964 resultados para Neurally-adjusted ventilatory assist


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This thesis tested interview techniques expected to assist children reporting on repeated events, such as ongoing abuse. The quality and quantity of information children provided was improved by several techniques that rehearsed children in key cognitive tasks. Developmental trends were found whereby techniques often assisted older children more than younger children.

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This document summarizes Governor Terry E. Branstad's Program and Budget Recommendations for the General Assembly

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This document summarizes Governor Terry E. Branstad's Program and Budget Recommendations for the General Assembly

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Introducción Los sistemas de puntuación para predicción se han desarrollado para medir la severidad de la enfermedad y el pronóstico de los pacientes en la unidad de cuidados intensivos. Estas medidas son útiles para la toma de decisiones clínicas, la estandarización de la investigación, y la comparación de la calidad de la atención al paciente crítico. Materiales y métodos Estudio de tipo observacional analítico de cohorte en el que reviso las historias clínicas de 283 pacientes oncológicos admitidos a la unidad de cuidados intensivos (UCI) durante enero de 2014 a enero de 2016 y a quienes se les estimo la probabilidad de mortalidad con los puntajes pronósticos APACHE IV y MPM II, se realizó regresión logística con las variables predictoras con las que se derivaron cada uno de los modelos es sus estudios originales y se determinó la calibración, la discriminación y se calcularon los criterios de información Akaike AIC y Bayesiano BIC. Resultados En la evaluación de desempeño de los puntajes pronósticos APACHE IV mostro mayor capacidad de predicción (AUC = 0,95) en comparación con MPM II (AUC = 0,78), los dos modelos mostraron calibración adecuada con estadístico de Hosmer y Lemeshow para APACHE IV (p = 0,39) y para MPM II (p = 0,99). El ∆ BIC es de 2,9 que muestra evidencia positiva en contra de APACHE IV. Se reporta el estadístico AIC siendo menor para APACHE IV lo que indica que es el modelo con mejor ajuste a los datos. Conclusiones APACHE IV tiene un buen desempeño en la predicción de mortalidad de pacientes críticamente enfermos, incluyendo pacientes oncológicos. Por lo tanto se trata de una herramienta útil para el clínico en su labor diaria, al permitirle distinguir los pacientes con alta probabilidad de mortalidad.

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Vcmax is the rate of maximum velocity of carboxylation of plants and is considered one of the most critical parameters for changes in vegetation in face of global changes and it has a direct impact on gross primary productivity. Physiological processes are considered the main sources of uncertainties in dynamic global vegetation models (DGVMs). The Caatinga biome, in the semiarid region of northeastern Brazil, is extremely important due to its biodiversity and endemism. In a field work realized in an area of preserved Caatinga forest, measurements of carbon assimilation (in response to light and CO2) were performed on 11 individuals of a native species. These results of Vcmax measurements in Caatinga were compared with parameterization of models, revealing that Vcmax is not well adjusted in several DGVMs. Also, the values obtained in the Caatinga field experiments were very close to empirical values obtained in the Northern hemisphere (Austria). These ecophysiological measurements can contribute in understanding of this biome

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Background There is evidence that certain mutations in the double-strand break repair pathway ataxia-telangiectasia mutated gene act in a dominant-negative manner to increase the risk of breast cancer. There are also some reports to suggest that the amino acid substitution variants T2119C Ser707Pro and C3161G Pro1054Arg may be associated with breast cancer risk. We investigate the breast cancer risk associated with these two nonconservative amino acid substitution variants using a large Australian population-based case–control study. Methods The polymorphisms were genotyped in more than 1300 cases and 600 controls using 5' exonuclease assays. Case–control analyses and genotype distributions were compared by logistic regression. Results The 2119C variant was rare, occurring at frequencies of 1.4 and 1.3% in cases and controls, respectively (P = 0.8). There was no difference in genotype distribution between cases and controls (P = 0.8), and the TC genotype was not associated with increased risk of breast cancer (adjusted odds ratio = 1.08, 95% confidence interval = 0.59–1.97, P = 0.8). Similarly, the 3161G variant was no more common in cases than in controls (2.9% versus 2.2%, P = 0.2), there was no difference in genotype distribution between cases and controls (P = 0.1), and the CG genotype was not associated with an increased risk of breast cancer (adjusted odds ratio = 1.30, 95% confidence interval = 0.85–1.98, P = 0.2). This lack of evidence for an association persisted within groups defined by the family history of breast cancer or by age. Conclusion The 2119C and 3161G amino acid substitution variants are not associated with moderate or high risks of breast cancer in Australian women.

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International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims: To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Method: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Results: Evaluated interventions have the potential to reduce the current burden of depression by 10–30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Conclusions: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantlyif there is a substantialincrease substantial increase intreatment coverage.

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Introduction. This is a pilot study of quantitative electro-encephalographic (QEEG) comodulation analysis, which is used to assist in identifying regional brain differences in those people suffering from chronic fatigue syndrome (CFS) compared to a normative database. The QEEG comodulation analysis examines spatial-temporal cross-correlation of spectral estimates in the resting dominant frequency band. A pattern shown by Sterman and Kaiser (2001) and referred to as the anterior posterior dissociation (APD) discloses a significant reduction in shared functional modulation between frontal and centro-parietal areas of the cortex. This research attempts to examine whether this pattern is evident in CFS. Method. Eleven adult participants, diagnosed by a physician as having CFS, were involved in QEEG data collection. Nineteen-channel cap recordings were made in five conditions: eyes-closed baseline, eyes-open, reading task one, math computations task two, and a second eyes-closed baseline. Results. Four of the 11 participants showed an anterior posterior dissociation pattern for the eyes-closed resting dominant frequency. However, seven of the 11 participants did not show this pattern. Examination of the mean 8-12 Hz amplitudes across three cortical regions (frontal, central and parietal) indicated a trend of higher overall alpha levels in the parietal region in CFS patients who showed the APD pattern compared to those who did not have this pattern. All patients showing the pattern were free of medication, while 71% of those absent of the pattern were using antidepressant medications. Conclusions. Although the sample is small, it is suggested that this method of evaluating the disorder holds promise. The fact that this pattern was not consistently represented in the CFS sample could be explained by the possibility of subtypes of CFS, or perhaps co-morbid conditions. Further, the use of antidepressant medications may mask the pattern by altering the temporal characteristics of the EEG. The results of this pilot study indicate that further research is warranted to verify that the pattern holds across the wider population of CFS sufferers.

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The construction industry should be a priority to all governments because it impacts economically and socially on all citizens. Sector turnover in industrialised economies typically averages 8-12% of GDP. Further, construction is critical to economic growth. Recent Australian studies estimate that a 10% gain in efficiency in construction translates to a 2.5% increase in GDP Inefficiencies in the Australian construction industry have been identified by a number of recent studies modelling the building process. They have identified potential savings in time of between 25% and 40% by reducing non-value added steps in the process. A culture of reform is now emerging in the industry – one in which alternate forms of project delivery are being trialed. Government and industry have identified Alliance Contracting as a means to increase efficiency in the construction industry as part of a new innovative procurement environment. Alliance contracting requires parties to form relationships and work cooperatively to provide a more complete service. This is a significant cultural change for the construction industry, with its well-known adversarial record in traditional contracting. Alliance contracts offer enormous potential benefits, but the Australian construction industry needs to develop new skills to effectively participate in the new relationship environment. This paper describes a collaborative project identifying skill needs for clients and construction professionals to more effectively participate in an increasingly sophisticated international procurement environment. The aim of identifying these skill needs is to assist industry, government, and skill developers to prepare the Australian construction workforce for the future. The collaborating Australian team has been fortunate to secure the Australian National Museum in Canberra as its live case study. The Acton Peninsula Development is the first major building development in the world awarded on the basis of a joint alliance contract.

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Timely feedback is a vital component in the learning process. It is especially important for beginner students in Information Technology since many have not yet formed an effective internal model of a computer that they can use to construct viable knowledge. Research has shown that learning efficiency is increased if immediate feedback is provided for students. Automatic analysis of student programs has the potential to provide immediate feedback for students and to assist teaching staff in the marking process. This paper describes a “fill in the gap” programming analysis framework which tests students’ solutions and gives feedback on their correctness, detects logic errors and provides hints on how to fix these errors. Currently, the framework is being used with the Environment for Learning to Programming (ELP) system at Queensland University of Technology (QUT); however, the framework can be integrated into any existing online learning environment or programming Integrated Development Environment (IDE)

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Some polycyclic aromatic hydrocarbons (PAHs) are ubiquitous in air and have been implicated as carcinogenic materials. Therefore, literature is replete with studies that are focused on their occurrence and profiles in indoor and outdoor air samples. However, because the relative potency of individual PAHs vary widely, health risks associated with the presence of PAHs in a particular environment cannot be extrapolated directly from the concentrations of individual PAHs in that environment. In addition, database on the potency of PAH mixtures is currently limited. In this paper, we have utilized multi-criteria decision making methods (MCDMs) to simultaneously correlate PAH-related health risk in some microenvironments to the concentration levels, ethoxyresorufin-O-deethylase (EROD) activity induction equivalency factors and toxic equivalency factors (TEFs) of PAHs found in those microenvironments. The results showed that the relative risk associated with PAHs in different air samples depends on the index used. Nevertheless, this approach offers a promising tool that could help identify microenvironments of concern and assist the prioritisation of control strategies.

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Injury is the fourth leading cause of death in Australia. Injury rates in Queensland are amongst the highest in Australia and 21.5% of people surveyed for this research reported that their lifestyle or that of an immediate family member had been permanently affected by injury. Injury results in over 40,000 hospital admissions and 200,000 attendances at hospital Emergency Departments in Queensland each year. Queensland's death rate from injuries is higher than the national average, with consistently higher rates of deaths related to transport injuries. Queensland statistics also show higher than national average rates of injuries due to falls, homicide and accidental drowning. (Pike, Muller, Baade & Ward, 2000) In 2000-01 injuries represented over $4 billion (or 8%) of total health system expenditure, and 185,000 disability-adjusted life years (DALYs), or 7% of the total morbidity burden of disease and injury in Australia in 2003. (Begg, Vos, Barker, Stevenson, Stanley & Lopez, 2007). Injury is one of seven key health areas identified by the Commonwealth, state and territory governments for priority attention as National Health Priority Areas

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Neo-Dandy was a practice-led research project that explored histories of a quintessential men’s and womenswear garment from across the ages — the formal white dress shirt. The aim was to generate a body of radically new mens’ shirts that, whilst incorporating characteristics normally associated with womenswear, would remain acceptable to male wearers. A detailed study identified a broad spectrum of historical design approaches, ranging from the orthodox man’s shirt to the many variations of the women’s blouse. Within this spectrum a threshold was discovered where the men’s shirt morphed into the woman’s blouse — a ‘design moment’ that appeared to typify the dandy figure (a fashion character who subversively confronts dress norms of their day). The research analysed thousands of archive catwalk images from leading contemporary menswear designers, and of these, only a small number tampered appreciably with the men’s white dress shirt — suggesting a new realm of possibility for fashion design innovation. This led to the creation of a new body of work labelled ‘Neo-Dandy’. Sixty ‘concept shirts’ were produced, with differing styles and varying degrees of detailing, that fitted the brief of being acceptable to male wearers, eminently ‘wearable’ and on a threshold position between menswear and womenswear. These designs were each tested, documented, and assessed in their capacity to evolve the Neo-Dandy aesthetic. Based on these outcomes, a list of key design principles for achieving this aesthetic was identified to assist designers in further evolving this style. The creative work achieved substantial public acclaim with the ‘Neo Dandy Collection’ winning a prestigious Design Institute of Australia Award (Lifestyle category) and being one of four finalists in the prestigious overall field for design excellence. It was subsequently curated into three major Brisbane exhibitions — the ARC Biennial, at Artisan Gallery and the industry leader, the Mercedes Benz Fashion Festival. The collection was also exhibited at the Queensland Art Gallery.

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Neo-Dandy was a practice-led research project that explored histories of a quintessential men’s and womenswear garment from across the ages — the formal white dress shirt. The aim was to generate a body of radically new mens’ shirts that incorporated characteristics normally associated with womenswear, whist remaining acceptable to male wearers. A detailed study identified a broad spectrum of historical design approaches, ranging from the orthodox man’s shirt to the many variations of the women’s blouse. Within this spectrum a threshold was discovered where the men’s shirt morphed into the woman’s blouse — a ‘design moment’ that appeared to typify the dandy figure (a fashion character who subversively confronts dress norms of their day). The research analysed thousands of archive catwalk images from leading contemporary menswear designers, and of these, only a small number tampered appreciably with the men’s white dress shirt — suggesting a new realm of possibility for fashion design innovation. This led to the creation of a new body of work labelled ‘Neo-Dandy’. Sixty ‘concept shirts’ were produced, with differing styles and varying degrees of detailing, that fitted the brief of being acceptable to male wearers, eminently ‘wearable’ and on a threshold position between menswear and womenswear. These designs were each tested, documented, and assessed in their capacity to evolve the Neo-Dandy aesthetic. Based on these outcomes, a list of key design principles for achieving this aesthetic was identified to assist designers in further evolving this style. The creative work achieved substantial public acclaim with the ‘Neo Dandy Collection’ winning a prestigious Design Institute of Australia Award (Lifestyle category) and being one of four finalists in the prestigious overall field for design excellence. It was subsequently curated into three major Brisbane exhibitions — the ARC Biennial, at Artisan Gallery and the industry leader, the Mercedes Benz Fashion Festival. The collection was also exhibited at the Queensland Art Gallery.

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Design as seen from the designer's perspective is a series of amazing imaginative jumps or creative leaps. But design as seen by the design historian is a smooth progression or evolution of ideas that they seem self-evident and inevitable after the event. But the next step is anything but obvious for the artist/creator/inventor/designer stuck at that point just before the creative leap. They know where they have come from and have a general sense of where they are going, but often do not have a precise target or goal. This is why it is misleading to talk of design as a problem-solving activity - it is better defined as a problem-finding activity. This has been very frustrating for those trying to assist the design process with computer-based, problem-solving techniques. By the time the problem has been defined, it has been solved. Indeed the solution is often the very definition of the problem. Design must be creative-or it is mere imitation. But since this crucial creative leap seem inevitable after the event, the question must arise, can we find some way of searching the space ahead? Of course there are serious problems of knowing what we are looking for and the vastness of the search space. It may be better to discard altogether the term "searching" in the context of the design process: Conceptual analogies such as search, search spaces and fitness landscapes aim to elucidate the design process. However, the vastness of the multidimensional spaces involved make these analogies misguided and they thereby actually result in further confounding the issue. The term search becomes a misnomer since it has connotations that imply that it is possible to find what you are looking for. In such vast spaces the term search must be discarded. Thus, any attempt at searching for the highest peak in the fitness landscape as an optimal solution is also meaningless. Futhermore, even the very existence of a fitness landscape is fallacious. Although alternatives in the same region of the vast space can be compared to one another, distant alternatives will stem from radically different roots and will therefore not be comparable in any straightforward manner (Janssen 2000). Nevertheless we still have this tantalizing possibility that if a creative idea seems inevitable after the event, then somehow might the process be rserved? This may be as improbable as attempting to reverse time. A more helpful analogy is from nature, where it is generally assumed that the process of evolution is not long-term goal directed or teleological. Dennett points out a common minsunderstanding of Darwinism: the idea that evolution by natural selection is a procedure for producing human beings. Evolution can have produced humankind by an algorithmic process, without its being true that evolution is an algorithm for producing us. If we were to wind the tape of life back and run this algorithm again, the likelihood of "us" being created again is infinitesimally small (Gould 1989; Dennett 1995). But nevertheless Mother Nature has proved a remarkably successful, resourceful, and imaginative inventor generating a constant flow of incredible new design ideas to fire our imagination. Hence the current interest in the potential of the evolutionary paradigm in design. These evolutionary methods are frequently based on techniques such as the application of evolutionary algorithms that are usually thought of as search algorithms. It is necessary to abandon such connections with searching and see the evolutionary algorithm as a direct analogy with the evolutionary processes of nature. The process of natural selection can generate a wealth of alternative experiements, and the better ones survive. There is no one solution, there is no optimal solution, but there is continuous experiment. Nature is profligate with her prototyping and ruthless in her elimination of less successful experiments. Most importantly, nature has all the time in the world. As designers we cannot afford prototyping and ruthless experiment, nor can we operate on the time scale of the natural design process. Instead we can use the computer to compress space and time and to perform virtual prototyping and evaluation before committing ourselves to actual prototypes. This is the hypothesis underlying the evolutionary paradigm in design (1992, 1995).