827 resultados para ways of seeing
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The set covering problem is an NP-hard combinatorial optimization problemthat arises in applications ranging from crew scheduling in airlines todriver scheduling in public mass transport. In this paper we analyze searchspace characteristics of a widely used set of benchmark instances throughan analysis of the fitness-distance correlation. This analysis shows thatthere exist several classes of set covering instances that have a largelydifferent behavior. For instances with high fitness distance correlation,we propose new ways of generating core problems and analyze the performanceof algorithms exploiting these core problems.
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In this paper, we introduce the concept of dyadic pulsations as a measure of sustainability in online discussion groups. Dyadic pulsations correspond to new communication exchanges occurring between two participants in a discussion group. A group that continuously integrates new participants in the on-going conversation is characterized by a steady dyadic pulsation rhythm. On the contrary, groups that either pursue close conversation or unilateral communication have no or very little dyadic pulsations. We show on two examples taken from Usenet discussion groups, that dyadic pulsations permit to anticipate future bursts in response delay time which are signs of group discussion collapses. We discuss ways of making this measure resilient to spam and other common algorithmic production that pollutes real discussions
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This study examined the interrelatedness of mother-infant and father-infant relationships as they develop over the first 4 months postpartum as well as the dynamics used by the couple to balance these relationships. First-time mother-father couples (n = 18) were interviewed separately at 1, 6, and 16 weeks postpartum using the Parent-Infant Relationship Interview. The data were analyzed using in-depth qualitative strategies. The parents' core themes of their early family relationships ranged from an undifferentiated unit at 1 week, to being a highly disorganized unit at 6 weeks, to a more integrated unit at 16 weeks. These results suggest that one should be thinking of early family relationships and parenting in terms of "messy processes" out of which new ways of being together are created. This disorganization plays a fundamental role in the establishment of early family relationships and warrants further empirical and clinical attention.
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This article summarizes the available evidence on the management of patients with subacute or chronic low back pain. The largest part is devoted to nonspecific low back pain but the models of spinal stenosis and disk herniation/sciatica are also specifically addressed. The authors point out the limited evidence available and the importance of a tailored approach for the individual patient. As the effect sizes of most therapies are rather small (close to that of a placebo), patients' preferences and other variables important for individualized management are highlighted. The task for the practitioner is difficult and awareness of this is important. Some speculation regarding potential future ways of improving patient care are presented.
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As a consequence of growing global migration, physicians in French speaking Switzerland often face communicational difficulties with allophone patients. This paper first discusses advantages and shortcomings of various ways of dealing with this kind of situations. The indication of using professional interpreters will be addressed, as well as some specific therapeutic, linguistic and relational features of triadic consultations involving a physician, a patient and an interpreter. Finally, useful practical information and advices are provided to clinicians in order to help them optimize their consultations with allophone patients.
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Abstract Background: Medical errors have recently been recognized as a relevant concern in public health, and increasing research efforts have been made to find ways of improving patient safety. In palliative care, however, studies on errors are scant. Objective: Our aim was to gather pilot data concerning experiences and attitudes of palliative care professionals on this topic. Methods: We developed a questionnaire, which consists of questions on relevance, estimated frequency, kinds and severity of errors, their causes and consequences, and the way palliative care professionals handle them. The questionnaire was sent to all specialist palliative care institutions in the region of Bavaria, Germany (n=168; inhabitants 12.5 million) reaching a response rate of 42% (n=70). Results: Errors in palliative care were regarded as a highly relevant problem (median 8 on a 10-point numeric rating scale). Most respondents experienced a moderate frequency of errors (1-10 per 100 patients). Errors in communication were estimated to be more common than those in symptom control. The causes most often mentioned were deficits in communication or organization. Moral and psychological problems for the person committing the error were seen as more frequent than consequences for the patient. Ninety percent of respondents declared that they disclose errors to the harmed patient. For 78% of the professionals, the issue was not a part of their professional training. Conclusion: Professionals acknowledge errors-in particular errors in communication-to be a common and relevant problem in palliative care, one that has, however, been neglected in training and research.
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Measurement of the blood pressure by the physician remains an essential step in the evaluation of cardiovascular risk. Ambulatory measurement and self-measurement of blood pressure are ways of counteracting the "white coat" effect which is the rise in blood pressure many patients experience in the presence of doctors. Thus, it is possible to define the cardiovascular risk of hypertension and identify the patients with the greatest chance of benefiting from antihypertensive therapy. However, it must be realised that normotensive subjects during their everyday activities and becoming hypertensive in the doctor's surgery, may become hypertensive with time, irrespective of the means used to measure blood pressure. These patients should be followed up regularly even if the decision to treat has been postponed.
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Current institutional and official representations of cancer are: coordination, integration, team approaches, quality management, full informed consent, patient centered communication and empowerment. Web access, comprehensive care plan summaries patient centered healthcare interactions and evidence-based programs are different ways of delivering the comprehensive care and follow-up cancer survivors deserve. The question remains, how to best explore and respect, in the meantime, more subjective dimensions such as patient beliefs, values, the meaning of the illness, preferences and needs. These aspects are fundamental elements in the construction of a trusting relationship, so as to find common ground, to be open to discuss anxiety and doubts and to provide information tailored to suit the patient's level of understanding, in order to reduce vulnerability to the feeling of being "lost in transition".
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Changes in intracellular Na(+) concentration underlie essential neurobiological processes, but few reliable tools exist for their measurement. Here we characterize a new synthetic Na(+)-sensitive fluorescent dye, Asante Natrium Green (ANG), with unique properties. This indicator was excitable in the visible spectrum and by two-photon illumination, suffered little photobleaching and located to the cytosol were it remained for long durations without noticeable unwanted effects on basic cell properties. When used in brain tissue, ANG yielded a bright fluorescent signal during physiological Na(+) responses both in neurons and astrocytes. Synchronous electrophysiological and fluorometric recordings showed that ANG produced accurate Na(+) measurement in situ. This new Na(+) indicator opens innovative ways of probing neuronal circuits.
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New ways of consuming tobacco or nicotine have recently been developed attracting smokers not only because of their novelty but also because they hope that it will decrease their health risks or will help them in smoking banned places. The objective of this paper is to review the current state of knowledge concerning the waterpipe, oral tobacco, nasal snuff, the electronic cigarette and tobacco heating devices. Although some products seem less harmful than cigarettes, we cannot encourage people to use them because we still do not have sufficient scientific data regarding their safety. Moreover, most of these products are addictive and we still do not know if they will play a role in harm reduction.
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Improving safety at nighttime work zones is important because of the extra visibility concerns. The deployment of sequential lights is an innovative method for improving driver recognition of lane closures and work zone tapers. Sequential lights are wireless warning lights that flash in a sequence to clearly delineate the taper at work zones. The effectiveness of sequential lights was investigated using controlled field studies. Traffic parameters were collected at the same field site with and without the deployment of sequential lights. Three surrogate performance measures were used to determine the impact of sequential lights on safety. These measures were the speeds of approaching vehicles, the number of late taper merges and the locations where vehicles merged into open lane from the closed lane. In addition, an economic analysis was conducted to monetize the benefits and costs of deploying sequential lights at nighttime work zones. The results of this study indicates that sequential warning lights had a net positive effect in reducing the speeds of approaching vehicles, enhancing driver compliance, and preventing passenger cars, trucks and vehicles at rural work zones from late taper merges. Statistically significant decreases of 2.21 mph mean speed and 1 mph 85% speed resulted with sequential lights. The shift in the cumulative speed distributions to the left (i.e. speed decrease) was also found to be statistically significant using the Mann-Whitney and Kolmogorov-Smirnov tests. But a statistically significant increase of 0.91 mph in the speed standard deviation also resulted with sequential lights. With sequential lights, the percentage of vehicles that merged earlier increased from 53.49% to 65.36%. A benefit-cost ratio of around 5 or 10 resulted from this analysis of Missouri nighttime work zones and historical crash data. The two different benefitcost ratios reflect two different ways of computing labor costs.
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BACKGROUND: A combination of radioimmunotherapy (RIT) and radiotherapy (RT) should allow one to increase the dose of radiation targeting a particular tumour without the concomitant increase of toxic side effects. This might be obtained if the dose limiting side effect of each individual radiation therapy concerned different organs. METHODS: Six patients with limited liver metastatic disease from colorectal cancer were treated with 6.9 GBq (range 4.7 to 8.4 GBq) 131I-labelled anti-CEA MAb F(ab')2 fragments combined with 20 Gy RT to the liver. Both treatments were given in close association, according to timing schedules evaluated in animals that gave the best results. RESULTS: Reversible bone marrow and liver toxicity was observed in 6 and 5 patients, respectively. Three patients who first received 20 Gy RT to the liver, showed a significant platelet drop upon completion of RT. Repeat computerized tomography (CT) after 2 months showed a minor response in 1 patient and stable disease in 3 patients. CONCLUSION: The study shows potential ways of combining RIT and RT, suggesting that this combination is feasible for the treatment of liver metastases.
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This project was undertaken jointly with a project supported by the Iowa Corn Promotion Board. Together the projects aimed at producing the organic acids, propionic acid and acetic acid, by fermentation. The impacts were to provide agriculturally-based alternatives to production of these acids, currently produced mainly as petrochemicals. The potentially high-demand use for acetic acid is as the "acetate" in Calcium Magnesium Acetate (CMA), the non-corrosive road deicer. Fermentation was, however, far from being an economically acceptable alternative. Gains were made in this work toward making this a feasible route. These advances included (1) development of a variant strain of propionibacteria capable of producing higher concentrations of acids; (2) comparison of conditions for several ways of cultivating free cells and establishment of the relative benefits of each; (3) achievement of the highest productivity in fermentations using immobilized cells; (4) identification of corn steep liquor as a lower cost substrate for the fermentation; (5) application of a membrane extraction system for acid recovery and reduction of product inhibition; and (6) initial use of more detailed economic analysis of process alternatives to guide in the identification of where the greatest payback potential is for future research. At this point, the fermentation route to these acids using the propionibacteria is technically feasible, but economically unfeasible. Future work with integration of the above process improvements can be expected to lead to further gains in economics. However, such work can not be expected to make CMA a less expensive deicer than common road salt.
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The concept of public art is a polysemic term, and the dispersion of its meaning is reflected in the different ways of working during the XXth Century. It cross the fields of sculpture, monument, visual arts and urban space, defined from a civic perspective. This timeline had been constructed after the publications of my PhD: http://www.tesisenred.net/handle/10803/1549
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The Leopold Center was created by the Iowa Legislature as part of the Iowa Groundwater Protection Act of 1987. The Leopold Center believes contribute to a healthy ways of thinking about markets for Iowa farmers, a better understanding of local ecosystems, public policies and economic practices, and partnerships with consumers.