976 resultados para Remaining useful life
Resumo:
BACKGROUND: Food allergy has been shown to have a significant impact on quality of life (QoL) and can be difficult to manage in order to avoid potentially life threatening reactions. Parental self-efficacy (confidence) in managing food allergy for their child might explain variations in QoL. This study aimed to examine whether self-efficacy in parents of food allergic children was a good predictor of QoL of the family. METHODS: Parents of children with clinically diagnosed food allergy completed the Food Allergy Self-Efficacy Scale for Parents (FASE-P), the Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), the GHQ-12 (to measure mental health) and the Food Allergy Independent Measure (FAIM), which measures perceived likelihood of a severe allergic reaction. RESULTS: A total of 434 parents took part. Greater parental QoL was significantly related to greater self-efficacy for food allergy management, better mental health, lower perceived likelihood of a severe reaction, older age in parent and child and fewer number of allergies (all p<0.05). Food allergy self-efficacy explained more of the variance in QoL than any other variable and self-efficacy related to management of social activities and precaution and prevention of an allergic reaction appeared to be the most important aspects. CONCLUSIONS: Parental self-efficacy in management of a child's food allergy is important and is associated with better parental QoL. It would be useful to measure self-efficacy at visits to allergy clinic in order to focus support; interventions to improve self-efficacy in parents of food allergic children should be explored. This article is protected by copyright. All rights reserved.
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The degree of reliance of newborn sharks on energy reserves from maternal resource allocation and the timescales over which these animals develop foraging skills are critical factors towards understanding the ecological role of top predators in marine ecosystems. We used muscle tissue stable carbon isotopic composition and fatty acid analysis of bull sharks Carcharhinus leucas to investigate early-life feeding ecology in conjunction with maternal resource dependency. Values of δ13C of some young-of-the-year sharks were highly enriched, reflecting inputs from the marine-based diet and foraging locations of their mothers. This group of sharks also contained high levels of the 20:3ω9 fatty acid, which accumulates during periods of essential fatty acid deficiency, suggesting inadequate or undeveloped foraging skills and possible reliance on maternal provisioning. A loss of maternal signal in δ13C values occurred at a length of approximately 100 cm, with muscle tissue δ13C values reflecting a transition from more freshwater/estuarine-based diets to marine-based diets with increasing length. Similarly, fatty acids from sharks >100 cm indicated no signs of essential fatty acid deficiency, implying adequate foraging. By combining stable carbon isotopes and fatty acids, our results provided important constraints on the timing of the loss of maternal isotopic signal and the development of foraging skills in relation to shark size and imply that molecular markers such as fatty acids are useful for the determination of maternal resource dependency.
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Purpose: Depression in older females is a significant and growing problem. Females who experience life stressors across the life span are at higher risk for developing problems with depression than their male counterparts. The primary aim of this study was (a) to examine gender-specific differences in the correlates of depression in older primary care patients based on baseline and longitudinal analyses; and (b) to examine the longitudinal effect of biopsychosocial risk factors on depression treatment outcomes in different models of behavioral healthcare (i.e., integrated care and enhanced referral). Method: This study used a quantitative secondary data analysis with longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study. A linear mixed model approach to hierarchical linear modeling was used for analysis using baseline assessment, and follow-up from three-month and six-month. Results: For participants diagnosed with major depressive disorder female gender was associated with increased depression severity at six-month compared to males at six-month. Further, the interaction between gender and life stressors found that females who reported loss of family and friends, family issues, money issues, medical illness was related to higher depression severity compared to males whereas lack of activities was related to lower depression severity among females compared to males. Conclusion: These findings suggest that gender moderated the relationship between specific life stressors and depression severity similar to how a protective factor can impact a person's response to a problem and reduce the negative impact of a risk factor on a problem outcome. Therefore, life stressors may be a reliable predictor of depression for both females and males in either behavioral health treatment model. This study concluded that life stressors influence males basic comfort, stability, and survival whereas life stressors influence females' development, personal growth, and happiness; therefore, life stressors may be a useful component to include in gender-based screening and assessment tools for depression. ^
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The purpose of this study was to correct some mistakes in the literature and derive a necessary and sufficient condition for the MRL to follow the roller-coaster pattern of the corresponding failure rate function. It was also desired to find the conditions under which the discrete failure rate function has an upside-down bathtub shape if corresponding MRL function has a bathtub shape. The study showed that if discrete MRL has a bathtub shape, then under some conditions the corresponding failure rate function has an upside-down bathtub shape. Also the study corrected some mistakes in proofs of Tang, Lu and Chew (1999) and established a necessary and sufficient condition for the MRL to follow the roller-coaster pattern of the corresponding failure rate function. Similarly, some mistakes in Gupta and Gupta (2000) are corrected, with the ensuing results being expanded and proved thoroughly to establish the relationship between the crossing points of the failure rate and associated MRL functions. The new results derived in this study will be useful to model various lifetime data that occur in environmental studies, medical research, electronics engineering, and in many other areas of science and technology.
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Social attitudes, attitudes toward financial risk and attitudes toward deferred gratification are thought to influence many important economic decisions over the life-course. In economic theory, these attitudes are key components in diverse models of behavior, including collective action, saving and investment decisions and occupational choice. The relevance of these attitudes have been confirmed empirically. Yet, the factors that influence them are not well understood. This research evaluates how these attitudes are affected by large disruptive events, namely, a natural disaster and a civil conflict, and also by an individual-specific life event, namely, having children.
By implementing rigorous empirical strategies drawing on rich longitudinal datasets, this research project advances our understanding of how life experiences shape these attitudes. Moreover, compelling evidence is provided that the observed changes in attitudes are likely to reflect changes in preferences given that they are not driven just by changes in financial circumstances. Therefore the findings of this research project also contribute to the discussion of whether preferences are really fixed, a usual assumption in economics.
In the first chapter, I study how altruistic and trusting attitudes are affected by exposure to the 2004 Indian Ocean tsunami as long as ten years after the disaster occurred. Establishing a causal relationship between natural disasters and attitudes presents several challenges as endogenous exposure and sample selection can confound the analysis. I take on these challenges by exploiting plausibly exogenous variation in exposure to the tsunami and by relying on a longitudinal dataset representative of the pre-tsunami population in two districts of Aceh, Indonesia. The sample is drawn from the Study of the Tsunami Aftermath and Recovery (STAR), a survey with data collected both before and after the disaster and especially designed to identify the impact of the tsunami. The altruistic and trusting attitudes of the respondents are measured by their behavior in the dictator and trust games. I find that witnessing closely the damage caused by the tsunami but without suffering severe economic damage oneself increases altruistic and trusting behavior, particularly towards individuals from tsunami affected communities. Having suffered severe economic damage has no impact on altruistic behavior but may have increased trusting behavior. These effects do not seem to be caused by the consequences of the tsunami on people’s financial situation. Instead they are consistent with how experiences of loss and solidarity may have shaped social attitudes by affecting empathy and perceptions of who is deserving of aid and trust.
In the second chapter, co-authored with Ryan Brown, Duncan Thomas and Andrea Velasquez, we investigate how attitudes toward financial risk are affected by elevated levels of insecurity and uncertainty brought on by the Mexican Drug War. To conduct our analysis, we pair the Mexican Family Life Survey (MxFLS), a rich longitudinal dataset ideally suited for our purposes, with a dataset on homicide rates at the month and municipality-level. The homicide rates capture well the overall crime environment created by the drug war. The MxFLS elicits risk attitudes by asking respondents to choose between hypothetical gambles with different payoffs. Our strategy to identify a causal effect has two key components. First, we implement an individual fixed effects strategy which allows us to control for all time-invariant heterogeneity. The remaining time variant heterogeneity is unlikely to be correlated with changes in the local crime environment given the well-documented political origins of the Mexican Drug War. We also show supporting evidence in this regard. The second component of our identification strategy is to use an intent-to-treat approach to shield our estimates from endogenous migration. Our findings indicate that exposure to greater local-area violent crime results in increased risk aversion. This effect is not driven by changes in financial circumstances, but may be explained instead by heightened fear of victimization. Nonetheless, we find that having greater economic resources mitigate the impact. This may be due to individuals with greater economic resources being able to avoid crime by affording better transportation or security at work.
The third chapter, co-authored with Duncan Thomas, evaluates whether attitudes toward deferred gratification change after having children. For this study we also exploit the MxFLS, which elicits attitudes toward deferred gratification (commonly known as time discounting) by asking individuals to choose between hypothetical payments at different points in time. We implement a difference-in-difference estimator to control for all time-invariant heterogeneity and show that our results are robust to the inclusion of time varying characteristics likely correlated with child birth. We find that becoming a mother increases time discounting especially in the first two years after childbirth and in particular for those women without a spouse at home. Having additional children does not have an effect and the effect for men seems to go in the opposite direction. These heterogeneous effects suggest that child rearing may affect time discounting due to generated stress or not fully anticipated spending needs.
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Human-assisted, trans-generational exposure to ocean warming and acidification has been proposed as a conservation and/or restoration tool to produce resilient offspring. To improve our understanding of the need for and the efficacy of this approach, we characterised life history and physiological responses in offspring of the marine polychaete Ophryotrocha labronica exposed to predicted ocean warming (OW: + 3 °C), ocean acidification (OA: pH -0.5) and their combination (OWA: + 3 °C, pH -0.5), following the exposure of their parents to either control conditions (within-generational exposure) or the same conditions (trans-generational exposure). Trans-generational exposure to OW fully alleviated the negative effects of within-generational exposure to OW on fecundity and egg volume and was accompanied by increased metabolic activity. While within-generational exposure to OA reduced juvenile growth rates and egg volume, trans-generational exposure alleviated the former but could not restore the latter. Surprisingly, exposure to OWA had no negative impacts within- or trans-generationally. Our results highlight the potential for trans-generational laboratory experiments in producing offspring that are resilient to OW and OA. However, trans-generational exposure does not always appear to improve traits, and therefore may not be a universally useful tool for all species in the face of global change.
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The history of literary copyright in nineteenth century Britain is dominated - understandably perhaps - by a preoccupation with the passing and impact of the Copyright Amendment Act 1842, so ably lobbied for by Sir Thomas Noon Talfourd. This article, however, draws attention away from the 1842 Act towards the Copyright Act 1814, the first legislative provision within British copyright law to introduce a lifetime term of protection for the author. Why and on what basis did the legislature do so?
In bringing a renewed attention to this often overlooked legislative measure, we consider the context and logic that underpinned to grant of a copyright term that was tethered to the life of the author. In doing so, we might also find a useful prism through which to look afresh at current copyright debates concerning the appropriate nature and scope of copyright protection in the 21st century.
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Background: To validate STOPPFrail, a list of explicit criteria for potentially inappropriate medications (PIMs) in frailer older adults with limited life expectancy. A Delphi consensus survey of an expert panel (n = 17) comprising specialists in geriatric medicine, clinical pharmacology, palliative care, psychiatry of old age, clinical pharmacy and general practice.
Methods: STOPPFrail criteria was initially created by the authors based on clinical
experience and appraisal of the available literature. Criteria were organised according to physiological system. Each criterion was accompanied by an explanation. Panellists ranked their agreement with each criterion on a 5-point Likert scale and invited to provide written feedback. Criteria with a median Likert response of 4/5 (agree/strongly agree) and a 25th centile of ≥4 were included in the final criteria.
Results: Three Delphi rounds were required. All panellists completed all rounds. Thirty criteria were proposed for inclusion; 26 were accepted. No new criteria were added. The first two criteria suggest deprescribing medications with no indication or where compliance is poor. The remaining 24 criteria include lipid-lowering therapies, alpha-blockers for hypertension, anti-platelets, neuroleptics, proton pump inhibitors, H-2 receptor antagonists, anti-spasmodics, theophylline, leukotriene antagonists, calcium supplements, bone anti-resorptive therapy, selective oestrogen receptor modulators, non-steroidal antiinflammatories, corticosteroids, 5-alpha reductase inhibitors, alpha-1 selective blockers, muscarinic antagonists, oral diabetic agents, ACE-inhibitors, angiotensin receptor blockers, systemic oestrogens, multivitamins, nutritional supplements and prophylactic antibiotics. Anticoagulants and anti-depressants were excluded. Despite incorporation of panellists’ suggestions, memantine and acetyl-cholinesterase inhibitors remained inconclusive.
Conclusion: STOPPFrail comprises 26 criteria, which have been judged by broad consensus, to be potentially inappropriate in frailer older patients with limited life expectancy. STOPPFrail may assist in deprescribing medications in these patients.
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Truck drivers are one of the largest occupational groups in Iran. Evidence from previous studies suggests that working and living conditions on the road engender many concerns for truck drivers, and their families and communities. This research aimed to explore the experiences of Iranian truck drivers regarding life on the road. This qualitative study was conducted among Iranian truck drivers working in the inter-state transportation sector. A purposeful sample of 20 truck drivers took part in this research. Data were collected through semi-structured interviews and analyzed based on qualitative content analysis. After analysis of the data, three main themes emerged: "Individual impacts related to the hardships of life on the road life", "Family impacts related to the hardships of road life", and "Having positive attitude towards work and road". These findings represent the dimensions of perspectives in the road-life of truck drivers. Although truck drivers possess positive beliefs about their occupation and life on the road, they and their families face many hardships which should be well understood. They also need support to be better able to solve the road-life concerns they face. This study's findings are useful for occupational programming and in the promotion of health for truck drivers.
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Research on intergenerational transmissions of poverty and inequality has tended to focus on material transfers. This paper refocuses attention on the intersection of material and psychosocial transfers, which reveals temporal and gendered complexities. It examines three key ideas emerging from the life course literature (relationality, intersectionality and intergenerationality) to shed light on how these complexities might be addressed. It is argued that a human wellbeing lens is potentially useful as a unifying framework to integrate these ideas as it interrogates what living well means over the life course and how it is constructed relationally.
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Purpose of review: Health-related quality of life (HRQoL) is an important patient-reported outcome measure following critical illness. ‘Validated’ and professionally endorsed generic measures are widely used to evaluate critical care intervention and guide practice, policy and research. Although recognizing that they are ‘here to stay’, leading QoL researchers are beginning to question their ‘fitness for purpose’. It is therefore timely to review critiques of their limitations in the wider healthcare and social science literatures and to examine the implications for critical care research including, in particular, emerging interventional studies in which HRQoL is the primary outcome of interest. Recent findings: Generic HRQoL measures have provided important yet limited insights into HRQoL among survivors of critical illness. They are rarely developed or validated in collaboration with patients and cannot therefore be assumed to reflect their experiences and perspectives. Summary: Collaboration with patients is advocated in order to improve the interpretation and utility of such data. Failure to do so may result in important study effects being overlooked and the dismissal of potentially useful interventions.
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Tämä diplomityö tutkii eri elinkaarihallinnan menetelmiä ja vertaa niitä TVO:n menetelmiin. Lisäksi TVO:n prosessin ongelmakohdat tunnistetaan ja niihin esitetään ratkaisuja. Vertailukohteina toimii ydinvoimateollisuuden lisäksi vesivoima, fossiiliset voimalaitokset sekä paperiteollisuus. Sähkön hinnan jatkaessa laskuaan on elinkaariajattelusta tullut ajankohtaista myös ydinvoimayhtiöille. Ydinvoimalaitoksien pitkän suunnitellun käyttöiän ansiosta laitoksen elinkaaren aikana voi tapahtua useita asioita, jotka vaikuttavat laitoksen investointitarpeisiin. Turvallisen sähköntuotannon varmistamiseksi eri laitososia on joko muokattava tai uusittava. Elinkaariajatteluun kuuluu tehokas laitoksen kunnon valvonta, laitoksen ikääntymiseen vaikuttavien ilmiöiden tunnistaminen, sekä ikääntymistä hillitsevien toimenpiteiden pitkän tähtäimen suunnittelu. Hyvällä ennakkosuunnittelulla pyritään varmistamaan se, että laitoksella voidaan tuottaa sähköä koko sen jäljellä olevan käyttöiän aikana. Kun tarpeiden tunnistus ja suunnittelu tehdään hyvissä ajoin mahdollistetaan myös investointien optimointi. Paras hyöty pyritään saamaan ajoittamalla oikeat investoinnit oikeaan aikaan.
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The study of ichthyio-plankton stages and its relations with the environment and other organisms is therefore crucial for a correct use of fishery resources. In this context, the extraction and the analysis of the content of the digestive tract, is a key method for the identification of the diet in early larval stages, the determination of the resources they rely on and possibly a comparison with the diet of other species. Additionally this approach could be useful in determination on occurrence of species competition. This technique is preceded by the analysis of morphometric data (Blackith & Reyment, 1971; Marcus, 1990), that is the acquisition of quantitative variables measured from the morphology of the object of study. They are linear distances, count, angles and ratios. The subsequent application of multivariate statistical methods, aims to quantify the changes in morphological measures between and within groups, relating them to the type and size of prey and evaluate if some changes appear in food choices along the larvae growth.
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This work aimed to evaluate how aging could influence patients' perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient's records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.
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Watercress (Nasturtium officinale R. Br.) is a semi-aquatic plant of the Brassicaceae family highly appreciated in the Mediterranean cuisine. It features sharp, peppery and slightly tangy taste and contains health-promoting phytochemicals. Its consumption as a fresh-cut product has increased in recent years, as well as the global market of minimally processed vegetables. This demand is driven by the growing interest in the role of food in promoting the human health and wellbeing and to meet consumer needs for fresh-like and more convenient foods. Due to the reduced shelf-life of this plant, the suitability of inert gas-enriched atmospheres and ionizing irradiation for preserving visual, nutritional and functional quality attributes during cold storage was studied. Watercress samples were gathered in the Northeast region of Portugal, rinsed in tap water and a portion was immediately analyzed (non-stored control). The remaining fresh material was packaged in polyethylene bags under N2- and Ar-enriched atmospheres, conventional atmosphere (air) and vacuum (no atmosphere). Samples under conventional atmosphere were irradiated at 1, 2 and 5 kGy of gamma-rays (predicted doses) in a 60Co experimental chamber. A non-irradiated control followed all the experiment. Then, all packaged samples were stored at 4 ºC for 7 days. The studied quality parameters included the colour that was measured with a Konica Minolta colorimeter, and total soluble solids and pH determined in squeezed juice. The proximate composition (moisture, proteins, fat, ash, carbohydrates and energy) was evaluated using the AOA C procedures. Organic acids, free sugars, fatty acids and tocopherols were analyzed by chromatographic techniques. Samples were also evaluated for its DPPH• scavenging activity, reducing power, and lipid peroxidation inhibition capacity trough the inhibition of the β-carotene bleaching and thiobarbituric acid reactive substances (TBAR S) formation. Differences among treatments were analyzed using the one-way analysis of variance (ANO VA) and a linear discriminant analysis (LDA ) was used to evaluate the effects on the overall postharvest quality. After evaluating the effect on the individual quality parameters, the LDA revealed that the Ar-enriched atmosphere and the irradiation at 2 kGy were suitable processing choices for preserving the integrity of the non-stored control samples during cold storage. Thus, these non-thermal treatments were highlighted for shelf-life extension of fresh-cut watercress.