979 resultados para POST-PARTO


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Vietnam has a unique culture which is revealed in the way that people have built and designed their traditional housing. Vietnamese dwellings reflect occupants’ activities in their everyday lives, while adapting to tropical climatic conditions impacted by seasoning monsoons. It is said that these characteristics of Vietnamese dwellings have remained unchanged until the economic reform in 1986, when Vietnam experienced an accelerated development based on the market-oriented economy. New housing types, including modern shop-houses, detached houses, and apartments, have been designed in many places, especially satisfying dwellers’ new lifestyles in Vietnamese cities. The contemporary housing, which has been mostly designed by architects, has reflected rules of spatial organisation so that occupants’ social activities are carried out. However, contemporary housing spaces seem unsustainable in relation to socio-cultural values because they has been influenced by globalism that advocates the use of homogeneous spatial patterns, modern technologies, materials and construction methods. This study investigates the rules of spaces in Vietnamese houses that were built before and after the reform to define the socio-cultural implications in Vietnamese housing design. Firstly, it describes occupants’ views of their current dwellings in terms of indoor comfort conditions and social activities in spaces. Then, it examines the use of spaces in pre-reform Vietnamese housing through occupants’ activities and material applications. Finally, it discusses the organisation of spaces in both pre- and post-reform housing to understand how Vietnamese housing has been designed for occupants to live, act, work, and conduct traditional activities. Understanding spatial organisation is a way to identify characteristics of the lived spaces of the occupants created from the conceived space, which is designed by designers. The characteristics of the housing spaces will inform the designers the way to design future Vietnamese housing in response to cultural contexts. The study applied an abductive approach for the investigation of housing spaces. It used a conceptual framework in relation to Henri Lefebvre’s (1991) theory to understand space as the main factor constituting the language of design, and the principles of semiotics to examine spatial structure in housing as a language used in the everyday life. The study involved a door-knocking survey to 350 households in four regional cities of Vietnam for interpretation of occupancy conditions and levels of occupants’ comfort. A statistical analysis was applied to interpret the survey data. The study also required a process of data selection and collection of fourteen cases of housing in three main climatic regions of the country for analysing spatial organisation and housing characteristics. The study found that there has been a shift in the relationship of spaces from the pre- to post-reform Vietnamese housing. It also indentified that the space for guest welcoming and family activity has been the central space of the Vietnamese housing. Based on the relationships of the central space with the others, theoretical models were proposed for three types of contemporary Vietnamese housing. The models will be significant in adapting to Vietnamese conditions to achieve socioenvironmental characteristics for housing design because it was developed from the occupants’ requirements for their social activities. Another contribution of the study is the use of methodological concepts to understand the language of living spaces. Further work will be needed to test future Vietnamese housing designs from the applications of the models.

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OBJECTIVE: To review and compare the mild traumatic brain injury (mTBI) vignettes used in postconcussion syndrome (PCS) research, and to develop 3 new vignettes. METHOD: The new vignettes were devised using World Health Organization (WHO) mTBI diagnostic criteria [1]. Each vignette depicted a very mild (VM), mild (M), or severe (S) brain injury. Expert review (N = 27) and readability analysis was used to validate the new vignettes and compare them to 5 existing vignettes. RESULTS: The response rate was 44%. The M vignette and existing vignettes were rated as depicting a mTBI; however, the fit-to-criteria of these vignettes differed significantly. The fit-to-criteria of the M vignette was as good as that of 3 existing vignettes and significantly better than 2 other vignettes. As expected, the VM and S vignettes were a poor fit-to-criteria. CONCLUSIONS: These new vignettes will assist PCS researchers to test the limits of important etiology factors by varying the severity of depicted injuries.

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This study investigated the specificity of the post-concussion syndrome (PCS) expectation-as-etiology hypothesis. Undergraduate students (n = 551) were randomly allocated to one of three vignette conditions. Vignettes depicted either a very mild (VMI), mild (MI), or moderate-to-severe (MSI) motor vehicle-related traumatic brain injury (TBI). Participants reported the PCS and PTSD symptoms that they imagined the depicted injury would produce. Secondary outcomes (knowledge of mild TBI, and the perceived undesirability of TBI) were also assessed. After data screening, the distribution of participants by condition was: VMI (n = 100), MI (n = 96), and MSI (n = 71). There was a significant effect of condition on PCS symptomatology, F(2, 264) = 16.55, p < .001. Significantly greater PCS symptomatology was expected in the MSI condition compared to the other conditions (MSI > VMI; medium effect, r = .33; MSI > MI; small-to-medium effect, r = .22). The same pattern of group differences was found for PTSD symptoms, F(2, 264) = 17.12, p < .001. Knowledge of mild TBI was not related to differences in expected PCS symptoms by condition; and the perceived undesirability of TBI was only associated with reported PCS symptomatology in the MSI condition. Systematic variation in the severity of a depicted TBI produces different PCS and PTSD symptom expectations. Even a very mild TBI vignette can elicit expectations of PCS symptoms.

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between mid 2010 and early 2011, Queensland road related infrastructures were devastated by flood and cyclone related natural disasters. Responding to these recent events and in preparing for more regular and intense climate-change induced events in future, the Queensland Government is now reviewing how post-disaster road infrastructure recovery projects are planned and delivered. In particular, there is awareness that rebuilding such infrastructure need sustainable strategies across economic, environmental and social dimensions. A comprehensive sustainability assessment framework for pre and post disaster situations can minimize negative impact on our communities, economy and environment. This research is underway to develop a comprehensive sustainability element frame work for post disaster management in road infrastructures in Queensland, Australia. Analyzing the implications of disruption to transport network and associated services is an important part of preparing local and regional responses to the impacts of natural disasters. This research can contribute to strategic planning, management leading to safe, efficient and integrated transport system that supports sustainable economic, social and environmental outcomes in Queensland. Within this context, this paper provides an overview of the qualitative mixed-method research approach involving literature reviews and case studies to explore and evaluate a number of sustainability elements with a view to develop operational strategies for disaster recovery road projects.

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The term post-war violence has been with us for much of the twentieth century but the issue itself has existed for centuries. The study of violence in post-war societies has been explored by philosophers (Erasmus), statesmen (Sir Thomas More) and sociologists (Emile Durkheim). In many cases the cessation of war and the signing of peace accords do not always mean an end to the violence. This book examines in considerable detail the causes and purposes of post-conflict violence and argues that features which constrain or encourage violence accumulate in such a manner as to create distinct and different types of post-war environments...

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This chapter describes the later Mesozoic history of Queensland, when the broad epicratonic basins that underlie most of the state west of the Great Dividing Range received the greater part of their sediment infill after ~210 Ma(middle Norian). The final major orogenic event—the Hunter Bowen Orogeny—had abated in the Tasmanides. These basins preserve relatively thin sedimentary successions that extend over about two-thirds of the area of the state...

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While scientists continue to explore the level of climate change impact to new weather patterns and our environment in general, there have been some devastating natural disasters worldwide in the last two decades. Indeed natural disasters are becoming a major concern in our society. Yet in many previous examples, our reconstruction efforts only focused on providing short-term necessities. How to develop resilience in the long run is now a highlight for research and industry practice. This paper introduces a research project aimed at exploring the relationship between resilience building and sustainability in order to identify key factors during reconstruction efforts. From extensive literature study, the authors considered the inherent linkage between the two issues as evidenced from past research. They found that sustainability considerations can improve the level of resilience but are not currently given due attention. Reconstruction efforts need to focus on resilience factors but as part of urban development, they must also respond to the sustainability challenge. Sustainability issues in reconstruction projects need to be amplified, identified, processed, and managed properly. On-going research through empirical study aims to establish critical factors (CFs) for stakeholders in disaster prone areas to plan for and develop new building infrastructure through holistic considerations and balanced approaches to sustainability. A questionnaire survey examined a range of potential factors and the subsequent data analysis revealed six critical factors for sustainable Post Natural Disaster Reconstruction that include: considerable building materials and construction methods, good governance, multilateral coordination, appropriate land-use planning and policies, consideration of different social needs, and balanced combination of long-term and short-term needs. Findings from this study should have an influence on policy development towards Post Natural Disaster Reconstruction and help with the achievement of sustainable objectives.

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Background: normal ageing processes impact on oropharyngeal swallowing function placing older adults at risk of developing oropharyngeal dysphagia (OD). Anecdotal clinical experience has observed that older patients recovering from hip fracture surgery commonly develop OD post-operatively. Objective: to document the presence of OD following hip fracture surgery, and the factors associated with OD. Methods: one hundred and eighty-one patients with a mean age of 83 years (range: 65–103) admitted to a specialised orthogeriatric unit were assessed for OD post-surgery for hip fracture. Pre-admission, intra-operative and post-operative factors were examined to determine their relationship with the presence of OD. Results: OD was found to be present post-operatively in 34% (n = 61) of the current population. Multivariate logistic regression analyses revealed the presence of pre-existing neurological and respiratory medical co-morbidities, presence of post-operative delirium, age and living in a residential aged care facility prior to hospital admission to be associated with the post-operative OD. Conclusion: these results highlight that OD is present in a large number of the older hip fracture population. Early identification of OD has important implications for the provision of timely dysphagia management that may prevent secondary complications and potentially reduce the hospital length of stay.

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Anisotropic damage distribution and evolution have a profound effect on borehole stress concentrations. Damage evolution is an irreversible process that is not adequately described within classical equilibrium thermodynamics. Therefore, we propose a constitutive model, based on non-equilibrium thermodynamics, that accounts for anisotropic damage distribution, anisotropic damage threshold and anisotropic damage evolution. We implemented this constitutive model numerically, using the finite element method, to calculate stress–strain curves and borehole stresses. The resulting stress–strain curves are distinctively different from linear elastic-brittle and linear elastic-ideal plastic constitutive models and realistically model experimental responses of brittle rocks. We show that the onset of damage evolution leads to an inhomogeneous redistribution of material properties and stresses along the borehole wall. The classical linear elastic-brittle approach to borehole stability analysis systematically overestimates the stress concentrations on the borehole wall, because dissipative strain-softening is underestimated. The proposed damage mechanics approach explicitly models dissipative behaviour and leads to non-conservative mud window estimations. Furthermore, anisotropic rocks with preferential planes of failure, like shales, can be addressed with our model.

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This thoughtful book is a much needed contribution to feminist ethics that is brimming with detailed and insightful analyses of the positioning of women in contemporary health care and particularly in relation to new reproductive technologies (NRTs). The clearly written and structured chapters provide accessible points to modern ethics, post-modernism, and feminist ethics. Margrit Shildrick takes on these areas with authority and vigour, building an argument for women to enter the relations of reproduction on terms more expressive of feminine desire...

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It has been known since Rhodes Fairbridge’s first attempt to establish a global pattern of Holocene sea-level change by combining evidence from Western Australia and from sites in the northern hemisphere that the details of sea-level history since the Last Glacial Maximum vary considerably across the globe. The Australian region is relatively stable tectonically and is situated in the ‘far-field’ of former ice sheets. It therefore preserves important records of post-glacial sea levels that are less complicated by neotectonics or glacio-isostatic adjustments. Accordingly, the relative sea-level record of this region is dominantly one of glacio-eustatic (ice equivalent) sea-level changes. The broader Australasian region has provided critical information on the nature of post-glacial sea level, including the termination of the Last Glacial Maximum when sea level was approximately 125 m lower than present around 21,000–19,000 years BP, and insights into meltwater pulse 1A between 14,600 and 14,300 cal. yr BP. Although most parts of the Australian continent reveals a high degree of tectonic stability, research conducted since the 1970s has shown that the timing and elevation of a Holocene highstand varies systematically around its margin. This is attributed primarily to variations in the timing of the response of the ocean basins and shallow continental shelves to the increased ocean volumes following ice-melt, including a process known as ocean siphoning (i.e. glacio-hydro-isostatic adjustment processes). Several seminal studies in the early 1980s produced important data sets from the Australasian region that have provided a solid foundation for more recent palaeo-sea-level research. This review revisits these key studies emphasising their continuing influence on Quaternary research and incorporates relatively recent investigations to interpret the nature of post-glacial sea-level change around Australia. These include a synthesis of research from the Northern Territory, Queensland, New South Wales, South Australia and Western Australia. A focus of these more recent studies has been the re-examination of: (1) the accuracy and reliability of different proxy sea-level indicators; (2) the rate and nature of post-glacial sea-level rise; (3) the evidence for timing, elevation, and duration of mid-Holocene highstands; and, (4) the notion of mid- to late Holocene sea-level oscillations, and their basis. Based on this synthesis of previous research, it is clear that estimates of past sea-surface elevation are a function of eustatic factors as well as morphodynamics of individual sites, the wide variety of proxy sea-level indicators used, their wide geographical range, and their indicative meaning. Some progress has been made in understanding the variability of the accuracy of proxy indicators in relation to their contemporary sea level, the inter-comparison of the variety of dating techniques used and the nuances of calibration of radiocarbon ages to sidereal years. These issues need to be thoroughly understood before proxy sea-level indicators can be incorporated into credible reconstructions of relative sea-level change at individual locations. Many of the issues, which challenged sea-level researchers in the latter part of the twentieth century, remain contentious today. Divergent opinions remain about: (1) exactly when sea level attained present levels following the most recent post-glacial marine transgression (PMT); (2) the elevation that sea-level reached during the Holocene sea-level highstand; (3) whether sea-level fell smoothly from a metre or more above its present level following the PMT; (4) whether sea level remained at these highstand levels for a considerable period before falling to its present position; or (5) whether it underwent a series of moderate oscillations during the Holocene highstand.

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There has been much discussion and controversy in the media recently regarding metal toxicity following large head metal on metal (MoM) total hip replacement (THR). Patients have been reported as having hugely elevated levels of metal ions with, at times, devastating systemic, neurolgical and/or orthopaedic sequelae. However, no direct correlation between metal ion level and severity of metallosis has yet been defined. Normative levels of metal ions in well functioning, non Cobalt-Chrome hips have also not been defined to date. The Exeter total hip replacement contains no Cobalt-Chrome (Co-Cr) as it is made entirely from stainless steel. However, small levels of these metals may be present in the modular head of the prosthesis, and their effect on metal ion levels in the well functioning patient has not been investigated. We proposed to define the “normal” levels of metal ions detected by blood test in 20 well functioning patients at a minimum 1 year post primary Exeter total hip replacement, where the patient had had only one joint replaced. Presently, accepted normal levels of blood Chromium are 10–100 nmol/L and plasma Cobalt are 0–20 nmol/L. The UK Modern Humanities Research Association (MHRA) has suggested that levels of either Cobalt or Chromium above 7 ppb (equivalent to 135 nmol/L for Chromium and 120 nmol/L for Cobalt) may be significant. Below this level it is indicated that significant soft tissue reaction and tissue damage is less likely and the risk of implant failure is reduced. Hips were a mixture of cemented and hybrid procedures performed by two experienced orthopaedic consultants. Seventy percent were female, with a mixture of head sizes used. In our cohort, there were no cases where the blood Chromium levels were above the normal range, and in more than 70% of cases, levels were below recordable levels. There were also no cases of elevated plasma Cobalt levels, and in 35% of cases, levels were negligible. We conclude that the implantation with an Exeter total hip replacement does not lead to elevation of blood metal ion levels.

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BACKGROUND: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. METHODS: Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. RESULTS: A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following 'failed DAIR' cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. CONCLUSIONS: As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings.