990 resultados para Ward-MLM


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This paper describes the cloning and characterization of a new member of the vascular endothelial growth factor (VEGF) gene family, which we have designated VRF for VEGF-related-factor. Sequencing of cDNAs from a human fetal brain library and RT-PCR products from normal and tumor tissue cDNA pools indicate two alternatively spliced messages with open reading frames of 621 and 564 bp, respectively. The predicted proteins differ at their carboxyl ends resulting from a shift in the open reading frame. Both isoforms show strong homology to VEGF at their amino termini, but only the shorter isoform maintains homology to VEGF at its carboxyl terminus and conserves all 16 cysteine residues of VEGF165. Similarity comparisons of this isoform revealed overall protein identity of 48% and conservative substitution of 69% with VEGF189. VRF is predicted to contain a signal peptide, suggesting that it may be a secreted factor. The VRF gene maps to the D11S750 locus at chromosome band 11q13, and the protein coding region, spanning approximately 5 kb, is comprised of 8 exons that range in size from 36 to 431 bp. Exons 6 and 7 are contiguous and the two isoforms of VRF arise through alternate splicing of exon 6. VRF appears to be ubiquitously expressed as two transcripts of 2.0 and 5.5 kb; the level of expression is similar among normal and malignant tissues.

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Aim: This qualitative study aims to provide insight into how Australian New Graduate Nurses (NGNs) experienced their transition to acute care nursing practice. Method: Nine NGNs each participated in three in-depth interviews conducted across their first year of practice. Constant comparative analysis was used to identify the emergent themes. Findings: The desire to fit in (establishment of secure social bonds) with ward staff is an important element of NGN transition experiences. Fitting in was about feeling one's self to be part of a social group, and participants made it clear that their perceptions of their success in establishing secure and meaningful social bonds in each new ward was extremely important for their sense of being as NGNs. Current NGN Transition Programmes (NGNTPs) involve multiple ward rotations, increasing the demand for the NGN to fit in. Thus participants were engaged in a deeply personal transition experience that was not necessarily aligned with multiple ward rotations. Conclusions: Although NGNTPs have the word “transition” in their title, it may be that current programmes are more focussed on organisations’ desire to “orient” NGNs to working within the acute care setting than facilitating personal transitions to practice. Further investigation of the impact of NGNTPs on NGNs and the associated multiple ward rotations is required.

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Introduction / objectives Many strategies are used to control MRSA in hospitals. Only a few have been assessed in clinical trials and it is not obvious how findings should be generalised between settings. Uncertainty remains about which strategies represent the most appropriate use of scarce resources. We assess the cost-effectiveness of alternative MRSA screening and infection control strategies in England and Wales and discuss international relevance. Methods Models of MRSA transmission in ICUs and general medical (GM) wards were developed and used to evaluate different screening methods combined with decolonisation or isolation. Strategies were compared in terms of costs and health benefits (quality adjusted life years, QALYs). Different prevalences, proportions of high risk patients and ward sizes were investigated, and probabilistic sensitivity analyses (PSA) conducted. Results Decolonisation strategies were cost-saving in ICUs at a 5% admission prevalence, with admission and weekly PCR screening the most cost-effective (£3,929/QALY). In ICUs, screening and isolation reduced infection rates by ~10%. With admission prevalence ≤5%, targeting screening and isolation to high risk patients was optimal. In GM wards decolonisation and isolation strategies, though able to reduce MRSA infection rates up to ~50%, were not cost-effective. Conclusion The largest reductions in MRSA infection were achieved by screening and decolonisation strategies, and were cost-effective in ICU settings. In comparison, there is limited potential for screening and control strategies to be cost-effective in GM wards due to lower infection and mortality rates.

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The need for accessible housing in Australia is acute. Both government and the community service sector recognise the importance of well designed accessible housing to optimise the integration of older people and people with disability, to encourage a prudent use of scarce health and community services and to enhance the liveability of our cities. In 2010, the housing industry, negotiated with the Australian Government and community representatives to adopt a nationally consistent voluntary code (Livable Housing Design) and a strategy to provide minimal level of accessibility in all new housing by 2020. Evidence from the implementation of such programs in the United Kingdom and USA, however, serves to question whether this aspirational goal can be achieved through voluntary codes. Minimal demand at the point of new sale, and problems in the production of housing to the required standards have raised questions regarding the application of program principles in the context of a voluntary code. In addressing the latter issue, this paper presents early findings from the analysis of qualitative interviews conducted with developers, builders and designers in various housing contexts. It identifies their “logics in use” in the production of housing in response to Livable Housing Design’s voluntary code and indicates factors that are likely to assist and impede the attainment of the 2020 aspirational goal.

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The effect of sample geometry on the melting rates of burning iron rods was assessed. Promoted-ignition tests were conducted with rods having cylindrical, rectangular, and triangular cross-sectional shapes over a range of cross-sectional areas. The regression rate of the melting interface (RRMI) was assessed using a statistical approach which enabled the quantification of confidence levels for the observed differences in RRMI. Statistically significant differences in RRMI were observed for rods with the same cross-sectional area but different cross-sectional shape. The magnitude of the proportional difference in RRMI increased with the cross-sectional area. Triangular rods had the highest RRMI, followed by rectangular rods, and then cylindrical rods. The dependence of RRMI on rod shape is shown to relate to the action of molten metal at corners. The corners of the rectangular and triangular rods melted faster than the faces due to their locally higher surface area to volume ratios. This phenomenon altered the attachment geometry between liquid and solid phases, increasing the surface area available for heat transfer, causing faster melting. Findings relating to the application of standard flammability test results in industrial situations are also presented.

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Nursing training for an Intensive Care Unit (ICU) is a resource intensive process. High demands are made on staff, students and physical resources. Interactive, 3D computer simulations, known as virtual worlds, are increasingly being used to supplement training regimes in the health sciences; especially in areas such as complex hospital ward processes. Such worlds have been found to be very useful in maximising the utilisation of training resources. Our aim is to design and develop a novel virtual world application for teaching and training Intensive Care nurses in the approach and method for shift handover, to provide an independent, but rigorous approach to teaching these important skills. In this paper we present a virtual world simulator for students to practice key steps in handing over the 24/7 care requirements of intensive care patients during the commencing first hour of a shift. We describe the modelling process to provide a convincing interactive simulation of the handover steps involved. The virtual world provides a practice tool for students to test their analytical skills with scenarios previously provided by simple physical simulations, and live on the job training. Additional educational benefits include facilitation of remote learning, high flexibility in study hours and the automatic recording of a reviewable log from the session. To the best of our knowledge, we believe this is a novel and original application of virtual worlds to an ICU handover process. The major outcome of the work was a virtual world environment for training nurses in the shift handover process, designed and developed for use by postgraduate nurses in training.

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In recent years, car club and racing websites and forums have become an increasingly popular way for car enthusiasts to access racing and car club news, chat-rooms and message boards. However, no North American research has been found that has examined opinions and driving experiences of car and racing enthusiasts. The purpose of this study was to examine car club members’ opinions about and experiences with various aspects of driving, road safety and traffic legislation, with a particular focus on street racing. A web-based questionnaire (Survey Monkey) was developed using the expert panel method and was primarily based on validated instruments or questions that were developed from other surveys. The questionnaire included: 1) driver concerns regarding traffic safety issues and legislation; 2) attitudes regarding various driving activities; 3) leisure-time activities, including club activities; 4) driving experiences, including offences and collisions; and 5) socio-demographic questions. The survey was pre- tested and piloted. Electronic information letters were sent out to an identified list of car clubs and forums situated in southern Ontario. Car club participants were invited to fill out the questionnaire. This survey found that members of car clubs share similar concerns regarding various road safety issues with samples of Canadian drivers, although a smaller percentage of car club members are concerned about speeding-related driving. Car club members had varied opinions regarding Ontario’s Street Racers, Stunt and Aggressive Drivers Legislation. The respondents agreed the most with the new offences regarding not sitting in the driver’s seat, having a person in the trunk, or driving as close as possible to another vehicle, pedestrian or object on or near the highway without a reason. The majority disagreed with police powers of impoundment and on-the-spot licence suspensions. About three quarters of respondents reported no collisions or police stops for traffic offences in the past five years. Of those who had been stopped, the most common offence was reported as speeding. This study is the first in Canada to examine car club members’ opinions about and experiences with various aspects of driving, road safety and traffic legislation. Given the ubiquity of car clubs and fora in Canada, insights on members’ opinions and practices provide important information to road safety researchers.

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Hollywood films and television programs are watched by a global audience. While many of these productions are still made in southern California, the last twenty years have seen new production centres emerge in the US, Canada and other locations worldwide. Global Hollywood has been made possible by this growing number of Local Hollywoods: locations equipped with the requisite facilities, resources and labour, as well as the political will and tax incentives, to attract and retain high-budget, Hollywood-standard projects. This new book gives an unprecedented insight into how the Gold Coast became the first outpost of Hollywood in Australia. When a combination of forces drove Hollywood studios and producers to work outside California, the Gold Coast's unique blend of government tax support, innovative entrepreneurs and diverse natural settings made it a perfect choice to host Hollywood productions. 'Local Hollywood' makes an essential contribution to the field of film and media studies, as well as giving film buffs a behind-the-scenes tour of the film industry.

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If there is one television programming staple for which Australian television drama is known internationally, it is the long-running television soap, with Neighbours (originally produced by Grundy in 1985) lauded as 'the most outstanding example of Australian series export' (Cunningham and Jacka, 1996). Twenty-five years on, this program still airs on domestic and international TV schedules five days a week, despite waning popularity with local Australian audiences. Considering past interest in the success and longevity of this soap, it is apposite to look again at the continuing progress of Neighbours foremost as a global brand. In comparison, Packed to the Rafters is treated here as a contemporary version of familiar Aussie themes related to everyday middle-class suburbia, populated with blue skies and feel-good characters expressing wholesome family values, but with a stylistic innovation defined here as domestic realism. As part of the production ecology of the late 2000s, Packed to the Rafters demonstrates the considerable role for local drama productions as loss leaders and flagship programming for commercial free-to-air networks up against an increasingly difficult domestic market.