11 resultados para Problème de Snell

em Deakin Research Online - Australia


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This research study explored nurse academics' perceptions and experiences of scholarship and research. Interviews were carried out with 20 nurse academics in four Australian states. A grounded theory approach was used to explore issues they faced. The paper discusses how academics engaged in research and scholarship integrate it into their work practices. The participants spoke of problems encountered, such as the difficulty of gaining higher degrees whilst undertaking additional research. They indicated they felt under significant pressure to publish. The organisational structures that a small number of institutions put in place to facilitate the development of a scholarly research culture are illustrated.

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Between 2000 and 2002 the home range, habitat selection and diet of foxes were examined in the Dandenong Creek Valley, Melbourne, Australia. The mean home range was 44.6 ha (range 19.2–152.6 ha). A significant selection towards blackberry and gorse used as diurnal shelter was found during the day with an active avoidance of less structurally complex vegetation types. Although there was obvious selection of certain habitats, the diet of the foxes was highly general and opportunistic and thus offers little potential as a factor to manipulate in order to reduce fox abundance. Given the strong preference for blackberry and gorse as a shelter resource, a habitat-manipulation strategy is suggested whereby patches of blackberry and gorse are removed and replaced with less structurally complex vegetation. Such a strategy has the potential to influence the density of foxes in semi-urban riparian environments such as those discussed in this study.


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Objective
To document incidence of depression, anxiety, and stress in women more than 6 months following an acute coronary syndrome.

Design
Participants were identified from a coronary care unit database. The Depression Anxiety Stress Scales 21 (DASS 21) was sent to potential participants via postal survey.

Setting
A metropolitan teaching hospital in Melbourne, Australia.

Participants
The cohort of women was aged between 55 and 70 years. They had been admitted to hospital with a diagnosis of acute coronary syndrome (ACS) between 6 and 14 months prior to participating in this study.

Main outcome measures
Scores on Depression, Anxiety, and Stress Scale (DASS 21).

Results
Of the 117 posted questionnaires, 39 women with a mean age of 63 (S.D. 4.97) responded to the survey, representing a response rate of 33.3%. Most participants scored within normal levels of depression (66.7%), anxiety (60.5%), and stress (70.3%), however, mild to extremely severe levels of each construct (33.4%, 39.6%, and 29.7%, respectively) were found.

Conclusions
The reporting of elevated levels of depression, anxiety and stress in a subset of women more than 6 months following an ACS event underscores the importance of ongoing screening for risk factors impacting on psychological well-being and the inclusion of this information in education and counseling strategies in both the inpatient and outpatient settings. Based on these pilot data, consideration of a screening system in the immediate post discharge period for women at risk and an education or support service are recommended.

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Lung transplant recipients (LTx) exhibit marked peripheral limitations to exercise. We investigated whether skeletal muscle Ca2+ and K+ regulation might be abnormal in eight LTx and eight healthy controls. Peak oxygen consumption and arterialized venous plasma [K+] (where brackets denote concentration) were measured during incremental exercise. Vastus lateralis muscle was biopsied at rest and analyzed for sarcoplasmic reticulum Ca2+ release, Ca2+ uptake, and Ca2+-ATPase activity rates; fiber composition; Na+-K+-ATPase (K+-stimulated 3-O-methylfluorescein phosphatase) activity and content ([3H]ouabain binding sites); as well as for [H+] and H+-buffering capacity. Peak oxygen consumption was 47% less in LTx (P < 0.05). LTx had lower Ca2+ release (34%), Ca2+ uptake (31%), and Ca2+-ATPase activity (25%) than controls (P < 0.05), despite their higher type II fiber proportion (LTx, 75.0 ± 5.8%; controls, 43.5 ± 2.1%). Muscle [H+] was elevated in LTx (P < 0.01), but buffering capacity was similar to controls. Muscle 3-O-methylfluorescein phosphatase activity was 31% higher in LTx (P < 0.05), but [3H]ouabain binding content did not differ significantly. However, during exercise, the rise in plasma [K+]-to-work ratio was 2.6-fold greater in LTx (P < 0.05), indicating impaired K+ regulation. Thus grossly subnormal muscle calcium regulation, with impaired potassium regulation, may contribute to poor muscular performance in LTx.

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Objective
Primary graft dysfunction, a severe form of lung injury that occurs in the first 72 hours after lung transplant, is associated with morbidity and mortality. We sought to assess the impact of an evidence-based guideline as a protocol for respiratory and hemodynamic management.

Methods
Preoperative and postoperative data for patients treated per the guideline (n = 56) were compared with those of a historical control group (n = 53). Patient data such as ratio of arterial Po2 to inspired oxygen fraction, central venous pressure, cumulative fluid balance, vasopressor dose, and serum urea and creatinine were measured and documented at specific times. Primary outcome was severity of primary graft dysfunction within the first 72 hours.

Results
Primary graft dysfunction grade was progressively lower in patients treated after introduction of the guideline (P = .01). Lower postoperative fluid balances (P = .01) and vasopressor doses (P = .007) were seen, with no associated renal dysfunction. There were no differences in duration of mechanical ventilation or mortality. Nonadherence to the guideline occurred in 10 cases (18%).

Conclusions
Implementation of an evidence-based guideline for managing respiratory and hemodynamic status is feasible and safe and was associated with reduction in severity of primary graft dysfunction. Further studies are required to determine whether such a guideline would lead to a consistent reduction in severity of primary graft dysfunction at other institutions. Creation of a protocol for postoperative care provides a template for further studies of novel therapies or management strategies for primary graft dysfunction.

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Despite the recent flourishing of ecopsychology research, risks may be involved if ecopsychology remains a loosely defined paradigm. We suggest that drawing from some of the central themes of Theodore Roszak’s The Voice of the Earth (1992), a seminal text of ecopsychology, may help to elucidate the unique contribution of ecopsychology and its sustained relevance for environmentally focused psychologies. To provide a comprehensive review, we consider The Voice of the Earth by placing this text in the context of Roszak’s broader body of literature, discussing his earlier and more recent works. We particularly focus on the theme of spiritual experience throughout Roszak’s literature, as we believe that this is one of the more unique and important aspects of his work that has implications for the future development of ecopsychology as a paradigm and social movement. In conclusion, we suggest that Roszak’s emphasis on the value of a spiritual or animistic experience of nature, as a means of fostering empathy toward the natural world, may assist in providing meaningful focus to contemporary ecopsychology.