973 resultados para Locally Advanced Head
Resumo:
Head and Neck Cancers (HNC) are a group of tumours located in the upper aero-digestive tract. Head and Neck Squamous Cell Carcinoma (HNSCC) represent about 90% of all HNC cases. It has been considered the sixth most malignant tumour worldwide and, despite clinical and technological advances, the five-year survival rate has not improved much in the last years. Nowadays, HNSCC is well established as a heterogeneous disease and that its development is due to accumulation of genetic events. Apart from the majority of the patients being diagnosed in an advanced stage, HNSCC is also a disease with poor therapeutic outcome. One of the therapeutic approaches is radiotherapy. However, this approach has different drawbacks like the radioresistance acquired by some tumour cells, leading to a worse prognosis. A major knowledge in radiation biology is imperative to improve this type of treatment and avoid late toxicities, maintaining patient quality of life in the subsequent years after treatment. Then, identification of genetic markers associated to radiotherapy response in patients and possible alterations in cells after radiotherapy are essential steps towards an improved diagnosis, higher survival rate and a better life quality. Not much is known about the radiation effects on cells, so, the principal aim of this study was to contribute to a more extensive knowledge about radiation treatment in HNSCC. For this, two commercial cell lines, HSC-3 and BICR-10, were used and characterized resorting to karyotyping, aCGH and MS-MLPA. These cell lines were submitted to different doses of irradiation and the resulting genetic and methylation alterations were evaluated. Our results showed a great difference in radiation response between the two cell lines, allowing the conclusion that HSC-3 was much more radiosensitive than BICR-10. Bearing this in mind, analysis of cell death, cell cycle and DNA damages was performed to try to elucidate the motifs behind this difference. The characterization of both cell lines allowed the confirmation that HSC-3 was derived from a metastatic tumour and the hypothesis that BICR-10 was derived from a dysplasia. Furthermore, this pilot study enabled the suggestion of some genetic and epigenetic alterations that cells suffer after radiation treatment. Additionally, it also allowed the association of some genetic characteristics that could be related to the differences in radiation response observable in this two cell lines. Taken together all of our results contribute to a better understanding of radiation effects on HNSCC allowing one further step towards the prediction of patients’ outcome, better choice of treatment approaches and ultimately a better quality of life.
Resumo:
Aim: To review the titles, roles and scope of practice of Advanced Practice Nurses internationally.----- Background: There is a worldwide shortage of nurses but there is also an increased demand for nurses with enhanced skills who can manage a more diverse, complex and acutely ill patient population than ever before. As a result, a variety of nurses in advanced practice positions has evolved around the world. The differences in nomenclature have led to confusion over the roles, scope of practice and professional boundaries of nurses in an international context.----- Method: CINAHL, Medline, and the Cochrane database of Systematic Reviews were searched from 1987 to 2008. Information was also obtained through government health and professional organisation websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant.----- Findings: There are many names for Advanced Practice Nurses, and although many of these roles are similar in their function, they can often have different titles.----- Conclusion: Advanced Practice Nurses are critical for the future, provide cost-effective care and are highly regarded by patients/clients. They will be a constant and permanent feature of future health care provision. However, clarification regarding their classification and regulation is necessary in some countries.
Resumo:
Clinical Nutrition for Oncology Patients provides clinicians with the information they need to help cancer survivors and patients make informed choices about their nutrition and improve their short-term and long-term health. This comprehensive resource outlines nutritional management recommendations for care prior to, during, and after treatment and addresses specific nutritional needs and complementary therapies that may be of help to a patient. This book is written by a variety of clinicians who not only care for cancer survivors and their caregivers but are also experts in the field of nutritional oncology.
Resumo:
Background Advanced paternal age (APA) is associated with an increased risk of neurodevelopmental disorders such as autism and schizophrenia, as well as with dyslexia and reduced intelligence. The aim of this study was to examine the relationship between paternal age and performance on neurocognitive measures during infancy and childhood. Methods and Findings A sample of singleton children (n = 33,437) was drawn from the US Collaborative Perinatal Project. The outcome measures were assessed at 8 mo, 4 y, and 7 y (Bayley scales, Stanford Binet Intelligence Scale, Graham-Ernhart Block Sort Test, Wechsler Intelligence Scale for Children, Wide Range Achievement Test). The main analyses examined the relationship between neurocognitive measures and paternal or maternal age when adjusted for potential confounding factors. Advanced paternal age showed significant associations with poorer scores on all of the neurocognitive measures apart from the Bayley Motor score. The findings were broadly consistent in direction and effect size at all three ages. In contrast, advanced maternal age was generally associated with better scores on these same measures. Conclusions The offspring of older fathers show subtle impairments on tests of neurocognitive ability during infancy and childhood. In light of secular trends related to delayed fatherhood, the clinical implications and the mechanisms underlying these findings warrant closer scrutiny.
Resumo:
The Guide contains the distilled findings from a major, two-year research project to explore those factors considered by industry practitioners to be critical to the successful adoption of ICT, both within their firms and between their firms and their trading partners. In the context of this project Critical Success Factors (CSFs) have been defined as, “Those things that absolutely, positively must be attended to in order to maximise the likelihood of a successful outcome for the stakeholder, defined in the stakeholder’s terms.” The guide includes: o Perceived benefits of ICT use across the head contractors’ sector o Types and levels of ICT used across the sector o Self-assessment tool o CSFs for medium- and high-level ICT users, including o Best Practice Profiles o Action Statements The material contained in this Guide has been generated following a number of principles: o For a given situation there is not a single ‘right answer’, but a number of solutions that have to be evaluated using a range of relevant factors. o Since there are as many solutions as there are ‘solvers’, factors for evaluation will ‘emerge’ from collective wisdom.
Resumo:
The over represented number of novice drivers involved in crashes is alarming. Driver training is one of the interventions aimed at mitigating the number of crashes that involve young drivers. To our knowledge, Advanced Driver Assistance Systems (ADAS) have never been comprehensively used in designing an intelligent driver training system. Currently, there is a need to develop and evaluate ADAS that could assess driving competencies. The aim is to develop an unsupervised system called Intelligent Driver Training System (IDTS) that analyzes crash risks in a given driving situation. In order to design a comprehensive IDTS, data is collected from the Driver, Vehicle and Environment (DVE), synchronized and analyzed. The first implementation phase of this intelligent driver training system deals with synchronizing multiple variables acquired from DVE. RTMaps is used to collect and synchronize data like GPS, vehicle dynamics and driver head movement. After the data synchronization, maneuvers are segmented out as right turn, left turn and overtake. Each maneuver is composed of several individual tasks that are necessary to be performed in a sequential manner. This paper focuses on turn maneuvers. Some of the tasks required in the analysis of ‘turn’ maneuver are: detect the start and end of the turn, detect the indicator status change, check if the indicator was turned on within a safe distance and check the lane keeping during the turn maneuver. This paper proposes a fusion and analysis of heterogeneous data, mainly involved in driving, to determine the risk factor of particular maneuvers within the drive. It also explains the segmentation and risk analysis of the turn maneuver in a drive.
Resumo:
Forensic analysis requires the acquisition and management of many different types of evidence, including individual disk drives, RAID sets, network packets, memory images, and extracted files. Often the same evidence is reviewed by several different tools or examiners in different locations. We propose a backwards-compatible redesign of the Advanced Forensic Formatdan open, extensible file format for storing and sharing of evidence, arbitrary case related information and analysis results among different tools. The new specification, termed AFF4, is designed to be simple to implement, built upon the well supported ZIP file format specification. Furthermore, the AFF4 implementation has downward comparability with existing AFF files.
Resumo:
The composition of many professional services firms in the Urban Development area has moved away from a discipline specific ‘silo’ structure to a more multidisciplinary environment. The benefits of multidisciplinarity have been seen in industry by providing synergies across many of the related disciplines. Similarly, the Queensland University of Technology, Bachelor of Urban Development degree has sought to broaden the knowledge base of students and achieve a greater level of synergy between related urban development disciplines through the introduction of generic and multidisciplinary units. This study aims to evaluate the effectiveness of delivering core property units in a multidisciplinary context. A comparative analysis has been undertaken between core property units and more generic units offered in a multidisciplinary context from introductory, intermediate and advanced years within the property program. This analysis was based on data collected from course performance surveys, student performance results, a student focus group and was informed by a reflective process from the student perspective and lecturer/ tutor feedback. The study showed that there are many benefits associated with multidisciplinary unit offerings across the QUT Urban Development program particularly in the more generic units. However, these units require a greater degree of management. It is more difficult to organise, teach and coordinate multidisciplinary student cohorts due to a difference in prior knowledge and experience between each of the discipline groups. In addition, the interaction between lecturers/ tutors and the students frequently becomes more limited. A perception exists within the student body that this more limited face to face contact with academic staff is not valuable which may be exacerbated by the quality of complimentary online teaching materials. For many academics, non-attendance at lectures was coupled with an increase in email communication. From the limited data collected during the study there appears to be no clear correlation between large multidisciplinary student classes and student academic performance or satisfaction.
Resumo:
Investigated the psychometric properties of the original and alternate sets of the Trail Making Test (TMT) and the Controlled Oral Word Association Test (COWAT; A. L. Benton and D. Hamsher, 1978) in 50 orthopedic and 15 closed head injured (1 yr after trauma) patients (aged 15–59 yrs). Although the alternate forms of both measures proved to be stable and consistent with each other in both groups, only the parallel sets of TMT reliably discriminated the clinical group from controls. Practice effects in the head injured were significant only for Trail B of TMT. Factor analysis of the control group's results identified Verbal Knowledge as a major contributor to performance on COWAT, whereas TMT was more dependent on Rapid Visual Search and Visuomotor Sequencing.