955 resultados para lack of involvement


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In vivo, neurons of the globus pallidus (GP) and subthalamic nucleus (STN) resonate independently around 70 Hz. However, on the loss of dopamine as in Parkinson's disease, there is a switch to a lower frequency of firing with increased bursting and synchronization of activity. In vitro, type A neurons of the GP, identified by the presence of Ih and rebound depolarizations, fire at frequencies (≤80 Hz) in response to glutamate pressure ejection, designed to mimic STN input. The profile of this frequency response was unaltered by bath application of the GABAA antagonist bicuculline (10 μM), indicating the lack of involvement of a local GABA neuronal network, while cross-correlations of neuronal pairs revealed uncorrelated activity or phase-locked activity with a variable phase delay, consistent with each GP neuron acting as an independent oscillator. This autonomy of firing appears to arise due to the presence of intrinsic voltage- and sodium-dependent subthreshold membrane oscillations. GABAA inhibitory postsynaptic potentials are able to disrupt this tonic activity while promoting a rebound depolarization and action potential firing. This rebound is able to reset the phase of the intrinsic oscillation and provides a mechanism for promoting coherent firing activity in ensembles of GP neurons that may ultimately lead to abnormal and pathological disorders of movement.

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This essay attempts to ascertain whether a particular meaning of globalisation, and view on its effects and the appropriate response to it, are becoming standardised across academia. To do so, it content-analyses a representative sample of new scholarship, mapping the various approaches of current researchers towards globalisation. The essay shows how globalisation remains a contested concept within studies of higher education, as in many other fields. Rather than globalisation being taken to refer unambiguously to global flows, pressures or trends, its meaning continues to depend on the particular perspective adopted by contemporary researchers. The same conflict is apparent concerning the impacts which are reputed to globalisation and with regard to the appropriate response to globalisation amongst academics and higher education institutions (HEIs) more generally. Perhaps the only apparent point of consensus amongst contemporary researchers is the claim that globalisation affects HEIs, rather than HEIs themselves being implicated in the promotion of globalisation. This position underplays the often important role of HEIs in encouraging cross-border flows and pressures, and global trends such as marketisation.

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Introduction - Rheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mortality, attributed to both traditional and novel cardiovascular risk factors. The metabolic syndrome, a cluster of classical cardiovascular risk factors, including hypertension, obesity, glucose intolerance, and dyslipidaemia, is highly prevalent in RA. Reports suggest that long-term glucocorticoid (GC) use may exacerbate individual cardiovascular risk factors, but there have been no studies in RA to assess whether it associates with the metabolic syndrome. We examined whether GC exposure associates with the presence of metabolic syndrome in patients with RA. Methods - RA patients (n = 398) with detailed clinical and laboratory assessments were categorised into three groups according to GC exposure: no/limited (<3 months) exposure (NE), low-dose (<7.5 mg/day) long-term exposure (LE), and medium-dose (greater than or equal to 7.5 mg to 30 mg/day) long-term exposure (ME). The metabolic syndrome was defined using the National Cholesterol Education Programme III guidelines. The association of GC exposure with the metabolic syndrome was evaluated using binary logistic regression. Results - The metabolic syndrome was present in 40.1% of this population and its prevalence did not differ significantly between the GC exposure groups (NE 37.9% versus LE 40.7% versus ME 50%, P = 0.241). Binary logistic regression did not demonstrate any increased odds for the metabolic syndrome when comparing ME with LE (odds ratio = 1.64, 95% confidence interval 0.92 to 2.92, P = 0.094) and remained non significant after adjusting for multiple potential confounders. Conclusions - Long-term GC exposure does not appear to associate with a higher prevalence of the metabolic syndrome in patients with RA. The components of the metabolic syndrome may already be extensively modified by other processes in RA (including chronic inflammation and treatments other than GCs), leaving little scope for additive effects of GCs.

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The problem of the lack of answer in questions of survey is usually dealt with different estimation and classification procedures from the answers to other questions. In this document, the results of applying fuzzy control methods for the vote -one of the variables with bigger lack of answer in opinion polls- are presented.

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The risk-to-benefit ratio for the use of low dose of aspirin in primary cardiovascular (CV) prevention in patients with diabetes mellitus remains to be clarified. We assessed the effect of aspirin on risk of CV events in type 2 diabetic patients with nephropathy, in order to verify the usefulness of Guidelines in clinical practice. We carried out a prospective multicentric study in 564 patients with type 2 diabetic nephropathy free of CV disease attending outpatient diabetes clinics. A total of 242 patients received antiplatelet treatment with aspirin 100 mg/day (group A), and 322 were not treated with antiplatelet drugs (group B). Primary end point was the occurrence of total major adverse cardio-vascular events (MACE). Secondary end points were the relative occurrence of fatal MACE. The average follow-up was 8 years. Total MACE occurred in 49 patients from group A and in 52 patients from group B. Fatal MACE occurred in 22 patients from group A and in 20 from group B; nonfatal MACE occurred in 27 patients from group A and in 32 patients from group B. Kaplan-Meier analysis did not show a statistically significant difference of cumulative MACE between the two groups. A not statistically significant difference in the incidence of both fatal (p = 0.225) and nonfatal CV events (p = 0.573) between the two groups was observed. These results were confirmed after adjustment for confounders (HR for MACE 1.11, 95 % CI 0.91-1.35). These findings suggest that low dose of aspirin is ineffective in primary prevention for patients with nephropathy. © 2014 Springer-Verlag Italia.

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Our research aimed to reveal the effects that can be observed during the buying process of food products and can influence the decisions of customers. We focused on the role of enduring involvement in customers’ behavioural loyalty, that is, the repurchase of food brands. To understand this relationship in a more sophisticated way, we involved two mediating constructs in our conceptual model: perceived risk and perceived knowledge of food products. The data collection was carried out among undergraduate students in frame of an online survey, and we used SPSS/AMOS software to test the model. The results only partly supported our hypothesis, although the involvement effects on loyalty and the two mediating constructs were strong enough, loyalty couldn’t be explained well by perceived risk and knowledge. The roles of further mediating/moderating variables should be determined and investigated in the next section of the research series.

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This sequential explanatory, mixed methods research design examines the role teachers should enact in the development process of the teacher evaluation system in Louisiana. These insights will ensure teachers are catalysts in the classroom to significantly increase student achievement and allow policymakers, practitioners, and instructional leaders to direct as learned decision makers.

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The purpose of this research is to explore on a deeper level the healthcare system of the United States, its background, and other factors that could provide possible solutions to simplify the fragmented healthcare system. The ultimate goal is the formation of concise ideas that could make the system, which prevents millions of Americans from obtaining adequate medical attention, substantially better. The paper will offer a better insight into the four different models of healthcare insurance found around the world in other developed countries with the purpose of establishing a comparison with that of the United States. The changes implemented by the Patient Protection and Affordable Care Act of 2010 are also analyzed to arrive at the conclusion of whether it has helped more American citizens get access to medical attention. Quality Improvement tools and thorough analysis of different methods from a financial, managerial, legal, and administrative perspective are used to provide valuable information that could aid in the implementation of modifications to the healthcare system of the United States in the near future.

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The goal of the research is to provide an overview of those factors that play a major role in structural failures and also to focus on the importance that bracing has in construction accidents. A temporary bracing system is important to construction safety, yet it is often neglected. Structural collapses often occur due to the insufficient support of loads that are applied at the time of failure. The structural load is usually analyzed by conceiving the whole structure as a completed entity, and there is frequently a lack of design or proper implementation of systems that can provide stability during construction. Often, the specific provisions and requirements of temporary bracing systems are left to the workers on the job site that may not have the qualifications or expertise for proper execution. To effectively see if bracing design should get more attention in codes and standards, failures which could have been avoided with the presence and/or the correct design of a bracing system were searched and selected among a variety of cases existing in the engineering literature. Eleven major cases were found, which span in a time frame of almost 70 years, clearly showing that the topic should get more attention. The case studies are presented in chronological order and in a systematic way. The failed structure is described in its design components and the sequence of failure is reconstructed. Then, the causes and failure mechanism are presented. Advice on how to avoid similar failures from happening again and hypothetic solutions which could have prevented the collapses are identified. The findings shows that insufficient or nonexistent bracing mainly results from human negligence or miscalculation of the load analysis and show that time has come to fully acknowledge that temporary structures should be more accounted for in design and not left to contractors' means and methods of construction.

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Background: Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Methods and Findings: Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93-1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93-1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82-1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76-1.10]). Conclusions: In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).

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There is a growing literature which documents the importance of early life environment for outcomes across the life cycle. Research, including studies based on Irish data, demonstrates that those who experience better childhood conditions go on to be wealthier and healthier adults. Therefore, inequalities at birth and in childhood shape inequality in wellbeing in later life, and the historical evolution of the mortality and morbidity of children born in Ireland is important for understanding the current status of the Irish population. In this paper, I describe these patterns by reviewing the existing literature on infant health in Ireland over the course of the 20th century. Up to the 1950s, infant mortality in Ireland (both North and South) was substantially higher than in other developed countries, with a large penalty for those born in urban areas. The subsequent reduction in this penalty, and the sustained decline in infant death rates, occurred later than would be expected from the experience in other contexts. Using records from the Rotunda Lying-in Hospital in Dublin, I discuss sources of disparities in stillbirth in the early 1900s. Despite impressive improvements in death rates since that time, a comparison with those born at the end of the century reveals that Irish children continue to be born unequal. Evidence from studies which track people across the life course, for example research on the returns to birthweight, suggests that the economic cost of this early life inequality is substantial.

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Haptoglobin (Hp), a heme-Iron chelator, has different isoforms which are associated with variable tendency toward infections: Hp 1-1, Hp 2-1, and Hp 2-2. Cystic fibrosis (CF) outcomes are variable and influenced by genetic and environmental factors. The aim of this study was to determine whether Hp phenotype influenced disease severity in CF. One hundred forty-two CF patients from two centers were analyzed for Haptoglobin phenotype using gel electrophoresis of hemoglobin enriched serum. Clinical and microbiological data including bacterial colonization status, lung function, presence of CF-related diabetes and liver disease, rate of exacerbation, and mortality were compared between Hp phenotype groups. We found a trend toward less mucoid PA among Hp 2-2 (20.4 %) compared with Hp 1-1 and Hp 2-1 individuals (33.3 %), p = 0.317. Hp 2-2 individuals also had less antibiotic courses, and lower inflammatory markers without statistical significance. Haptoglobin phenotype is unlikely to be an important modifier of CF phenotype.

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Transparency has been proposed to both change the way journalism is being produced and increase its credibility. However, little research has been conducted to assess the connection between transparency and credibility. This study utilizes an experimental setting (N=1320) to measure what impact transparency have on source and message credibility from the user perspective. The results reveals an almost absence of any transparency effect on both source and message credibility although some small significant effects could be observed primarily regarding internal hyperlinks, comments and contextual information. Although further research is desperately needed in this area the study suggest that transparency does not affect the credibility of journalism in the eyes of the contemporary audience and thus have limited appeal as a new norm in journalism.