Fatigue, physical performance, and systemic inflammation in patients with chronic obstructive pulmonary disease

Thesis (Ph.D.)--University of Washington, 2016-06

Impact of senescence and disease on the structural and functional performance of the visual pathway

The diagnosis and monitoring of ocular disease presents considerable clinical difficulties for two main reasons i) the substantial physiological variation of anatomical structure of the visual pathway and ii) constraints due to technical limitations of diagnostic hardware. These are further confounded by difficulties in detecting early loss or change in visual function due to the masking of disease effects, for example, due to a high degree of redundancy in terms of nerve fibre number along the visual pathway. This thesis addresses these issues across three areas of study: 1. Factors influencing retinal thickness measures and their clinical interpretation As the retina is the principal anatomical site for damage associated with visual loss, objective measures of retinal thickness and retinal nerve fibre layer thickness are key to the detection of pathology. In this thesis the ability of optical coherence tomography (OCT) to provide repeatable and reproducible measures of retinal structure at the macula and optic nerve head is investigated. In addition, the normal physiological variations in retinal thickness and retinal nerve fibre layer thickness are explored. Principal findings were: • Macular retinal thickness and optic nerve head measurements are repeatable and reproducible for normal subjects and diseased eyes • Macular and retinal nerve fibre layer thickness around the optic nerve correlate negatively with axial length, suggesting that larger eyes have thinner retinae, potentially making them more susceptible to damage or disease • Foveola retinal thickness increases with age while retinal nerve fibre layer thickness around the optic nerve head decreases with age. Such findings should be considered during examination of the eye with suspect pathology or in long-term disease monitoring 2. Impact of glucose control on retinal anatomy and function in diabetes Diabetes is a major health concern in the UK and worldwide and diabetic retinopathy is a major cause of blindness in the working population. Objective, quantitative measurements of retinal thickness. particularly at the macula provide essential information regarding disease progression and the efficacy of treatment. Functional vision loss in diabetic patients is commonly observed in clinical and experimental studies and is thought to be affected by blood glucose levels. In the first study of its kind, the short term impact of fluctuations in blood glucose levels on retinal structure and function over a 12 hour period in patients with diabetes are investigated. Principal findings were: • Acute fluctuations in blood glucose levels are greater in diabetic patients than normal subjects • The fluctuations in blood glucose levels impact contrast sensitivity scores. SWAP visual fields, intraocular pressure and diastolic pressure. This effect is similar for type 1 and type 2 diabetic patients despite the differences in their physiological status. • Long-term metabolic control in the diabetic patient is a useful predictor in the fluctuation of contrast sensitivity scores. • Large fluctuations in blood glucose levels and/or visual function and structure may be indicative of an increased risk of development or progression of retinopathy 3. Structural and functional damage of the visual pathway in glaucomatous optic neuropathy The glaucomatous eye undergoes a number of well documented pathological changes including retinal nerve fibre loss and optic nerve head damage which is correlated with loss of functional vision. In experimental glaucoma there is evidence that glaucomatous damage extends from retinal ganglion cells in the eye, along the visual pathway, to vision centres in the brain. This thesis explores the effects of glaucoma on retinal nerve fibre layer thickness, ocular anterior anatomy and cortical structure, and its correlates with visual function in humans. Principal findings were: • In the retina, glaucomatous retinal nerve fibre layer loss is less marked with increasing distance from the optic nerve head, suggesting that RNFL examination at a greater distance than traditionally employed may provide invaluable early indicators of glaucomatous damage • Neuroretinal rim area and retrobulbar optic nerve diameter are strong indicators of visual field loss • Grey matter density decreases at a rate of 3.85% per decade. There was no clear evidence of a disease effect • Cortical activation as measured by fMRI was a strong indicator of functional damage in patients with significant neuroretinal rim loss despite relatively modest visual field defects These investigations have shown that the effects of senescence are evident in both the anterior and posterior visual pathway. A variety of anatomical and functional diagnostic protocols for the investigation of damage to the visual pathway in ocular disease are required to maximise understanding of the disease processes and thereby optimising patient care.

Symbolic use of export information:a multidimensional conceptualisation, its' effect on performance and key antecedents

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Developing performance measures of mangrove wetlands using simulation models of hydrology, nutrient biogeochemistry, and community dynamics

The goal of mangrove restoration projects should be to improve community structure and ecosystem function of degraded coastal landscapes. This requires the ability to forecast how mangrove structure and function will respond to prescribed changes in site conditions including hydrology, topography, and geophysical energies. There are global, regional, and local factors that can explain gradients of regulators (e.g., salinity, sulfides), resources (nutrients, light, water), and hydroperiod (frequency, duration of flooding) that collectively account for stressors that result in diverse patterns of mangrove properties across a variety of environmental settings. Simulation models of hydrology, nutrient biogeochemistry, and vegetation dynamics have been developed to forecast patterns in mangroves in the Florida Coastal Everglades. These models provide insight to mangrove response to specific restoration alternatives, testing causal mechanisms of system degradation. We propose that these models can also assist in selecting performance measures for monitoring programs that evaluate project effectiveness. This selection process in turn improves model development and calibration for forecasting mangrove response to restoration alternatives. Hydrologic performance measures include soil regulators, particularly soil salinity, surface topography of mangrove landscape, and hydroperiod, including both the frequency and duration of flooding. Estuarine performance measures should include salinity of the bay, tidal amplitude, and conditions of fresh water discharge (included in the salinity value). The most important performance measures from the mangrove biogeochemistry model should include soil resources (bulk density, total nitrogen, and phosphorus) and soil accretion. Mangrove ecology performance measures should include forest dimension analysis (transects and/or plots), sapling recruitment, leaf area index, and faunal relationships. Estuarine ecology performance measures should include the habitat function of mangroves, which can be evaluated with growth rate of key species, habitat suitability analysis, isotope abundance of indicator species, and bird census. The list of performance measures can be modified according to the model output that is used to define the scientific goals during the restoration planning process that reflect specific goals of the project.

Roseate spoonbill reproduction as an indicator for restoration of the Everglades and the Everglades estuaries

Ecological monitoring is key to successful ecosystem restoration. Because all components within an ecosystem cannot be monitored, it is important to select indicators that are representative of the system, integrate system responses, clearly respond to system change, can be effectively and efficiently monitored, and are easily communicated. The roseate spoonbill is one ecological indicator species that meets these criteria within the Everglades ecosystem. Monitoring of roseate spoonbills in Florida Bay over the past 70 years has shown that aspects of this species’ reproduction respond to changes in hydrology and corresponding changes in prey abundance and availability. This indicator uses nesting location, nest numbers and nesting success in response to food abundance and availability. In turn, prey abundance is a function of hydrological conditions (especially water depth) and salinity. Metrics and targets for these performance measures were established based on previous findings. Values of each metric were translated into indices and identified as stoplight colors with green indicating that a given target has been met, yellow indicating that conditions are below the target, but within an acceptable range of it, and red indicating the measure is performing poorly in relation to the target.

THE USE OF THE EARLY WARNING INDICATOR REPORT TO IMPACT NINTH GRADE PROMOTION RATES IN A LARGE URBAN SCHOOL DISTRICT

Abstract The purpose of this study was to examine how four high schools used an Early Warning Indicator Report (EWIR) to improve ninth grade promotion rates. Ninth grade on-time promotion is an early predictor of a student’s likelihood to graduate (Bornsheuer, Polonyi, Andrews, Fore, & Onwuegbuzie, 2011; Leckrone & Griffith, 2006; Roderick, Kelley-Kemple, Johnson, & Beechum, 2014; Zvoch, 2006). The analysis revealed both similarities and differences in the ways that the four schools used the EWIR. The research took place in a large urban school district in the Mid-Atlantic. Sixteen participants from four high schools and the district’s central office voluntarily participated in face-to-face interviews. The researcher utilized a qualitative case study method to examine the implementation of the EWIR system in Wyatt School District. The interview data was transcribed and analyzed, along with district documents, to identify categories in this cross case analysis. Three primary themes emerged from the data: (1) targeted school structures for EWIR implementation, (2) the EWIR identified necessary supports for students, and (3) the central office support for school staff. The findings revealed the various ways that the target schools implemented the EWIR in their buildings and the level of support that they received from the central office that aided them in using the EWIR to improve ninth grade promotion rates. Based on the findings of this study, the researcher provided a number of key recommendations: (1) Districts should provide professional development to schools to ensure that schools have the support they need to implement the EWIR successfully; (2) There should be increased accountability from the central office for schools using the EWIR to identify impactful interventions for ninth graders; and (3) The district needs to assign dedicated central office staff to support the implementation of the EWIR in high schools across the district. As schools continue to face the challenge of improving ninth grade promotion rates, effective use of an Early Warning Indicator Report is recommended to provide school and district staff with data needed to impact overall student performance.

Multicultural work environment as a key in cross-cultural negotiations and organizations’ performance: Canada overview

Es necesario que los gerentes sean líderes y establezcan relaciones sólidas con los empleados, para luego establecer las mismas con socios potenciales. Para lograr este objetivo, Con el fin de cumplir este objetivo, el uso de estrategias y técnicas de negociación es crucial, así como la importancia de la conciencia cultural y de la diversidad. La globalización no sólo ha movido a los mercados sino también a las personas, la inmigración es un fenómeno fuerte hoy en día y varios países, como Canadá, han sido inclusivos y han apoyado a estos nuevos ciudadanos. Las empresas de Canadá, sin importar la industria, han asumido el reto de integrar una fuerza laboral diversa con el propósito de adquirir nuevos conocimientos y crecer a nivel nacional, pero sobre todo en el ámbito internacional. Igualmente, es esencial tener en cuenta las ventajas y limitaciones del multiculturalismo dentro de la empresa y específicamente en las negociaciones interculturales.

Neck Circumference As A New Anthropometric Indicator For Prediction Of Insulin Resistance And Components Of Metabolic Syndrome In Adolescents: Brazilian Metabolic Syndrome Study.

To evaluate the correlation between neck circumference and insulin resistance and components of metabolic syndrome in adolescents with different adiposity levels and pubertal stages, as well as to determine the usefulness of neck circumference to predict insulin resistance in adolescents. Cross-sectional study with 388 adolescents of both genders from ten to 19 years old. The adolescents underwent anthropometric and body composition assessment, including neck and waist circumferences, and biochemical evaluation. The pubertal stage was obtained by self-assessment, and the blood pressure, by auscultation. Insulin resistance was evaluated by the Homeostasis Model Assessment-Insulin Resistance. The correlation between two variables was evaluated by partial correlation coefficient adjusted for the percentage of body fat and pubertal stage. The performance of neck circumference to identify insulin resistance was tested by Receiver Operating Characteristic Curve. After the adjustment for percentage body fat and pubertal stage, neck circumference correlated with waist circumference, blood pressure, triglycerides and markers of insulin resistance in both genders. The results showed that the neck circumference is a useful tool for the detection of insulin resistance and changes in the indicators of metabolic syndrome in adolescents. The easiness of application and low cost of this measure may allow its use in Public Health services.

Evaluation of the performance of different plastics used to seal nylon cDNA arrays

cDNA arrays are a powerful tool for discovering gene expression patterns. Nylon arrays have the advantage that they can be re-used several times. A key issue in high throughput gene expression analysis is sensitivity. In the case of nylon arrays, signal detection can be affected by the plastic bags used to keep membranes humid. In this study, we evaluated the effect of five types of plastics on the radioactive transmittance, number of genes with a signal above the background, and data variability. A polyethylene plastic bag 69 μm thick had a strong shielding effect that blocked 68.7% of the radioactive signal. The shielding effect on transmittance decreased the number of detected genes and increased the data variability. Other plastics which were thinner gave better results. Although plastics made from polyvinylidene chloride, polyvinyl chloride (both 13 μm thick) and polyethylene (29 and 7 μm thick) showed different levels of transmittance, they all gave similarly good performances. Polyvinylidene chloride and polyethylene 29 mm thick were the plastics of choice because of their easy handling. For other types of plastics, it is advisable to run a simple check on their performance in order to obtain the maximum information from nylon cDNA arrays.

Microbiological indicators for the assessment of performance in the hazard analysis and critical control points (HACCP) system in meat lasagna production

The HACCP system is being increasingly used to ensure food safety. This study investigated the validation of the control measures technique in order to establish performance indicators of this HACCP system in the manufacturing process of Lasagna Bolognese (meat lasagna). Samples were collected along the manufacturing process as a whole, before and after the CCPs. The following microorganism s indicator (MIs) was assessed: total mesophile and faecal coliform counts. The same MIs were analyzed in the final product, as well as, the microbiological standards required by the current legislation. A significant reduction in the total mesophile count was observed after cooking (p < 0.001). After storage, there was a numerical, however non-significant change in the MI count. Faecal coliform counts were also significantly reduced (p < 0.001) after cooking. We were able to demonstrate that the HACCP system allowed us to meet the standards set by both, the company and the Brazilian regulations, proved by the reduction in the established indicators

Evaluation technique for determining wheel performance in the grinding of aerospace materials

Nickel-based super alloys are used in a variety of applications in which high-temperature strength and resistance to creep, corrosion, and oxidation are required, such as in aircraft gas turbines, combustion chambers, and automotive engine valves. The properties that make these materials suitable for these applications also make them difficult to grind. Grinding systems for such materials are often built around vitrified cBN (cubic boron nitride) wheels to realize maximum productivity and minimum cost per part. Conditions that yield the most economical combination of stock removal rate and wheel wear are key to the successful implementation of the grinding system. Identifying the transition point for excessive wheel wear is important. The aim of this study is to compare the performance of different cBN wheels when grinding difficult-to-grind (DTG) materials by determining the 'wheel wear characteristic curve', which correlates the G-ratio to the calculated tangential force per abrasive grain. With the proposed methodology, a threshold force per grit above which the wheel wear rate increases rapidly can be quickly identified. A comparison of performance for two abrasive product formulations in the grinding of three materials is presented. The obtained results can be applied for the development of grinding applications for DTG materials.

PROPOSAL OF A PERFORMANCE MEASURING SYSTEM APPLIED TO AGRICULTURAL MECHANIZATION

The leaders` organizations of several different sectors have as characteristic to measure their own performance in a systematic way. However, this concept is still unusual in agricultural enterprises, including the mechanization sector. Mechanization has an important role on the production costs and to know its performance is a key factor for the agricultural enterprise success. This work was generated by the importance that measurement of performance has for the management and the mechanization impact on the production costs. Its aim is to propose an integrated performance measurement system to give support to agricultural management. The methodology was divided in two steps: adjustment of a conceptual model based on Balanced Score Card - BSC; application of the model in a study case at sugar cane mill. The adjustment and the application of the conceptual model allowed to obtain the performance index in a systematic way, that are associated to: costs and deadline ( traditionally used); control and improvement on the quality of operations and support process; environmental preservation; safety; health; employees satisfaction; development of information systems. The adjusted model helped the development of the performance measurement system for the mechanized management systems and the index allows an integrated view of the enterprise, related to its strategic objectives.

A cross-national comparison of Australian and Canadian supervisors' attributional and evaluative responses to subordinate performance

In a program of laboratory and field research over the last decade, the author has replicated and extended the attribution model of leadership (Green & Mitchell, 1979). This paper reports a cross-national test of the model, in which 172 Australian and 144 Canadian work supervisors' recalled their attributional and evaluative responses to high and low levels of subordinate performance. It was expected that the supervisors' responses would conform to the predictions established in the earlier studies, but that there would be key differences across the cultures. In particular, Australians were expected to endorse more internal attributions for subordinate performance than Canadians, and to focus more on individual characteristics in evaluating performance. Results supported the model's robustness and the hypothesised cross-national differences. The implications of these results are discussed in terms of crosscultural research opportunities, and the need to take account of small but potentially important differences in supervisory styles across cultures.

Performance impacts of appraisal and coping with stress in workplace settings: The role of affect and emotional intelligence

We review the literature on stress in organizational settings and, based on a model of job insecurity and emotional intelligence by Jordan, Ashkanasy and Härtel (2002), present a new model where affective responses associated with stress mediate the impact of workplace stressors on individual and organizational performance outcomes. Consistent with Jordan et al., emotional intelligence is a key moderating variable. In our model, however, the components of emotional intelligence are incorporated into the process of stress appraisal and coping. The chapter concludes with a discussion of the implications of these theoretical developments for understanding emotional and behavioral responses to workplace.