Using modeling as a co-design approach in the planning process of new care environments

Current research shows a relationship between healthcare architecture and patient-related Outcomes. The planning and designing of new healthcare environments is a complex process; the needs of the various end-users of the environment must be considered, including the patients, the patients’ significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modelling utilizing system dynamics in the pre-design phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction, and then interviewed them about their experience. An explorative and qualitative design was used to describe participants’ experiences of participating in the group modelling projects. Participants (n=20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analysed by qualitative content analysis. Two themes were formed, representing the experiences in the group modeling process: ‘Partaking in the G-M created knowledge and empowerment’and ‘Partaking in the G-M was different from what was expected and required time and skills’. The method can support participants in design teams to focus more on their healthcare organization, their care activities and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.

The Hanging/hanged Patient and Relevance to Pre-hospital Care

Death and injury from hanging is a complex situation, which requires careful and appropriate assessment and management in the pre-hospital environment. It is arguably an area of limited understanding and therefore may not be assessed and managed in the most effective manner. Most hanged/hanging patients will be found in their homes, rather than in institutions. It could be argued that due to prevalence as a suicide method, the majority of pre-hospital ambulance service staff will be responded to at least one hanged or hanging patient within their careers, thus a greater understanding will benefit both clinician and patient. Patients who attempt or achieve suicide will rarely achieve fracturing the spine and severing the spinal cord, bringing into question the requirement for the traditional cervical collar and spinal immobilisation techniques. Death from asphyxiation and carotid/vagal reflex require consideration and management as does raised ICP, which is likely to occur.

'Producing the Scene': the Evolution of the Director in British Theatre 1900-50

The role of the director as the individual who harnesses and controls resources to shape the theatrical product to a personal artistic vision, begins to emerge in British theatre in the early years of the twentieth century. What distinguishes the role from that of the actor-manager who had led the profession since the seventeenth century, is that it separates off from the leading actor in performance. The power and authority of the director (or producer as he or she tended to be known initially) is exercised in the pre-performance stage. In the first half of the century there were still old-style actor-managers—Donald Wolfit is a prime example—and many of the new directors had begun their careers as actors and some continued to act their in their own productions. But the perception of the function of the director began to change radically. In part this was linked to the early attempts to create a new model of producing company or ‘repertory’ theatre which required a different set of administrative as well as artistic skills to tackle the challenge of a short-run system of multiple play production. This became especially important in the developing network of regional repertory theatres which were established as autonomous, locally-specific institutions predicated on policies opposed to the dominant commercial ethos. The best-known of the early directors, most notably H.Granville Barker, confined their radical experiments to short-lived metropolitan experiments, or, as in the case of Terence Gray and J.B.Fagan, operated within the influential Oxbridge nexus. Others such as H.K.Ayliff, Herbert Prentice, William Armstrong and William Bridges-Adams remain comparatively obscure because of their long-term ‘provincial’ connections or, as in the case of Nugent Monck and Edy Craig because their creativity was largely channelled through amateur actors. This chapter will explore the evolving role of the director as both a necessary functionary and an artistic innovator within the changing structures of British theatre.

The cultural policy in Italy and the innovations of the XXI century

The paper analyzes the development of the first experiences of the sixteenth century cultural policy in Italy until the beginning of the twenty-first century with the institutional reform initiated by the Minister Dario Franceschini. In the pre-unification State it has been many important contributions of several local rulers who imposed conservation policies to prevent the dispersal of works of art. After the unification of Italy (1861) the laws of protection of the national heritage have helped to initiate the first important initiatives that have developed in practice only at the end of the twentieth century. Great institutional innovations and regulatory activated in the twenty-first century and of which this paper provides some important insights and deepening.

Effects of physical exercise training in DNA damage and repair activity in humans with different genetic polymorphisms ofhOGG1(Ser326Cys)

The main purpose of this pilot study was to investigate the possible influence of genetic polymorphisms of the hOGG1 (Ser326Cys) gene in DNA damage and repair activity by 8-oxoguanine DNA glycosylase 1 (OGG1 enzyme) in response to 16 weeks of combined physical exercise training. Thirty-two healthy Caucasian men (40-74 years old) were enrolled in this study. All the subjects were submitted to a training of 16 weeks of combined physical exercise. The subjects with Ser/Ser genotype were considered as wild-type group (WTG), and Ser/Cys and Cys/Cys genotype were analysed together as mutant group (MG). We used comet assay in conjunction with formamidopyrimidine DNA glycoslyase (FPG) to analyse both strand breaks and FPG-sensitive sites. DNA repair activity were also analysed with the comet assay technique. Our results showed no differences between DNA damage (both strand breaks and FPG-sensitive sites) and repair activity (OGG1) between genotype groups (in the pre-training condition). Regarding the possible influence of genotype in the response to 16 weeks of physical exercise training, the results revealed a decrease in DNA strand breaks in both groups, a decrease in FPG-sensitive sites and an increase in total antioxidant capacity in the WTG, but no changes were found in MG. No significant changes in DNA repair activity was observed in both genotype groups with physical exercise training. This preliminary study suggests the possibility of different responses in DNA damage to the physical exercise training, considering the hOGG1 Ser326Cys polymorphism.

Effect of grape seed extract on oxidative, color and sensory stability of pre-cooked, frozen, re-heated beef sausage model system

The processing of meats at the factory level can trigger the onset of lipid oxidation, which can lead to meat quality deterioration. Warmed over flavor is an off-flavor, which is associated with oxidative deterioration in meat. To avoid or delay the auto-oxidation process in meat products, synthetic and natural antioxidants have been successfully used. Grape (Vitis Vinifera) is of special interest due to its high content of phenolic compounds. Grape seed extract sold commercially as a dietary supplement, has the potential to reduce lipid oxidation and WOF in cooked ground beef when added at 1%. The objective of study 1 was to compare the antioxidant activity of natural antioxidants including grape seed extract and some herbs belonging to the Lamiaciae family: rosemary (Rosmarinus Officinalis), sage (Salvia Officinalis) and oregano (Origanum Vulgare) with commercial synthetic antioxidants like BHT, BHA, propyl gallate and ascorbic acid using the ORAC assay. All sample solutions were prepared to contain 1.8 gm sample/10 ml solvent. The highest antioxidant activity was observed for the grape seed extract sample (359.75 µM TE), while the lowest was observed for BHA, propyl gallate and rosemary also showed higher antioxidant potential with ORAC values above 300 μmol TE/g. ORAC values obtained for ascorbic acid and Sage were between 250-300μ mol TE/g while lowest values were obtained for Butylated Hydroxytoluene (28.50 µM TE). Based on the high ORAC values obtained for grape seed extract, we can conclude that byproducts of the wine/grape industry have antioxidant potential comparable to or better than those present in synthetic counterparts. The objective of study 2 was to compare three levels of grape seed extract (GSE) to commonly used antioxidants in a pre-cooked, frozen, stored beef and pork sausage model system. Antioxidants added for comparison with control included grape seed extract (100, 300, 500 ppm), ascorbic acid (AA, 100 ppm of fat) and propyl gallate (PG, 100 ppm of fat). Product was formed into rolls, frozen, sliced into patties, cooked on a flat griddle to 70C, overwrapped in PVC, and then frozen at –18C for 4 months. GSE- and PG-containing samples retained their fresh cooked beef odor and flavor longer (p<0.05) than controls during storage. Rancid odor and flavor scores of GSE-containing samples were lower (p<0.05) than those of controls after 4 months of storage. The L* value of all samples increased (p<0.05) during storage. Thiobarbituric acid reactive substances (TBARS) of the control and AA-containing samples increased (p<0.05); those of GSE-containing samples did not change significantly (p>0.05) over the storage period.

Invented spelling activities in small groups and early spelling and reading

Our aim was to assess the impact of an invented spelling programme conducted in small groups on children’s written language acquisition in Portuguese. We expected the experimental group to have better post-test results than the control group in spelling and reading. Participants were 160 preschool-age children who were randomly divided into an experimental and a control group. Their age, cognitive ability, knowledge of letters and phonological abilities were controlled. Children’s spelling and reading were evaluated in a pre- and a post-test. Inbetween, experimental group participated in an invented spelling programme in small groups and the control group in story readings. The experimental group showed better results in spelling and reading in the post-test than the control one. Different dynamics occurred in the small groups which had different impacts on children’s acquisitions. These results provide empirical support for the proposal that invented spelling should be incorporated into early literacy instruction.

The background impact in HEI math lectures: an experience in math in the 1st year of Accounting and Management Degree

It is a fact, and far from being a new one, that students have been entering Higher Education courses with many different backgrounds in terms of secondary school programs they attended. The impact of these basic skills is a general and worldwide challenge, fundamentally when facing some specific “constructive” subjects like foreign languages and Mathematics. Working with students with an extensive variety of Math qualifications is an outrageous challenge when they enter an advanced Math course, leading to an almost generalized expectations’ failure - from students enrolled in course and from their teachers, who feel powerless in trying to monitor knowledge construction from completely different “starting points”. If teachers’ "haste" is average, more than half of the students do not “go along” and give up, even before experiencing any kind of evaluation procedure. On the contrary, if the “speed” is too low, others are discouraged (feeling not progressing at all) and the teacher runs the risk of not meeting the minimum objectives (general and specific) of its course, which may have a negative impact on students’ future training development. Failure in Mathematics, despite being a recurrent and global issue, does not have any “magical solution”, however, in general, teachers in this area seem untiring, searching, investigating, trying and implementing new and old “recipes” to tackle and demystify this subject. In this article we describe a project developed in a Math course, with the first year students from an Accounting and Management bachelor degree, and its outcomes since it was brought to practice, revealing its impact in students’ success, from approval to dropout rates, in this course. We will shortly describe students’ differentiated Math backgrounds, their results in a pre-assessment analysis and how we try to deal with these differences and level them up, having in mind the same “finish line”. One should never forget that all these students where officially accepted in higher education institutions, so they are ones’ reality, the reality of institutions whose name one should value and strive to defend.

Fish nodavirus lytic cycle and semipermissive expression in mammalian and fish cell cultures

In this study, Dicentrarchus labrax encephalitis virus (DIEV), which causes sea bass encephalitis, was propagated in cell culture, thus allowing study of its lytic cycle, DIEV infection of mammalian and fish cells induced different patterns of expression of capsid proteins, which were assembled as virus-like particles, accumulating in the cytoplasm either as diffuse masses or in vesicles, as shown by electron microscopy, These particles correspond to virions, as shown by their ability to induce Secondary infection, Fish cells proved to be more permissive for DIEV than mammalian cells, although virus yield remained low, RNA analysis of infected sea bass cells revealed DIEV RNA3, in addition to genomic RNA1 and RNA2, and the presence of the RNA;! minus strand, thus demonstrating the replication of the DIEV genome, In addition, DIEV RNA-dependent RNA polymerase was associated with mature virions even after purification by a CsCl gradient, but it was dissociated when capsids were destabilized, In addition to providing more information about the relatedness of DIEV to the members of the family Nodaviridae, this study shows that fish nodaviruses may not be able to infect as wide a variety of cells as insect nodaviruses can.

Contested Play and Clean Water: McMillan Park, Race, and the Built Environment in Washington, D.C., 1900-1941

This study focuses on the intersection of the politics and culture of open public space with race relations in the United States from 1900 to 1941. The history of McMillan Park in Washington, D.C. serves as a lens to examine these themes. Ultimately, the park’s history, as documented in newspapers, interviews, reports, and photographs, reveals how white residents attempted to protect their dominance in a racial hierarchy through the control of both the physical and cultural elements of public recreation space. White use of discrimination through seemingly neutral desires to protect health, safety, and property values, establishes a congruence with their defense of residential property. Without similar access to legal methods, African Americans acted through direct action in gaps of governmental control. Their use of this space demonstrates how African-American residents of Washington and the United States contested their race, recreation, and spatial privileges in the pre-World War II era.

Nutritional status and its impact on time and relocation in postoperative complications of abdominal patients undergoing surgery

Introduction: The nutritional state is the independent factor that most influences the post-operational results in elective surgeries. Objective: to evaluate the influence of the nutritional state on the hospitalization period and on the post-operative complications of patients submitted to abdominal surgery. Methods: prospective study with 99 surgical patients over 18 years of age, submitted to abdominal surgeries in the period from April to October of 2013, in the Instituto de Medicina Integral Professor Fernando Figueira (IMIP). All patients were submitted to anthropometric nutritional evaluations through the body mass Index (BMI), arm circumference (AC) and triceps skinfold thickness (TEST). The biochemical evaluation was carried out from the leukogram and serum albumin results. The identification of candidate patients to nutritional therapy (NT) was carried out through the nutritional risk (NR) evaluation by using the BMI, loss of weight and hypoalbuminemia. The information about post-operational complications, hospitalization period and clinical diagnosis was collected from the medical records. Program SPSS version 13.0 and significance level of 5% were used for the statistical analysis. Results: The malnutrition diagnosed by the AC showed significant positive association with the presence of post-operative complications (p=0.02) and with hospitalization period (p=0.02). The presence of NR was greater when evaluated by hypoalbuminemia (28.9%), however, only 4% of the sample carried out the NT in the pre-operational period. The hospitalization period was greater for patients with malignant neoplasia (p<0.01). Conclusion: The malnutrition diagnosis of patients submitted to abdominal surgeries is associated to greater risk of post-operational complications and longer hospitalization permanence.

Bioelectric Impedance Analysis in the Diagnosis of Vesicoureteral Reflux

Background: Vesicoureteral reflux (VUR) is a common abnormality of the urinary tract in childhood. Objectives: As urine enters the ureters and renal pelvis during voiding in vesicoureteral reflux (VUR), we hypothesized that change in body water composition before and after voiding may be less different in children with VUR. Patients and Methods: Patients were grouped as those with VUR (Group 1) and without VUR (Group 2). Bioelectric impedance analysis was performed before and after voiding, and third space fluid (TSF) (L), percent of total body fluid (TBF%), extracellular fluid (ECF%), and intracellular fluid (ICF%) were recorded. After change of TSF, TBF, ECF, ICF (ΔTSF, ΔTBF%, ΔECF%, ΔICF%), urine volume (mL), and urine volume/body weight (mL/kg) were calculated. Groups 1 and 2 were compared for these parameters. In addition, pre- and post-voiding body fluid values were compared in each group. Results: TBF%, ECF%, ICF%, and TSF in both pre- and post-voiding states and ΔTBF%, ΔECF%, ΔICF%, and ΔTSF after voiding were not different between groups. However, while post-voiding TBF%, ECF% was significantly decreased in Group 1 (64.5 ± 8.1 vs 63.7 ± 7.2, P = 0.013 for TBF%), there was not post-voiding change in TSF in the same group. On the other hand, there was also a significant TSF decrease in Group 2. Conclusions: Bladder and ureter can be considered as the third space. Thus, we think that BIA has been useful in discriminating children with VUR as there was no decreased in patients with VUR, although there was decreased TSF in patients without VUR. However, further studies are needed to increase the accuracy of this hypothesis.

Cultural identity in landscape architecture, renovation of Managua's lakeside

This thesis examines a design approach in landscape architecture in which cultural and historical values are reinterpreted in a contemporary urban environment. The site of this project is located in Managua's lakeside area, which was destroyed by hurricane Mitch in 1998. The lakeside area has been an attraction to Managua's residents because of its beautiful views and fresh breezes. The majority of Nicaragua's population is of indigenous descent; however, Managua's urban environment is predominantly of European influence. The pre-Columbian heritage of Nicaraguans is hidden in their cultural expressions, such as the names of places and religious rituals. This project provides a new lakeside area for Managua in which cultural identity in landscape architecture is represented in the use of the site and in a rescue of Managua's residents' pride in their pre-Columbian heritage. The lakeside renovation was planned using pre-Columbian design methodology and vocabulary to create a functional and environmentally sens~velandscape.

Stock price and volume effects associated with changes in the composition of the FTSE Bursa Malaysian KLCI

We examine the stock price and volume effects associated with changes in the composition of the FTSE Bursa Malaysia Kuala Lumpur Composite Index (KLCI), over the time period of 2005–2012. We find evidence to support the price pressure hypothesis for both additions to and deletions from the KLCI. This is because significant stock price and trading volume effects in the pre index revision period are entirely reversed after the announcement of the news. Our empirical findings can be explained by the market microstructure literature. Significant changes in liquidity cause trading volume and stock prices to reverse back to their original level before the index revisions took place.