906 resultados para Aggressive


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Most standard algorithms for prediction with expert advice depend on a parameter called the learning rate. This learning rate needs to be large enough to fit the data well, but small enough to prevent overfitting. For the exponential weights algorithm, a sequence of prior work has established theoretical guarantees for higher and higher data-dependent tunings of the learning rate, which allow for increasingly aggressive learning. But in practice such theoretical tunings often still perform worse (as measured by their regret) than ad hoc tuning with an even higher learning rate. To close the gap between theory and practice we introduce an approach to learn the learning rate. Up to a factor that is at most (poly)logarithmic in the number of experts and the inverse of the learning rate, our method performs as well as if we would know the empirically best learning rate from a large range that includes both conservative small values and values that are much higher than those for which formal guarantees were previously available. Our method employs a grid of learning rates, yet runs in linear time regardless of the size of the grid.

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Purpose: Many haematological cancer survivors report long-term physiological and psychosocial effects beyond treatment completion. These survivors continue to experience impaired quality of life (QoL) as a result of their disease and aggressive treatment. As key members of the multidisciplinary team, the purpose of this study is to examine the insights of cancer nurses to inform future developments in survivorship care provision. Methods: Open text qualitative responses from two prospective Australian cross-sectional surveys of nurses (n=136) caring for patients with haematological cancer. Data were analysed thematically, using an inductive approach to identify themes. Results: This study has identified a number of issues that nurses perceive as barriers to quality survivorship care provision. Two main themes were identified; the first relating to the challenges nurses face in providing care (‘care challenges’), and the second relating to the challenges of providing survivorship care within contemporary health care systems (‘system challenges’). Conclusions: Cancer nurses perceive the nature of haematological cancer and its treatment, and of the health care system itself, as barriers to the provision of quality survivorship care. Care challenges such as the lack of a standard treatment path and the relapsing or remitting nature of haematological cancers may be somewhat intractable, but system challenges relating to clearly defining and delineating professional responsibilities and exchanging information with other clinicians are not. Implications for Cancer Survivors: Addressing the issues identified will facilitate cancer nurses’ provision of survivorship care, and help address haematological survivors’ needs with regard to the physical and psychosocial consequences of their cancer and treatment.

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Objective: The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit. Method: This was a prospective, non-randomized intervention study comparing treatment as usual (TAU) with TAU plus massage therapy intervention (MT) over consecutive 7 week blocks (May–August 2006). MT consisted of a 20 min massage therapy session offered daily to patients during their period of hospitalization. The Kennedy Nurses’ Observational Scale for Inpatient Evaluation (NOSIE), the Symptom Checklist-90–Revised (SCL-90-R), the State–Trait Anxiety Inventory (STAI) and stress hormone (saliva cortisol) levels were used to measure patient outcomes at admission and discharge from the unit. The Staff Observation Aggression Scale–Revised (SOAS-R) was used to monitor the frequency and severity of aggressive incidents on the unit. Results: There was a significant reduction in self-reported anxiety (p < 0.001), resting heart rate (p < 0.05) and cortisol levels (p < 0.05) immediately following the initial and final massage therapy sessions. Significant improvements in hostility (p = 0.007) and depression scores (p < 0.001) on the SCL-90-R were observed in both treatment groups. There was no group×time interaction on any of the measures. Poor reliability of staff-reported incidents on the SOAS-R limited the validity of results in this domain. Conclusions: Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. Study limitations preclude any definite conclusions on the effect of massage therapy on aggressive incidents in an acute psychiatric setting. Randomized controlled trials are warranted.

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There is an increasing demand for Unmanned Aerial Systems (UAS) to carry suspended loads as this can provide significant benefits to several applications in agriculture, law enforcement and construction. The load impact on the underlying system dynamics should not be neglected as significant feedback forces may be induced on the vehicle during certain flight manoeuvres. The constant variation in operating point induced by the slung load also causes conventional controllers to demand increased control effort. Much research has focused on standard multi-rotor position and attitude control with and without a slung load. However, predictive control schemes, such as Nonlinear Model Predictive Control (NMPC), have not yet been fully explored. To this end, we present a novel controller for safe and precise operation of multi-rotors with heavy slung load in three dimensions. The paper describes a System Dynamics and Control Simulation Toolbox for use with MATLAB/SIMULINK which includes a detailed simulation of the multi-rotor and slung load as well as a predictive controller to manage the nonlinear dynamics whilst accounting for system constraints. It is demonstrated that the controller simultaneously tracks specified waypoints and actively damps large slung load oscillations. A linear-quadratic regulator (LQR) is derived and control performance is compared. Results show the improved performance of the predictive controller for a larger flight envelope, including aggressive manoeuvres and large slung load displacements. The computational cost remains relatively small, amenable to practical implementations.

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AIMS The aim of this narrative review of the literature was to examine the current state of knowledge regarding the impact of aggressive surgical interventions for severe stroke on patient and caregiver quality of life and caregiver outcomes. BACKGROUND Decompressive hemicraniectomy (DHC) is a surgical therapeutic option for treatment of massive middle cerebral artery infarction (MCA), lobar intracerebral hemorrhage (ICH), and severe aneurysmal subarachnoid hemorrhage (aSAH). Decompressive hemicraniectomy has been shown to be effective in reducing mortality in these three life-threatening conditions. Significant functional impairment is an experience common to many severe stroke survivors worldwide and close relatives experience decision-making difficulty when confronted with making life or death choices related to surgical intervention for severe stroke. DATA SOURCES Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PsychInfo. REVIEW METHODS A narrative review methodology was utilized in this review of the literature related to long-term outcomes following decompressive hemicraniectomy for stroke. The key words decompressive hemicraniectomy, severe stroke, middle cerebral artery stroke, subarachnoid hemorrhage, lobar ICH, intracerebral hemorrhage, quality of life, and caregivers, literature review were combined to search the databases. RESULTS Good functional outcomes following DHC for life-threatening stroke have been shown to be associated with younger age and few co-morbid conditions. It was also apparent that quality of life was reduced for many stroke survivors, although not assessed routinely in studies. Caregiver burden has not been systematically studied in this population. CONCLUSION Most patients and caregivers in the studies reviewed agreed with the original decision to undergo DHC and would make the same decision again. However, little is known about quality of life for both patients and caregivers and caregiver burden over the long-term post-surgery. Further research is needed to generate information and interventions for the management of ongoing patient and carer recovery following DHC for severe stroke.

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Copyright estates have been unduly empowered by the extension of the term of copyright protection in Europe, the United States, Australia and elsewhere. The Estate of the Irish novelist, James Joyce, has been particularly aggressive in policing his revived copyrights. The "keepers of the flame" have relied upon threats of legal action to discourage the production of derivative works based upon the canonical texts of the novelist. The Estate has also jealously guarded the reputation of the author by vetoing the use of his work in various scholarly productions. Most radically of all, the grandson Stephen Joyce threatened to take legal action to prevent the staging of "Rejoyce Dublin 2004", a festival celebrating the centenary of Bloomsday. In response, the Irish Parliament rushed through emergency legislation, entitled the Copyright and Related Rights (Amendment) Act 2004 (Ireland) to safeguard the celebrations. The legislation clarified that a person could place literary and artistic works on public exhibition, without breaching the copyright vested in such cultural texts. Arguably, though, the ad hoc legislation passed by the Irish Parliament is inadequate. The Estate of James Joyce remains free to exercise its suite of economic and moral rights to control the use and adaptation of works of the Irish novelist. It is contended that copyright law needs to be revised to promote the interests of libraries and other cultural institutions. Most notably, the defence of fair dealing should be expanded to allow for the transformative use of copyright works, particularly in respect of adaptations and derived works. There should be greater scope for compulsory licensing and crown acquisition of revived copyrights.

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This chapter discusses the fast emerging challenges for Malay and Muslim sexual minority storytellers in the face of an aggressive state-sponsored Islamisation of a constitutionally secular Malaysia. I examine the case of Azwan Ismail, a gay Malay and Muslim Malaysian who took part in the local ‘It Gets Better’ project, and who suffered an onslaught of hostile comments from fellow Malay Muslims. Azwan’s experience makes one question how a message of discouraging suicidal tendencies among sexual minority youths can be so vehemently misperceived. Azwan’s existential challenges – stemming from the tension between his own constructions of self and those of others – (re)present a unique challenge in the long struggle for human rights. In my examination of the arising contradictions, I highlight the challenges for Azwan’s existential self – one who is deemed morally bankrupt by hostile audiences. The purist Sunni Islam agenda in a constitutionally secular Malaysia not only rejects the human rights of the sexual minorities in Malaysia but has also influenced, and is often a leading hostile voice in both regional and international blocs. This self-righteous, supremacist and authoritarian Islam discourages discourse and attacks all differing opinions. This resulting disabling environment for vulnerable, minority communities and their human rights manifests in State-endorsed discrimination, compulsory counselling, forced rehabilitation and criminalisation. It places the rights of the sexual minorities to live within such a society in doubt. In discussing the arising issues, I draw upon literature that investigates the way in which personal stories have traditionally been used to advance human rights. Included too, is the significance and implications of the work by social psychologists in explaining the loss of credibility of personal stories. I then advance an analytical framework that will allow storytelling as a very individual form of witnessing to reclaim and regain its ‘truth to power’.

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The beliefs, attitudes and understandings of pre-service teachers towards bullying and more recently, cyberbullying remains unclear. Previous studies have found them to be generally lacking confidence to address bullying, which could impact negatively on school climate if, when they enter the profession, these beliefs undermine existing anti-bullying initiatives. This study explores Australian pre-service teachers' (N= 717) understanding and knowledge of traditional bullying and cyberbullying and their confidence and capacity to deal with it. Findings from self-report, anonymous questionnaires from students attending three universities in Australia indicated that two thirds (66%) of current pre-service teachers felt informed to very informed and capable to very capable (62%) of dealing with school bullying and 90% could discern cyber and traditional bullying behaviours from other online and offline aggressive acts. Gender and Year level differences were found. The potential impact of their knowledge and understanding of bullying and cyberbullying on school climate, and sustaining and maintaining anti-bullying interventions as they enter the profession is discussed.

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Controversies between private and public broadcasters over the broadcasting of live sports, especially cricket, during important sports events have emerged as a serious legal issue in Pakistan. Controversy between Geo Super and Pakistan Television over live telecast of the ICC Cricket World Cup is a typical example of such controversies. An aggressive legal battle, during a most important cricketing event, not only hampered the enjoyment of cricket viewers across the country but also gave Pakistan a bad name across the globe. This article discusses in detail this controversy and highlights lacunas in the existing sports broadcasting regime of Pakistan. There are no clear and well defined sports broadcasting laws in Pakistan. The Pakistan Electronic Media Regulatory Authority (PEMRA) rules are of general nature. Secondly, PEMRA rules are not comprehensive and explicit enough to provide clear guidelines about sports broadcasting. This may be a possible reason why sports broadcasting controversies reach the highest court in Pakistan, the Supreme Court of Pakistan. Despite these ugly battles between broadcasters, the government of Pakistan has never given due importance to this issue and no efforts have been made at any level to come up with legislation on sports broadcasting to avoid such controversies or to resolve them amicably in the light of well-defined laws on this subject. The purpose of this article is to draw the attention of the concerned authorities towards this important issue because in future more such controversies may be expected in the absence of a sports broadcasting regime in the country.

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Multicentric carpotarsal osteolysis (MCTO) is a rare skeletal dysplasia characterized by aggressive osteolysis, particularly affecting the carpal and tarsal bones, and is frequently associated with progressive renal failure. Using exome capture and next-generation sequencing in five unrelated simplex cases of MCTO, we identified previously unreported missense mutations clustering within a 51 base pair region of the single exon of MAFB, validated by Sanger sequencing. A further six unrelated simplex cases with MCTO were also heterozygous for previously unreported mutations within this same region, as were affected members of two families with autosomal-dominant MCTO. MAFB encodes a transcription factor that negatively regulates RANKL-induced osteoclastogenesis and is essential for normal renal development. Identification of this gene paves the way for development of novel therapeutic approaches for this crippling disease and provides insight into normal bone and kidney development.

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Recent research suggests that aggressive driving may be influenced by driver perceptions of their interactions with other drivers in terms of ‘right’ or ‘wrong’ behaviour. Drivers appear to take a moral standpoint on ‘right’ or ‘wrong’ driving behaviour. However, ‘right’ or ‘wrong’ in the context of road use is not defined solely by legislation, but includes informal rules that are sometimes termed ‘driving etiquette’. Driving etiquette has implications for road safety and public safety since breaches of both formal and informal rules may result in moral judgement of others and subsequent behaviours designed to punish the ‘offender’ or ‘teach them a lesson’. This paper outlines qualitative research that was undertaken with drivers to explore their understanding of driving etiquette and how they reacted to other drivers’ observance or violation of their understanding. The aim was to develop an explanatory framework within which the relationships between driving etiquette and aggressive driving could be understood, specifically moral judgement of other drivers and punishment of their transgression of driving etiquette. Thematic analysis of focus groups (n=10) generated three main themes: (1) courtesy and reciprocity, and the notion of two-way responsibility, with examples of how expectations of courteous behaviour vary according to the traffic interaction; (2) acknowledgement and shared social experience: ‘giving the wave’; and (3) responses to breaches of the expectations/informal rules. The themes are discussed in terms of their roles in an explanatory framework of the informal rules of etiquette and how interactions between drivers can reinforce or weaken a driver’s understanding of driver etiquette and potentially lead to driving aggression.

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Previously, we reported catch-up weight gain, growth, and improved lung function in a group of malnourished cystic fibrosis (CF) children receiving aggressive nutritional supplementation for 1 year compared with a forced expiratory volume in 1 s (FEV1)-, height-, and sex-matched comparison group receiving standard therapy. To evaluate long-term effects, the clinical progress of both groups has been studied over a 5 year period. The supplemented group (n = 10) received supplements for a median of 1.35 years to achieve nutritional rehabilitation. Compared with the nonsupplemented group (n = 14), the previously supplemented group had lower mortality (2 vs. 4, N.S.) and significantly greater weight and height z scores at 4 and 5 years. The progression of pulmonary function abnormalities as measured by FEV, and forced vital capacity (FVC) slopes was greater at 3 years in the nonsupplemented group (FEV1, p < 0.05) but no significant differences in rates of deterioration of pulmonary function were seen after 5 years in the two groups of survivors. We conclude that intensive nutritional support for 1 year has both short-and long-term effects on nutrition and growth, still evident some years after the cessation of this therapeutic modality. Supplementation for periods of longer than 1 year may produce greater gains and possibly prolong the improvement in pulmonary function observed in the earlier study. © 1992 Raven Press, Ltd., New York.

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Objectives: The aim of this study was to evaluate the effects of low-dose (10 mg) and high-dose (80 mg) atorvastatin on carotid plaque inflammation as determined by ultrasmall superparamagnetic iron oxide (USPIO)-enhanced carotid magnetic resonance imaging (MRI). The hypothesis was that treatment with 80 mg atorvastatin would demonstrate quantifiable changes in USPIO-enhanced MRI-defined inflammation within the first 3 months of therapy. Background: Preliminary studies indicate that USPIO-enhanced MRI can identify macrophage infiltration in human carotid atheroma in vivo and hence may be a surrogate marker of plaque inflammation. Methods: Forty-seven patients with carotid stenosis >40% on duplex ultrasonography and who demonstrated intraplaque accumulation of USPIO on MRI at baseline were randomly assigned in a balanced, double-blind manner to either 10 or 80 mg atorvastatin daily for 12 weeks. Baseline statin therapy was equivalent to 10 mg of atorvastatin or less. The primary end point was change from baseline in signal intensity (ΔSI) on USPIO-enhanced MRI in carotid plaque at 6 and 12 weeks. Results: Twenty patients completed 12 weeks of treatment in each group. A significant reduction from baseline in USPIO-defined inflammation was observed in the 80-mg group at both 6 weeks (ΔSI 0.13; p = 0.0003) and at 12 weeks (ΔSI 0.20; p < 0.0001). No difference was observed with the low-dose regimen. The 80-mg atorvastatin dose significantly reduced total cholesterol by 15% (p = 0.0003) and low-density lipoprotein cholesterol by 29% (p = 0.0001) at 12 weeks. Conclusions: Aggressive lipid-lowering therapy over a 3-month period is associated with significant reduction in USPIO-defined inflammation. USPIO-enhanced MRI methodology may be a useful imaging biomarker for the screening and assessment of therapeutic response to "anti-inflammatory" interventions in patients with atherosclerotic lesions. (Effects of Atorvastatin on Macrophage Activity and Plaque Inflammation Using Magnetic Resonance Imaging [ATHEROMA]; NCT00368589).

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Inflammation is a recognized risk factor for the vulnerable atherosclerotic plaque. USPIO-enhanced MRI imaging is a promising non-i nvasive method to identify high-risk atheromatous plaque inflammation in vivo in humans, in which areas of focal signal loss on MR images have been shown to correspond to the location of activated macrophages, typically at the shoulder regions of the plaque. This is the first report in humans describing simultaneous USPIO uptake within atheroma in two different arterial territories and again emphasises that atherosclerosis is a truly systemic disease. With further work, USPIO-enhanced MR imaging may be useful in identifying inflamed vulnerable atheromatous plaques in vivo, so refining patient selection for intervention and allowing appropriate early aggressive pharmacotherapy to prevent plaque rupture.

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My PhD-thesis Body Images! Psychoanalytical Analysis of Finnish Performance and Body Art in the 1980s and 1990s considers Finnish performance and body art performed mainly by visual artists. In Part I, I chart the historical construction of performance art and its extension since the beginning of the 21st century. There are several wievs of the historical background of performance art. I introduce three different genealogies of performance art. One is Rose-Lee Goldberg s view. She connects performance art with the European avant-garde already at the beginning of the 20th century from futurists and dadaists to Russian avant-garde and the Bauhaus. I prefer to present performance art as contemporary art, which began to take shape in connection with visual arts in the 1950s and 1960s. The focus on the body is apparent in nearly all performance art. Nevertheless, throug the concept of body art I want to empasize the artist s body as the place of art. Body art (as part of performance art) functions as thematic and interpretive concept, which allows me to focus on performances where the questions of body image, narcissism, desire, language and pleasure are incorporated in particular intensive ways. In Part II, I explore the arrival of performance art in Finnish visual arts in the 1980s. I study the new generation s relation to earlier Finnish happenings (1960s) and performative actions in 1970 s. I briefly introduce performance groups of the 1980s art scene and consider their reception in media. The main focus is on the group Jack Helen Brut, in which I see many similarities to the so- called Theatre of Images. The goal of this part II is to provide historical context for the performance analysis that follows. In Part III, I develop the concept of body image which is my main theoretical term. The concept of body image is used according to Lacanian psychoanalytical theory, especially his considerations of mirror stages. My first mapping of body image, which I call imaginary body image, is based on Lacan s famous mirror stage article (1949). According to my reading, body image is narcistic and aggressive. The important concepts here are ego, imaginary, méconnaisance and alienation. In 1953 Lacan began to develop different version on mirror stage, in which he emphasized the primacy of symbolic dimension. It is not image, but language which constructs the foundations of body image. Central concepts in this chater are Other as language, ego-ideal, demand and desire. In the last chapter I connect the third version of the mirror stage to concepts of gaze, phantasy, real, jouissance and object a. In previous chapters I had considered body image in relation to ego. Now I explore it in relation to subject. In my reading the body image is fragile phenomen, which oscillates between yearning for coherence and phantasies of fragmented images. Part IV of the thesis begins with an introduction to the central concepts and debates in performace studies over the last few decades. Important concepts are presence, performativity and theatricality. The main substance of my thesis, however, is the performance analysis, which focuses on works by three Finnish artists and one Finnish group. The first analysis concerns the performance (1992) of Kimmo Schroderus. I discuss the relationship between narcissism and body art and the changes in demands projected on body images of men in recent decades in a Euro-American context. I also explore this performance in relation to the myth of Narcissus, which I reinterpret through Narcissus s aggression against his own body. The group Homo S is the main subject of the next analysis. I discuss the relationship between feminist art and performance art, especially in the United States in the 1960s and 1970s. Homo S is different from this early performance art because of its anarchism, humor and rejection of all ideals. Homo S characterizes its performance Body Body (1983) as liberating vulgar feminism . Sociality and performance of erotic relations between women are central in Body Body. Pia Lindman s performances are the subjects of my third analysis. I study three of her performances: Olen muoto (1993), 17 and in love (1994) and Arranged views (1995). I interpret these performances as efforts to disperse the imaginary and symbolic structures of the body image. She constructs the peculiar object a and phantasy space of her own. In the last analysis I move from questions of image and gaze to a study of language, sound and jouissance. I discuss at a general level the performance of orality and helplesness (Hilflosigkeit) in body art. The central elements in Pentti Otto Koskinen s performances are the ear, listening and receptive gestures and postions. Perseveraatio (1998) can be understood representing as submission to the super-ego s power, which compels one to enjoy. I examine particularly closely the performance Maissi on hyvää ei missään nimessä maissia (1995), which I interpret as the return of a baby s body image to the liminal site of choice: language or jouissance?