640 resultados para Karzen, Kathy


Relevância:

10.00% 10.00%

Publicador:

Resumo:

Gemstone Team Organ Storage and Hibernation

Relevância:

10.00% 10.00%

Publicador:

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Objectives: To evaluate the empirical evidence linking nursing resources to patient outcomes in intensive care settings as a framework for future research in this area. Background: Concerns about patient safely and the quality of care are driving research on the clinical and cost-effectiveness of health care interventions, including the deployment of human resources. This is particularly important in intensive care where a large proportion of the health care budget is consumed and where nursing staff is the main item of expenditure. Recommendations about staffing levels have been trade but may not be evidence based and may not always be achieved in practice. Methods: We searched systematically for studies of the impact of nursing resources (e.g. nurse-patient ratios, nurses' level of education, training and experience) on patient Outcomes, including mortality and adverse events, in adult intensive care. Abstracts of articles were reviewed and retrieved if they investigated the relationship between nursing resources and patient Outcomes. Characteristics of the studies were tabulated and the quality of the Studies assessed. Results: Of the 15 studies included in this review, two reported it statistical relationship between nursing resources and both mortality and adverse events, one reported ail association to mortality only, seven studies reported that they Could not reject the null hypothesis of no relationship to mortality and 10 studies (out of 10 that tested the hypothesis) reported a relationship to adverse events. The main explanatory mechanisms were the lack of time for nurses to perform preventative measures, or for patient surveillance. The nurses' role in pain control was noted by One author. Studies were mainly observational and retrospective and varied in scope from 1 to 52 units. Recommendations for future research include developing the mechanisms linking nursing resources to patient Outcomes, and designing large multi-centre prospective Studies that link patient's exposure to nursing care oil a shift-by-shift basis over time. (C) 2007 Elsevier Ltd. All rights reserved.

Relevância:

10.00% 10.00%

Publicador:

Relevância:

10.00% 10.00%

Publicador:

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Patterns of endemism in the Neotropics have been explained by restriction of forest to ‘refugia’ in arid cold-stages of the Quaternary (Haffer J (1969)
Speciation in Amazonian forest birds. Science 165: 131–137). The palaeoecological record, however, shows no such forest contraction. We review
palaeoecological and phylogenetic data on the response of Neotropical taxa and communities to climatic changes of the Cenozoic. Solar insolation varies
over this period with latitude and geography, including shifts in opposite directions between high and low latitudes. In the Neotropics, distribution and
abundance patterns originate on a wide range of timescales through the Cenozoic, down to the currently dominant precession forcing (20 kyr). In contrast,
distributions and abundances at higher latitudes are controlled by obliquity forcing (40 kyr). The patterns observed by Haffer (1969) are likely derived
from pre-Quaternary radiations and are not inconsistent with palaeoecological findings of continuous forest cover in major areas of the Neotropics
during the Quaternary. The relative proportions of speciation processes have changed through time between predominantly sympatric to predominantly
allopatric depending on the prevailing characteristics of orbitally forced climatic changes. Behaviour of Neotropical organisms and ecosystems on long
timescales may be influenced much more by precessional forcing than by the obliquity forcing that controls high-latitude climate change and glaciations.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The effect of vision on the excitability of corticospinal projections to the flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscles of right human forearm was investigated before and during discrete movement of the opposite limb. An external force opposed the initial phase of the movement (wrist flexion) and assisted the reverse phase, so that recruitment of the wrist extensors was minimized. Three conditions were used as follows: viewing the inactive right limb (Vision), viewing the mirror image of the moving left limb (Mirror), and with vision of the right limb occluded (No Vision). Transcranial magnetic stimulation was delivered to the left motor cortex: before, at the onset of, or during the left limb movement to obtain motor evoked potentials (MEPs) in the muscles of the right forearm. At and following movement onset, MEPs obtained in the right FCR were smaller in the Vision condition than in the Mirror and No Vision conditions. A distinct pattern of variation was obtained for the ECR. In all conditions, MEPs in this muscle were elevated upon or following movement of the opposite limb. An additional analysis of ipsilateral silent periods indicated that interhemispheric inhibition plays a role in mediating these effects. Activity-dependent changes in corticospinal output to a resting limb during discrete actions of the opposite limb are thus directly contingent upon where one looks. Furthermore, the extent to which vision exerts an influence upon projections to specific muscles varies in accordance with the functional contribution of their homologs to the intended action.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

In consumer research, we frequently focus on the phenomenon of transformation, whether the transformatory effects of a particular consumption community or the great body of work being carried out under the banner of transformative consumer research. However, there is a particular transformation which occurs in the field of interpretivist consumer research that, we would argue, is overlooked—that of researcher transformation. We present as data our reflexive considerations on the ways in which our own research with vulnerable consumers has affected and changed us. We consider short-term transformations in the field, reflecting on the various ways that researcher identity is carefully managed and negotiated to fit with the social–cultural setting. We also consider longer term transformations and discuss the enduring impact of the research process—the people we have met, the homes we have visited, and the stories we have heard. By reflecting on the shaping of identities ‘in the field’, we aim to deepen our appreciation of the interpretive consumer research process and contribute to theoretical understanding of transformative identity research. Copyright © 2012 John Wiley & Sons, Ltd.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

BackgroundRas-related nuclear protein (Ran) is required for cancer cell survival in vitro and human cancer progression, but the molecular mechanisms are largely unknown.MethodsWe investigated the effect of the v-myc myelocytomatosis viral oncogene homolog (Myc) on Ran expression by Western blot, chromatin immunoprecipitation, and luciferase reporter assays and the effects of Myc and Ran expression in cancer cells by soft-agar, cell adhesion, and invasion assays. The correlation between Myc and Ran and the association with patient survival were investigated in 14 independent patient cohorts (n = 2430) and analyzed with Spearman's rank correlation and Kaplan-Meier plots coupled with Wilcoxon-Gehan tests, respectively. All statistical tests were two-sided.ResultsMyc binds to the upstream sequence of Ran and transactivates Ran promoter activity. Overexpression of Myc upregulates Ran expression, whereas knockdown of Myc downregulates Ran expression. Myc or Ran overexpression in breast cancer cells is associated with cancer progression and metastasis. Knockdown of Ran reverses the effect induced by Myc overexpression in breast cancer cells. In clinical data, a positive association between Myc and Ran expression was revealed in 288 breast cancer and 102 lung cancer specimens. Moreover, Ran expression levels differentiate better or poorer survival in Myc overexpressing breast (?(2) = 24.1; relative risk [RR] = 9.1, 95% confidence interval [CI] = 3.3 to 24.7, P <.001) and lung (?(2) = 6.04; RR = 2.8, 95% CI = 1.2 to 6.3; P = .01) cancer cohorts.ConclusionsOur results suggest that Ran is required for and is a potential therapeutic target of Myc-driven cancer progression in both breast and lung cancers.