898 resultados para Neuromuscular manifestations


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In recent years, with the impact of the global knowledge economy, a more comprehensive urban development approach, so called 'knowledge-based urban development', has gained significant popularity. This paper discusses the critical connections among knowledge-based urban development strategies, knowledge-intensive industries and information and communication technology infrastructures. In particular, the research focuses on investigating the application of the knowledge-based urban development concept by discussing one of the South East Asia's large scale knowledge-based urban development manifestations of Malaysia's Multimedia Super Corridor. The paper scrutinises Malaysia's experience in the development and evolution of the Multimedia Super Corridor from the angle of knowledge-based urban development policy implementation, infrastructural implications, and actors involved in its development and management. This paper provides a number of lessons learned from the Multimedia Super Corridor on the orchestration of knowledge-based development that is a necessity for cities seeking successful knowledge city and knowledge economy transformations.

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Anxiety disorders have been viewed as manifestations of broad underlying predisposing personality constructs such as neuroticism combined with more specific individual differences of unhelpful information processing styles. Given the high prevalence of anxiety and the significant impairment that it causes, there is an important need to continue to explore successful treatments for this disorder. Research indicates that there is still room for significantly improving attrition rates and treatment adherence. Traditionally Motivational Interviewing (MI) has been used to facilitate health behaviour change. Recently MI has been applied to psychotherapy and has been shown to improve the outcome of CBT. However, these studies have been limited to only considering pre- and post-treatment measures and neglected to consider when changes occur along the course of therapy. This leaves the unanswered question of what is the impact of pre-treatment MI on the treatment trajectory of therapy. This study provides preliminary research into answering this question by tracking changes on a weekly basis along the course of group CBT. Prior to group CBT, 40 individuals with a principal anxiety disorder diagnosis were randomly assigned to receive either 3 individual sessions of MI or placed on a waitlist control group. All participants then received the same dosage of 10 weekly 2 hour sessions of group CBT. Tracking treatment outcome trajectory over the course of CBT, the pre-treatment MI group, compared to the control group, experienced a greater improvement early on in the course of therapy in their symptom distress, interpersonal relationships and quality of life. This early advantage over the control group was then maintained throughout therapy. These results not only demonstrate the value of adding MI to CBT, but also highlight the immediacy of MI effects. Further research is needed to determine the robustness of these effects to inform clinical implications of how to best apply MI to improve treatment adherence to CBT for anxiety disorders.

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Many music programs in Australia deliver a United States (US) package created by the Recreational Music-Making Movement, founded by Karl Bruhn and Barry Bittman. This quasi-formal group of music makers, academics and practitioners uses the logic of decentralised global networks to connect with local musicians, offering them benefits associated with their ‘Recreational Music Program’ (RMP). These RMPs encapsulate the broad goals of the movement, developed in the US during the 1980s, and now available as a package, endorsed by the National Association of Music Merchants (NAMM), for music retailers and community organisations to deliver locally (Bittman et al., 2003). High participation rates in RMPs have been historically documented amongst baby boomers with disposable income. Yet the Australian programs increasingly target marginalised groups and associated funding sources, which in turn has lowered the costs of participation. This chapter documents how Australian manifestations of RMPs presently report on the benefits of participation to attract cross-sector funding. It seeks to show the diversity of participants who claim to have developed and accessed resources that improve their capacity for resilience through recreational music performance events. We identify funding issues pertaining to partnerships between local agencies and state governments that have begun to commission such music programs. Our assessment of eight Australian RMPs includes all additional music groups implemented since the first program, their purposes and costs, the skills and coping strategies that participants developed, how organisers have reported on resources, outcomes and attracted funding. We represent these features through a summary table, standard descriptive statistics and commentaries from participants and organisers.

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This paper addresses a previously unconsidered history — that of Aboriginal characters in Australian soap operas. Rejecting critical approaches which have obtained even into the 1990s, it refuses to judge these characters as 'good' or 'bad' manifestations of indigeneity. Rather, using the idea that genre is a way of closing down interpretive possibilities, the paper looks at the manner in which generic expectations around soap operas produce particular valences for these representations of Aboriginality. It points to the many ways in which these indigenous characters are insistently constructed as liminal in soap operas' structural communities - simultaneously inside and outside of the group. This is seen to accord with the suggestions of Jakubowicz et al about the ways in which Aboriginal people are positioned by wider social discourses.

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We have read with great interest the retrospective study by Caffaro and Avanzi1 evaluating the relation between narrowing of the spinal canal and neurological deficits in patients with burst-type fractures of the spine. The authors are to be commended for obtaining detailed neurological and radiological data in a large cohort of 227 patients. The authors conclude: “The percentage of narrowing of the spinal canal proved to be a pre-disposing factor for the severity of the neurological status in thoracolumbar and lumbar burst-type fractures according to the classifications of Denis and Magerl.” Although this conclusion is mainly in accordance with previous findings, we would like to comment on the methodological approach applied in the current study.

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Overweight and obesity are a significant cause of poor health worldwide, particularly in conjunction with low levels of physical activity (PA). PA is health-protective and essential for the physical growth and development of children, promoting physical and psychological health while simultaneously increasing the probability of remaining active as an adult. However, many obese children and adolescents have a unique set of physiological, biomechanical, and neuromuscular barriers to PA that they must overcome. It is essential to understand the influence of these barriers on an obese child's motivation in order to exercise and tailor exercise programs to the special needs of this population. Chapter Outline • Introduction • Defining Physical Activity, Exercise, and Physical Fitness • Physical Activity, Physical Fitness, And Motor Competence In Obese Children • Physical Activity and Obesity in Children • Physical Fitness in Obese Children • Balance and Gait in Obese Children • Motor Competence in Obese Children • Physical Activity Guidelines for Obese Children • Clinical Assessment of the Obese Child • Physical Activity Characteristics: Mode • Physical Activity Characteristics: Intensity • Physical Activity Characteristics: Frequency • Physical Activity Characteristics: Duration • Conclusion

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Oral intake of ascorbic acid is essential for optimum health in human beings. Continuous ambulatory peritoneal dialysis (CAPD) patients have an increased need for ascorbic acid, because of increased loss through dialysate, reduced intake owing to nausea and loss of appetite, and increased oxidative stress. However, optimum intake is still controversial. We studied 50 clinically stable patients to determine the relationship between oral ascorbic acid intake and serum ascorbic acid (SAA) level. Total oral intake ranged from 28 mg daily to 412 mg daily. Only one patient had an oral intake of ascorbic acid below 60 mg per day. The SAA levels ranged from 1 mg/L to 36.17 mg/L. Although a strong correlation existed between intake and SAA (p < 0.001, R2 = 0.47), the variation in SAA at any given intake level was wide. Of the studied patients, 62% had an SAA < 8.7 mg/L, 40% had an SAA < 5.1 mg/L (below the level in a healthy population), and 12% had a level below 2 mg/L (scorbutic). None of the patients demonstrated clinical manifestations of scurvy. Our results show that, in CAPD patients, ascorbic acid deficiency can be reliably detected only with SAA measurements, and oral intake may influence SAA level. To maintain ascorbic acid in the normal range for healthy adults, daily oral intake needs to be increased above the U.S. recommended dietary allowance to 80-140 mg.

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This chapter summarizes the responses to four questions in each of the chapters in this volume. The questions addressed the use of a conceptual framework that guides the chapter, issues of domain-generality, how personal epistemology relates to teaching, and how personal epistemologies change. We concluded that all of the chapters discussed the distinction between constructivist and transmission teaching practices, while suggesting that there are many inconsistencies in understanding the relationship between the nature of beliefs and teachers’ practices regardless of the relative sophistication of teachers’ personal epistemologies. We also summarized a multi-component instructional model for calibrating teaching practices based on suggestions in each of the chapters, and made four suggestions for future research, including the need for an integrated theory that accounts for the development and manifestations of personal pistemology in the classroom, the generalizability of fi ndings across different measurements, a set of guidelines to promote teacher epistemological change, and an explicit instructional model that explains the development and calibration of beliefs and practices. The goal of this volume was to examine the relationship between teachers’ personal epistemologies and teacher education. Sixteen different chapters addressed one or more aspects of this issue. Although each of the chapters addressed different aspects of teachers’ personal epistemologies, a number of common themes are apparent across the chapters. We believe it is useful to articulate these themes in greater detail to provide a better retrospective understanding of this volume, as well as a better prospective framework for future research and changes to teacher training programs. We divide this chapter into two main sections. The fi rst section addresses four key questions about the nature of teachers’ personal epistemologies that were discussed in the introductory chapter as part of a larger set of questions. These questions focus on how to conceptualize these beliefs as explicit models; whether beliefs are domain-specifi c or domain-general; how beliefs are related to teaching; and how beliefs change over time. We provide a summary of each chapter in terms of these four questions. The second section proposes four general suggestions for future research based on the studies reported within this volume.

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Parkinson's disease (PD) patients may be at higher risk of malnutrition because of the symptoms associated with the disease and the side effects of the medication used to manage it. A decline in nutritional status is associated with many adverse outcomes related to health and quality of life. It is not clear, however, to what extent this population is currently affected by malnutrition. The objective of this review was to systematically assess the methodology and outcomes of studies reporting the prevalence of malnutrition in PD patients. Studies that attempted to classify participants with PD into nutritional risk and/or malnutrition categories using body mass index, weight change, anthropometric measures, and nutritional screening and assessment scores were included. The prevalence of malnutrition ranged from 0% to 24% in PD patients, while 3–60% of PD patients were reported to be at risk of malnutrition. There was a large degree of variation among studies in the methods chosen, the definition of malnutrition using those methods, and the detail in which the methodological protocols were reported. The true extent of malnutrition in the PD population has yet to be accurately quantified. It is important, however, to screen for malnutrition at the time of PD diagnosis.

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Diabetes is an increasingly prevalent disease worldwide. Providing early management of the complications can prevent morbidity and mortality in this population. Peripheral neuropathy, a significant complication of diabetes, is the major cause of foot ulceration and amputation in diabetes. Delay in attending to complication of the disease contributes to significant medical expenses for diabetic patients and the community. Early structural changes to the neural components of the retina have been demonstrated to occur prior to the clinically visible retinal vasculature complication of diabetic retinopathy. Additionally visual functionloss has been shown to exist before the ophthalmoscopic manifestations of vasculature damage. The purpose of this thesis was to evaluate the relationship between diabetic peripheral neuropathy and both retinal structure and visual function. The key question was whether diabetic peripheral neuropathy is the potential underlying factor responsible for retinal anatomical change and visual functional loss in people with diabetes. This study was conducted on a cohort with type 2 diabetes. Retinal nerve fibre layer thickness was assessed by means of Optical Coherence Tomography (OCT). Visual function was assessed using two different methods; Standard Automated Perimetry (SAP) and flicker perimetry were performed within the central 30 degrees of fixation. The level of diabetic peripheral neuropathy (DPN) was assessed using two techniques - Quantitative Sensory Testing and Neuropathy Disability Score (NDS). These techniques are known to be capable of detecting DPN at very early stages. NDS has also been shown as a gold standard for detecting 'risk of foot ulceration'. Findings reported in this thesis showed that RNFL thickness, particularly in the inferior quadrant, has a significant association with severity of DPN when the condition has been assessed using NDS. More specifically it was observed that inferior RNFL thickness has the ability to differentiate individuals who are at higher risk of foot ulceration from those who are at lower risk, indicating that RNFL thickness can predict late-staged DPN. Investigating the association between RNFL and QST did not show any meaningful interaction, which indicates that RNFL thickness for this cohort was not as predictive of neuropathy status as NDS. In both of these studies, control participants did not have different results from the type 2 cohort who did not DPN suggesting that RNFL thickness is not a marker for diagnosing DPN at early stages. The latter finding also indicated that diabetes per se, is unlikely to affect the RNFL thickness. Visual function as measured by SAP and flicker perimetry was found to be associated with severity of peripheral neuropathy as measured by NDS. These findings were also capable of differentiating individuals at higher risk of foot ulceration; however, visual function also proved not to be a maker for early diagnosis of DPN. It was found that neither SAP, nor flicker sensitivity have meaningful associations with DPN when neuropathy status was measured using QST. Importantly diabetic retinopathy did not explain any of the findings in these experiments. The work described here is valuable as no other research to date has investigated the association between diabetic peripheral neuropathy and either retinal structure or visual function.

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Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline.

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In John Frazer's seminal book An Evolutionary Architecture (1995), from which this essay is extracted, a fundamental approach is established for have natural systems can unfold mechanisms for negotiating the complex design space inherent in architectural systems. In this essay, which forms a critical part of the book, Frazer draws both correlations and distinctions from natural processes as emulated in design processes and form as active manifestations within natural systems. Form is seen as an evolving agent generated via the rules of descriptive genetic coding, functioning as a part of a metabolic environment. Frazer's process-model establishes the realm in which computation must manoeuvre to produce a valid solution space, including the operations of self-organisation, complexity and emergent behaviour. Addressing design as an authored practice, he extends the transference of 'creativity' from the explicit impression into form, to the investment of though, organisation and strategy in the computational processes which produce form. Frazer's text concentrates astutely on the practising of the evolutionary paradigm, the output of which postulates an architecture born of the relationships to dynamic environmental and socio-economic contexts, and realised through morphogenetic materialisation.

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Students who experience high levels of anger both in and out of school are at risk of exhibiting multiple negative developmental outcomes including poor school performance, peer problems, behavioral difficulties, and concurrent emotional distress. Given this developmental trajectory, it is important for mental health professionals working within school settings to accurately identify those students manifesting anger-related problems at an early age. This chapter provides an overview of instruments designed to assess levels of anger and associated cognitive and behavioral manifestations in children and youth. Among those instruments highlighted is the Multidimensional School Anger Inventory (MSAI)specifically designed to measure anger, hostility, and aggressive behavioral expression in school settings. The role of anger assessment in developing appropriate early intervention and anger management treatment plans is also discussed.

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'The Landing was an exhibition of paintings held at Gallery Barry Keldoulis in Sydney in 2008. The exhibition comprised 7 paintings and a 3-channel video work. The show built upon the artist's interest in drawing parallels between, while simultaneously disrupting the hermetic integrity of both the painted and virtual surface. In this exhibition this was drawn out by the intentionally scratchy and blanched qualities of the painted surface contrasted against the careful delineations and gradation of their subject matter which was drawn exclusively from virtual 3D animated spaces. Conversely, the video work collapsed a series of picture-perfect objects into a dense and incoherent whole. These tensions and slippages act as manifestations of the indeterminacies that frame our subjectivity more broadly - as artist or viewer. As Barry Keldoulis writes: 'Alwast’s practice engages the construction of ‘reality’ in both the digital and painterly worlds. His seamless stitching together of the various modes of virtual reality... is in this exhibition contrasted with his paintings, which show a fondness for what many now see as the quaint naivety of the medium, and the foibles of humanity the painted surface exudes when compared to the clinical exactitude of the virtual world.'(2008, http://www.gbk.com.au/artists/peter-alwast/the-landing) Works from 'The Landing' were included in the exhibition 'Temperature 2: New Queensland Art' (2009, curated by Frank McBride) at the Museum of Brisbane.