. Within this model, the sequence of construction activities, the responsibilities of the parties and the critical aspect of each phase of the project are identified. This model can then be utilized at both the design and/ or the construction stage in order to secure project success.

Using Pareto principle plus statistic methodology in establishing a cost estimating model

Previous experience and research indicated that the Pareto Principle (80/20 Principle) has been widely used in many industries to achieve more with less. The study described in this paper concurs that this principle can be applied to improve the estimating accuracy and efficiency, especially in design development stage of projects. In fact, establishing an effective cost estimating model to improve accuracy and efficiency in design development stage has been a subject, which has attracted many research attentions over several decades. For over almost 40 years, research studies indicate that using the 80/20 Principle is one of the approaches. However, most of these studies were built by assumption, theoretical analysis or questionnaire survey. The objective of this research is to explore a logical and systematic method to establish a cost estimating model based on the Pareto Principle. This paper includes extensive literatures review on cost estimating accuracy and efficiency in the construction industry that points out the current gap of knowledge area and understanding of the topical. These reviews assist in developing the direction for the research and explore the potential methodology of using the Pareto Principle in the new cost estimating model. The findings of this paper suggest that combining the Pareto Principle with statistical analysis could be used as the technique to improve the accuracy and efficiency of current estimating methods in design development stage.

The Plasmodium translocon of exported proteins (PTEX) component thioredoxin-2 is important for maintaining normal blood-stage growth

Plasmodium parasites remodel their vertebrate host cells by translocating hundreds of proteins across an encasing membrane into the host cell cytosol via a putative export machinery termed PTEX. Previously PTEX150, HSP101 and EXP2 have been shown to be bona fide members of PTEX.

Here we validate that PTEX88 and TRX2 are also genuine members of PTEX and provide evidence that expression of PTEX components are also expressed in early gametocytes, mosquito and liver stages, consistent with observations that protein export is not restricted to asexual stages. Although amenable to genetic tagging, HSP101, PTEX150, EXP2 and PTEX88 could not be genetically deleted in Plasmodium berghei, in keeping with the obligatory role this complex is postulated to have in maintaining normal blood-stage growth.

In contrast, the putative thioredoxin-like protein TRX2 could be deleted, with knockout parasites displaying reduced grow-rates, both in vivo and in vitro, and reduced capacity to cause severe disease in a cerebral malaria model. Thus, while not essential for parasite survival, TRX2 may help to optimize PTEX activity. Importantly, the generation of TRX2 knockout parasites that display altered phenotypes provides a much-needed tool to dissect PTEX function.

Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder

Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness.

Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled.

There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.

A mathematical model of neuromuscular adaptation to resistance training and its application in a computer simulation of accommodating loads

A large corpus of data obtained by means of empirical study of neuromuscular adaptation is currently of limited use to athletes and their coaches. One of the reasons lies in the unclear direct practical utility of many individual trials. This paper introduces a mathematical model of adaptation to resistance training, which derives its elements from physiological fundamentals on the one side, and empirical findings on the other. The key element of the proposed model is what is here termed the athlete’s capability profile. This is a generalization of length and velocity dependent force production characteristics of individual muscles, to an exercise with arbitrary biomechanics. The capability profile, a two-dimensional function over the capability plane, plays the central role in the proposed model of the training-adaptation feedback loop. Together with a dynamic model of resistance the capability profile is used in the model’s predictive stage when exercise performance is simulated using a numerical approximation of differential equations of motion. Simulation results are used to infer the adaptational stimulus, which manifests itself through a fed back modification of the capability profile. It is shown how empirical evidence of exercise specificity can be formulated mathematically and integrated in this framework. A detailed description of the proposed model is followed by examples of its application—new insights into the effects of accommodating loading for powerlifting are demonstrated. This is followed by a discussion of the limitations of the proposed model and an overview of avenues for future work.

A Response to Critique of the Refreeze Step in Lewin’s Model of Organizational Change from the Viewpoint of Organizational Behavior

Problem Statement
This paper responds to criticism of Kurt Lewin’s three step model of organizational change in increasingly turbulent environments. It explores whether the refreeze step of Kurt Lewin’s notable three step model is still applicable to organizational change processes in the age of globalisation and digitalisation.

Method
Literature review and critical analysis of applied examples are used to provide an overview of Kurt Lewin’s three-step change model. Authors’ observations and reflections are integrated in the discussion. The changing contemporary environment and the implications for the refreeze step of Lewin’s model are accordingly discussed.

Conclusions
The paper concludes that a balance of stability and movement; of discrete and emergent change; is the reality for today’s organizations, and forms the touchstone for Lewin’s formulation of change theories. Alignment is observed between notions of desired equilibrium in Lewin’s model and the contemporary underpinnings of sustainability. Technology and the modern pace of organizational change are also factors to consider. There has hence been an adaptation of his theoretical heritage that is current and sufficiently robust to withstand the criticisms of the refreeze stage.

Sporobolus stapfianus, a model desiccation-tolerant grass

Sporobolus stapfianus Gandoger, one of ~40 known ‘anabiotic’grass species (i.e. ‘able to regain vital activity from a state of latent life’), is the most versatile tool for research into desiccation tolerance in vegetative grass tissue. Current knowledge on this species is presented, including the features that suit it for investigations into the plant’s ability to survive dehydration of its leaf protoplasm. The main contributors to desiccation tolerance in S. stapfianus leaves appear to be: accumulation during dehydration of protectants of membranes and proteins; mechanisms limiting oxidative damage; a retention of protein synthetic activity in late stages of drying that is linked with changes in gene expression and in the proteomic array; and an ability to retain net synthesis of ATP during drying. S. stapfianus exemplifies an advanced stage of an evolutionary trend in desiccation tolerant plants towards increased importance of the dehydration phase (for induction of tolerance, for synthesis of protectants and for proteomic changes).

Categorization of disaster decision support needs for the development of an integrated model for DMDSS

The wide variety of disasters and the large number of activities involved have resulted in the demand for separate Decision Support System (DSS) models to manage different requirements. The modular approach to model management is to provide a framework in which to focus multidisciplinary research and model integration. A broader view of our approach is to provide the flexibility to organize and adapt a tailored DSS model (or existing modular subroutines) according to the dynamic needs of a disaster. For this purpose, the existing modular subroutines of DSS models are selected and integrated to produce a dynamic integrated model focussed on a given disaster scenario. In order to facilitate the effective integration of these subroutines, it is necessary to select the appropriate modular subroutine beforehand. Therefore, subroutine selection is an important preliminary step towards model integration in developing Disaster Management Decision Support Systems (DMDSS). The ability to identify a modular subroutine for a problem is an important feature before performing model integration. Generally, decision support needs are combined, and encapsulate different requirements of decision-making in the disaster management area. Categorization of decision support needs can provide the basis for such model selection to facilitate effective and efficient decision-making in disaster management. Therefore, our focus in this paper is on developing a methodology to help identify subroutines from existing DSS models developed for disaster management on the basis of needs categorization. The problem of the formulation and execution of such modular subroutines are not addressed here. Since the focus is on the selection of the modular subroutines from the existing DMDSS models on basis of a proposed needs classification scheme.

Clinical implications of a staging model for bipolar disorders

A model of staging in the field of bipolar disorder (BD) should offer a means for clinicians to predict response to treatment and more general outcome measures, such as the level of functioning and autonomy. The present staging model emphasizes the assessment of patients in the interepisodic period and includes: latent phase: individuals who present mood and anxiety symptoms and increased risk for developing threshold BD; Stage I – patients with BD who present well established periods of euthymia and absence of overt psychiatric morbidity between episodes; Stage II – patients who present rapid cycling or current axis I or II comorbidities; Stage III – patients who present a clinically relevant pattern of cognitive and functioning deterioration, as well as altered biomarkers; and Stage IV – patients who are unable to live autonomously and present altered brain scans and biomarkers. Such a model implies a longitudinal appraisal of clinical variables, as well as assessment of neurocognition and biomarkers in the interepisodic period. Staging facilitates understanding of the mechanisms underlying progression of the disorder, assists in treatment planning and prognosis and, finally, underscores the imperative for early intervention.

Understanding the link between body image and binge eating: a model comparison approach

Purpose
The present study tests several competing, explanatory models—dual pathways, escape from awareness, and objectification theory—for the established link between body dissatisfaction and binge eating.

Methods
408 women aged between 18 and 40 years completed a survey designed to assess contributions of proposed mediators (dietary restraint and negative affect from the dual pathway model, self-distraction from the escape from awareness model, and interoceptive deficits from objectification theory) for the body dissatisfaction–binge eating relationship.

Results
Although mediation analyses supported the dual pathway model and objectification theory when tested separately, the dual pathway model most strongly predicted the body dissatisfaction–binge eating relationship. Both model-implied mediators (dietary restraint and negative affect) made significant unique contributions, accounting for roughly one-quarter of the shared variance between body dissatisfaction and binge eating when tested separately from other mediators. Improvements in variance explained were negligible once other proposed mediators were included in a test of models combined.

Conclusions
Collectively, these findings suggest the superiority of the dual pathway model over objectification theory and the escape model, but the remaining unaccounted for covariance suggests need to consider alternative mechanisms that may also account for the relationship between body dissatisfaction and binge eating.

Towards stage specific treatments: Effects of duration of illness on therapeutic response to adjunctive treatment with N-acetyl cysteine in schizophrenia.

Schizophrenia is a chronic and often debilitating disorder in which stage of illness appears to influence course, outcome, prognosis and treatment response. Current evidence suggests roles for oxidative, neuroinflammatory, neurotrophic, apoptotic, mitochondrial and glutamatergic systems in the disorder; all targets of N-acetyl cysteine (NAC). A double blind, placebo controlled trial suggested NAC to be beneficial to those diagnosed with schizophrenia. The current manuscript aims to investigate duration of the illness as a key factor that may be modulating the response to NAC in the participants who took part in the study. A sample of 121 participants were randomized in a double fashion to 24weeks (placebo=62; NAC=59). Clinical and functional variables were collected over the treatment period. Duration of the illness at baseline was grouped into <10years, 10-<20years and >20years. Mixed Model Repeated Measures Analysis was used to explore the effect of illness duration on response to treatment with NAC. A significant interaction between duration of the illness and response to treatment with NAC was consistently found for positive symptoms and functional variables, but not for negative or general symptoms or for side effects related outcomes. The pattern of changes suggests this mediator effect of duration of illness in response to treatment is more evident in those participants with 20years or more of illness duration. Our results suggest a potential advantage of adjunctive NAC over placebo on functioning and positive symptoms reduction in those patients with chronic schizophrenia. This has potential for suggesting stage specific treatments.

A two-stage dynamic group decision making method for processing ordinal information

In group decision making (GDM) problems, ordinal data provide a convenient way of articulating preferences from decision makers (DMs). A number of GDM models have been proposed to aggregate such kind of preferences in the literature. However, most of the GDM models that handle ordinal preferences suffer from two drawbacks: (1) it is difficult for the GDM models to manage conflicting opinions, especially with a large number of DMs; and (2) the relationships between the preferences provided by the DMs are neglected, and all DMs are assumed to be of equal importance, therefore causing the aggregated collective preference not an ideal representative of the group's decision. In order to overcome these problems, a two-stage dynamic group decision making method for aggregating ordinal preferences is proposed in this paper. The method consists of two main processes: (i) a data cleansing process, which aims to reduce the influence of conflicting opinions pertaining to the collective decision prior to the aggregation process; as such an effective solution for undertaking large-scale GDM problems is formulated; and (ii) a support degree oriented consensus-reaching process, where the collective preference is aggregated by using the Power Average (PA) operator; as such, the relationships of the arguments being aggregated are taken into consideration (i.e., allowing the values being aggregated to support each other). A new support function for the PA operator to deal with ordinal information is defined based on the dominance-based rough set approach. The proposed GDM model is compared with the models presented by Herrera-Viedma et al. An application related to controlling the degradation of the hydrographic basin of a river in Brazil is evaluated. The results demonstrate the usefulness of the proposed method in handling GDM problems with ordinal information.

The HWMD maturity model: a foundational framework to measure effectiveness of institutional research e-infrastructures

There is a nationally recognised need for a framework and tools to measure progress in implementing e-infrastructures for research from an institutional, organisational unit and service perspective. This paper describes the development of a prototype maturity model and self-assessment tool in response to that need. The authors present a background to the environment of technology enabling services for research and the challenges of fluidity of boundaries around traditional services and roles as institutions respond to the needs of the research community. The conceptual basis of the model is presented along with the model and its various elements that explain how the model is in its current form. The information provided in this paper, combined with field site test feedback, will promote discussion and debate amongst the community and opportunities will present to gather input to optimise the model. The next steps would be to further elaborate and test the constructs and indicators of the model in field test sites and to further develop the self -assessment tool.