964 resultados para 185-801
Resumo:
Background: The prevalence of end-stage kidney disease (ESKD) patients is increasing in Vietnam; however, the impact of ESKD and its treatment on a person’s quality of life (QOL) is not well understood. Objective: This research sought to examine the association between monthly income, comorbidity, length of time on dialysis, social support and health-related quality of life (HRQOL) among Vietnamese ESKD patients. Method: Using a descriptive design, 95 patients who were receiving haemodialysis (HD) and peritoneal dialysis (PD) from one hospital in Hanoi, were conveniently sampled. Results: ESKD patients reported having a moderate level of HRQOL. Factors associated with QOL were social support (r= .268, p<.05), comorbid health conditions (r= –.185, p<.05), and length of time on dialysis (r= .182, p<.05). However, monthly income was not significantly related to HRQOL (p>.05). Conclusion: The results seem to indicate that ESKD patients in Vietnam have a high level of support from family members, friends and significant others. There was also a negative impact of comorbid conditions on the QOL of these patients. Based on the results of this study, nurses ought to develop nursing interventions which will lead to a better QOL for patients, and further research into the QOL for ESKD patients in Vietnam is warranted.
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To date, the available literature mainly discusses Twitter activity patterns in the context of individual case studies, while comparative research on a large number of communicative events and their dynamics and patterns is missing. By conducting a comparative study of more than 40 different cases (covering topics such as elections, natural disasters, corporate crises, and televised events) we identify a number of distinct types of discussion that can be observed on Twitter. Drawing on a range of communicative metrics, we show that thematic and contextual factors influence the usage of different communicative tools available to Twitter users, such as original tweets, @replies, retweets, and URLs. Based on this first analysis of the overall metrics of Twitter discussions, we also demonstrate stable patterns in the use of Twitter in the context of major topics and events.
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The decision of Carrapetta v. Rado [2012] NSWCA 202 raises a short but very practical point relating to the right to deliver a notice to complete or have otherwise called for completion where time is of the essence of the contract in circumstances where a settlement statement subsequently sent from the seller has overstated the amount owing under the contract. It was common ground , following the oft quoted High Court decisions of Neeta (Epping) Pty Ltd v Phillips(1974) 131 CLR 286 and Louinder v Leis (1982) 149 CLR 509 that a Notice to Complete which called for completion outside the terms of the contract would be invalid. These decisions also further confirm the long accepted principles that a seller who is not “ready willing and able” to perform all their obligations or who is otherwise in breach of contract at the time could not deliver a Notice to Complete (at[27]).The issue in this case did not so much concern the efficacy of the Notice to Complete at the time was delivered ,but the legal effect upon the Notice to Complete of the later delivery of a settlement statement for what the buyer considered to be performance beyond that required by the contract.
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Background & aim: This paper describes nutrition care practices in acute care hospitals across Australia and New Zealand. Methods: A survey on nutrition care practices in Australian and New Zealand hospitals was completed by Directors of dietetics departments of 56 hospitals that participated in the Australasian Nutrition Care Day Survey 2010. Results: Overall 370 wards representing various specialities participated in the study. Nutrition risk screening was conducted in 64% (n=234) of the wards. Seventy nine percent(n=185) of these wards reported using the Malnutrition Screening Tool, 16% using the Malnutrition Universal Screening Tool (n=37), and 5% using local tools (n=12). Nutrition risk rescreening was conducted in 14% (n=53) of the wards. More than half the wards referred patients at nutrition risk to dietitians and commenced a nutrition intervention protocol. Feeding assistance was provided in 89% of the wards. “Protected” meal times were implemented in 5% of the wards. Conclusion: A large number of acute care hospital wards in Australia and New Zealand do not comply with evidence-based practice guidelines for nutritional management of malnourished patients. This study also provides recommendations for practice.
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This paper investigates learning environments from the view of the key users - students. Recent literature on designing Learning Landscapes indicates a near absence of the student voice, assuming that the majority of students are either uninterested or unable to express what they want or need, in a learning environment. The focus of this research is to reveal Architecture and Fashion Design students’ perceptions of their learning environments. Furthermore, this study questions the appropriateness of usual design of learning spaces for Design students, or if the environment needs to be specifically catered for the learning of different disciplines of Design, such as Architecture and Fashion Design. Senior Architecture and Fashion Design students were invited to participate in a qualitative mixed method study, including investigation into existing literature, questionnaires, focus groups and spontaneous participatory research. Through the analysis of data it was found that students’ perceptions validate discipline specific learning environments and contribute towards the development of a framework for the design of future Learning Landscapes, for Design education.
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Mycobacterium abscessus is a rapidly growing mycobacteria responsible for progressive pulmonary disease, soft tissue and wound infections, and can contaminate clinical specimens. Nontuberculous mycobacteria (NTM) are generally considered environmental organisms though M. abscessus has not featured frequently in environmental studies, particularly those examining potable water. In a study of Brisbane potable water, M. abscessus was isolate from ten different locations. The incidence of disease due to M. abscessus has been increasing in Queensland. Aim: To compare genotypically the M. abscessus isolates obtained from water to those obtained from human clinical specimens. Methods: From a study of Brisbane potable water between 2007 and 2009, ten isolates confirmed as M. abscessus were recovered. In addition, one strain was isolated from a rainwater tank of a patient with disease due to M. avium, and another from the swimming pool of a patient with M. intracellulare disease. A random sample of 74 clinical isolates referred to the QLD Mycobacterial reference laboratory during the same time period was available for comparison using repPCR strain typing (Diversilab). Results: The drinking water isolates formed two distinct strain patterns (A and B) that shared >90% similarity. The tankwater isolate (pattern C) shared >85% similarity with the potable water isolates, but the pool isolate (D) was distinctly different. Fifty-three clinical isolates clustered tightly (>95% similarity) with the Group A potable water isolates, 4 patients with Group B. Thirteen patient isolates clustered with the Rainwater tank isolate. One patient matched the pool isolate. There were a further 3 patient isolates that were unrelated to the water isolates. No differences were found between strain types in terms of geographic origin, gender, age, or site/type of infection. Conclusion: The high degree of similarity between strains of M. abscessus from potable water and strains causing infection in humans from the same area, strengthens the possibility that drinking water may be a source of infection in these patients.
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A well-engineered scaffold for regenerative medicine, which is suitable to be translated from the bench to the bedside, combines inspired design, technical innovation and precise craftsmanship. Electrospinning and additive manufacturing are separate approaches to manufacturing scaffolds for a variety of tissue engineering applications. A need to accurately control the spatial distribution of pores within scaffolds has recently resulted in combining the two processing methods, to overcome shortfalls in each technology. This review describes where electrospinning and additive manufacturing are used together to generate new porous structures for biological applications.
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Energy represents the cornerstone of modern life. However, current patterns of energy production are unsustainable. This is true for both the developed and developing worlds. In this context, this paper considers how, from a conceptual perspective, the law can contribute to more sustainable patterns of energy production can be addressed. The approach that this paper adopts is to consider two of the most important concepts that are relevant to the governance of modern environmental and societal challenges: human dignity and sustainable development. It is within this context that this paper contends that the convergence of these concepts provides the platform for a novel approach to encourage the sustainable production of energy by way of a ‘right to sustainable energy’. With this in mind, this paper considers the forum in which a right to sustainable energy may be developed and outlines the content of the proposed right.
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This article reports on the design and implementation of a Computer-Aided Die Design System (CADDS) for sheet-metal blanks. The system is designed by considering several factors, such as the complexity of blank geometry, reduction in scrap material, production requirements, availability of press equipment and standard parts, punch profile complexity, and tool elements manufacturing method. The interaction among these parameters and how they affect designers' decision patterns is described. The system is implemented by interfacing AutoCAD with the higher level languages FORTRAN 77 and AutoLISP. A database of standard die elements is created by parametric programming, which is an enhanced feature of AutoCAD. The greatest advantage achieved by the system is the rapid generation of the most efficient strip and die layouts, including information about the tool configuration.
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Over the past two decades medical researchers and modernist feminist researchers have contested the meaning of menopause. In this article we examine various meanings of menopause in major medical and feminist literature and the construction of menopause in a semi-structured interview study of general practitioners in rural South Australia. Three discursive themes are identified in these interviews; (i) the hormonal menopause – symptoms, risk, prevention; (ii) the informed menopausal woman; and (iii) decision-making and hormone replacement therapy. By using the discourse of prevention, general practitioners construct menopause in relation to women's health care choices, empowerment and autonomy. We argue that the ways in which these concepts are deployed by general practitioners in this study produces and constrains the options available to women. The implications of these general practitioner accounts are discussed in relation to the proposition that medical and feminist descriptions of menopause posit alternative but equally-fixed truths about menopause and their relationship with the range of responses available to women at menopause. Social and cultural explanations of disease causality (c.f.Germov 1998, Hardey 1998) are absent from the new menopause despite their being an integral part of the framework of the women's health movement and health promotion drawn on by these general practitioners. Further, the shift of responsibility for health to the individual woman reinforces practice claims to empower women, but oversimplifies power relations and constructs menopause as a site of self-surveillance. The use of concepts from the women's health movement and health promotion have nevertheless created change in both the positioning of women as having ‘choices’ and the positioning of some general practitioners in terms of greater information provision to women and an attention to the woman's autonomy. In conclusion, we propose that a new menopause has evolved from a discursive shift in medicine and that there exists within this new configuration, claiming the empowerment of women as an integral part of health care for menopause, the possibility for change in medical practice which will broaden, strengthen, and maintain this position.
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The absence of qualitative analysis in mainstream research on eating disorders is discussed in the following article as being a weakness in developing theory and clinical practice. This article includes an analysis of interviews with British healthcare workers who manage anorexic patients. This analysis presents an example of qualitative methodology in the form of discourse analysis, which is argued to provide a systematic, yet flexible approach to research on eating disorders. The overwhelming prevalence of anorexia nervosa in women is specifically examined within the context of the identification of the "discourse of femininity. " The research findings are discussed in relation to the use of discursive practices that contribute to the maintenance and reproduction of clinical processes and their relative efficacy.
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The international legal regime on shipbreaking is in its formative years. At the international level, the shipbreaking industry is partially governed by the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal. However, how far this convention will be applicable for all aspects of transboundary movement of end-of-life ships is still, at least in the view of some scholars, a debatable issue. Against this backdrop, the International Maritime Organisation (IMO) has adopted a new, legally binding convention for shipbreaking. There is a rising voice from the developing countries that the convention is likely to impose more obligations on recycling facilities in the developing countries than on shipowners from rich nations. This may be identified as a clear derogation from the globally recognized international environmental law principle of common but differentiated treatment. This article will examine in detail major international conventions regulating transboundary movement and environmentally sound disposal of obsolete ships, as well as the corresponding laws of Bangladesh for implementing these conventions in the domestic arena. Moreover this article will examine in detail the recently adopted IMO Ship Recycling Convention.
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Despite playing an extremely important role in shaping communities, the role and contribution of planners is not widely understood or acknowledged. At the same time, there is a shortage of planners in Australia, especially in non-urban areas. Thus, though an online survey of 185 rural and regional planners, this research explores their motivations, expectations and experiences. Most enjoyed and felt confident in their role, explaining that they valued the relaxed family orientated rural lifestyle and the varied nature of the planning work. Although they sometimes felt isolated, the non-urban location provided quicker progression to senior roles, the ability to engage directly with the community and to see the consequences of their decisions. Only half felt their education had prepared them well for their role, citing gaps in terms of computerised modelling, team leadership and conflict resolution skills. Their feedback centred on providing a more practical course, focussing more on regional planning, and encouraging urban and rural experience placements. As the first study to quantifiably explore rural and regional Australian planners perceptions of their role and challenges, the findings illustrate current experiences, key planning challenges, perceived educational gaps and future priorities.
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Database security techniques are available widely. Among those techniques, the encryption method is a well-certified and established technology for protecting sensitive data. However, once encrypted, the data can no longer be easily queried. The performance of the database depends on how to encrypt the sensitive data, and an approach for searching and retrieval efficiencies that are implemented. In this paper we analyze the database queries and the data properties and propose a suitable mechanism to query the encrypted database. We proposed and analyzed the new database encryption algorithm using the Bloom Filter with the bucket index method. Finally, we demonstrated the superiority of the proposed algorithm through several experiments that should be useful for database encryption related research and application activities.