General practitioners’ management of the long-term sick role

In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees / patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons’s model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

Multi-bubble sonoluminescence: Laboratory curiosity, or real world application?

Sonoluminescence (SL) involves the conversion of mechanical [ultra]sound energy into light. Whilst the phenomenon is invariably inefficient, typically converting just 10^-4 of the incident acoustic energy into photons, it is nonetheless extraordinary, as the resultant energy density of the emergent photons exceeds that of the ultrasonic driving field by a factor of some 10 ¹². Sonoluminescence has specific [as yet untapped] advantages in that it can be effected at remote locations in an essentially wireless format. The only [usual] requirement is energy transduction via the violent oscillation of microscopic bubbles within the propagating medium. The dependence of sonoluminescent output on the generating sound field's parameters, such as pulse duration, duty cycle, and position within the field, have been observed and measured previously, and several relevant aspects are discussed presently. We also extrapolate the logic from a recently published analysis relating to the ensuing dynamics of bubble 'clouds' that have been stimulated by ultrasound. Here, the intention was to develop a relevant [yet computationally simplistic] model that captured the essential physical qualities expected from real sonoluminescent microbubble clouds. We focused on the inferred temporal characteristics of SL light output from a population of such bubbles, subjected to intermediate [0.5-2MPa] ultrasonic pressures. Finally, whilst direct applications for sonoluminescent light output are thought unlikely in the main, we proceed to frame the state-of-the- art against several presently existing technologies that could form adjunct approaches with distinct potential for enhancing present sonoluminescent light output that may prove useful in real world [biomedical] applications.

Effects of peer network interactions on adolescent cannabis use

Purpose
This study capitalises on three waves of longitudinal data from a cohort of 4351 secondary school pupils to examine the effects on individuals’ cannabis use uptake of both peer cannabis use and position within a peer network.

Design/methodology/approach
Both cross-sectional and individual fixed effects models are used to estimate the effect on cannabis use of nominated friends’ cannabis use, of reciprocity and transitivity of nominations across the friendship cluster, and of interactions between these nominated friends. Post hoc analyses parsed the behaviour of reciprocating and non-reciprocating friends.

Findings
Cannabis use varied depending on the stability of friendship network and the degree of reciprocity and interconnectedness within the group. Behavioural influence was strong, but interaction effects were observed between the prevalence of cannabis use among friends, the structure of the friendship group and ego’s proximity to group members. These interactions demonstrate that behavioural influence is more salient in more cohesive groups. When reciprocating and non-reciprocating friends’ mean cannabis use were separated, influence from reciprocating friends was estimated at twice the magnitude of other friends.

Originality/value
While preventing any one individual from using cannabis is likely to have a multiplier effect on classmates, the bonds and interactions between classmates will determine which classmates are affected by this multiplier and the salience of that effect.

Prying into the intimate secrets of animal lives; software beyond hardware for comprehensive annotation in 'Daily Diary' tags

BACKGROUND: Smart tags attached to freely-roaming animals recording multiple parameters at infra-second rates are becoming commonplace, and are transforming our understanding of the way wild animals behave. Interpretation of such data is complex and currently limits the ability of biologists to realise the value of their recorded information.

DESCRIPTION: This work presents Framework4, an all-encompassing software suite which operates on smart sensor data to determine the 4 key elements considered pivotal for movement analysis from such tags (Endangered Species Res 4: 123-37, 2008). These are; animal trajectory, behaviour, energy expenditure and quantification of the environment in which the animal moves. The program transforms smart sensor data into dead-reckoned movements, template-matched behaviours, dynamic body acceleration-derived energetics and position-linked environmental data before outputting it all into a single file. Biologists are thus left with a single data set where animal actions and environmental conditions can be linked across time and space.

CONCLUSIONS: Framework4 is a user-friendly software that assists biologists in elucidating 4 key aspects of wild animal ecology using data derived from tags with multiple sensors recording at high rates. Its use should enhance the ability of biologists to derive meaningful data rapidly from complex data.

Efeitos da toxicidade por metais pesados em Rhizobium leguminosarum bv. trifolii: diversidade e resposta de população isoladas de uma mina de chumbo

Nas últimas décadas verificou-se um aumento da contaminação dos solos com metais pesados resultante de processos antropogénicos. As descargas de efluentes industriais, a actividade mineira e a aplicação de lamas residuais e de fertilizantes são as principais fontes de metais pesados. Em certas regiões, a acumulação destes elementos nos solos tem atingido níveis preocupantes para o equilíbrio dos ecossistemas. Vários estudos têm demonstrado que os metais influenciam os microrganismos afectando adversamente o seu crescimento, morfologia e actividades bioquímicas resultando num decréscimo da biomassa e diversidade. Entre os microrganismos do solo, as bactérias pertencentes ao género Rhizobium têm um elevado interesse científico, económico e ecológico devido à sua capacidade para fixar azoto. Deste modo, o trabalho desenvolvido ao longo desta tese incidiu sobre o efeito da toxicidade imposta pelos metais nas bactérias fixadoras de azoto, em particular em Rhizobium leguminosarum bv. trifolii e teve como principais objectivos: determinar o efeito dos metais pesados na sobrevivência e na capacidade de fixar azoto dos isolados de rizóbio; avaliar a influência dos metais na diversidade das populações de rizóbio isoladas de solos contaminados; determinar os níveis de tolerância do rizóbio a diferentes metais e analisar a resposta ao stresse oxidativo imposto pelo cádmio. A Mina do Braçal foi o local de estudo escolhido uma vez que os seus solos estão muito contaminados com metais em resultado da extracção de minério durante mais de 100 anos. Foram escolhidos 3 solos com diferentes graus de contaminação, o solo BC com concentrações reduzidas de metais, escolhido por estar numa zona já fora da mina e designado por solo controlo e os solos BD e BA considerados medianamente e muito contaminados, respectivamente. O Pb e o Cd foram os metais predominantes nestes solos, assim como o metalóide As, cujas concentrações ultrapassaram largamente os limites previstos na lei. Sendo as enzimas do solo boas indicadoras da qualidade do mesmo, foi determinada a actividade de algumas como a desidrogenase (DHA) e a catalase (CAT). Ambas as enzimas correlacionaramse negativamente com as concentrações de metais nos solos. A dimensão das populações indígenas de rizóbio nos solos contaminados (BD e BA) foi bastante baixa, 9,1 bactérias g-1 de solo e 7,3 bactérias g-1 de solo, respectivamente, quando em comparação com a população do solo BC (4,24x104 bactérias g-1 de solo). Estes resultados parecem estar relacionados com o elevado conteúdo em metais e com o pH ácido dos solos. A capacidade simbiótica também foi afectada pela presença de metais, uma vez que os isolados originários do solo BD mostraram menor capacidade em fixar azoto do que os isolados do solo controlo. A diversidade das populações de rizóbio foi determinada com recurso à análise dos perfis de plasmídeos, perfis de REP e ERIC-PCR de DNA genómico e perfis de proteínas e lipopolissacarídeos. No conjunto dos 35 isolados analisados foram identificados 11 plasmídeos com pesos moleculares entre 669 kb e 56 kb. Embora a incidência de plasmídeos tenha sido superior nos isolados do solo BC verificou-se maior diversidade plasmídica na população isolada do solo BD. Resultados similares foram obtidos com os perfis de REP e ERIC-PCR e perfis de proteínas, que indicaram maior diversidade nas populações dos solos contaminados (BD e BA), contrariamente ao verificado por outros autores. O grau de tolerância aos metais pesados e ao arsénio dos vários isolados testados dependeu do metal e do local de origem. No geral, os isolados do solo BD mostraram maior tolerância aos metais do que os isolados do solo controlo, o que está de acordo com o esperado uma vez que geralmente as populações dos locais contaminados são mais tolerantes. Contudo, os isolados do local mais contaminado (BA) foram muito tolerantes apenas ao chumbo mostrando-se sensíveis aos restantes metais. A inoculação dos solos BC, BD e BA após irradiação com estirpes seleccionadas de rizóbio permitiu avaliar a sua sobrevivência ao longo de 12 meses em condições mais realistas. Verificou-se que após um decréscimo inicial, os isolados inoculados no solo BC conseguiram recuperar a dimensão das suas populações para números similares aos inicialmente introduzidos, contrariamente ao verificado no solo BD onde o número de rizóbios decresceu ao longo dos 12 meses. As condições adversas do solo BA apenas permitiram a sobrevivência de 4 isolados até aos 3 meses e apenas dois deles conseguiram sobreviver após 12 meses, designadamente C 3-1 e A 17-3. Estes isolados possuem um plasmídeo de 669 kb que poderá estar na base da sobrevivência destas estirpes. Por outro lado, o último isolado é originário do solo contaminado e por isso estará também mais adaptado a sobreviver às elevadas concentrações de Pb existentes no solo BA. Por fim, constatou-se que o cádmio, um dos metais presente em concentrações mais elevadas nos solos em estudo, é um indutor de stresse oxidativo nos isolados de rizóbio menos tolerantes o que foi confirmado pelo aumento de ROS e danos celulares ao nível dos lípidos.

Cooperative positioning for heterogeneous wireless systems

Future emerging market trends head towards positioning based services placing a new perspective on the way we obtain and exploit positioning information. On one hand, innovations in information technology and wireless communication systems enabled the development of numerous location based applications such as vehicle navigation and tracking, sensor networks applications, home automation, asset management, security and context aware location services. On the other hand, wireless networks themselves may bene t from localization information to improve the performances of di erent network layers. Location based routing, synchronization, interference cancellation are prime examples of applications where location information can be useful. Typical positioning solutions rely on measurements and exploitation of distance dependent signal metrics, such as the received signal strength, time of arrival or angle of arrival. They are cheaper and easier to implement than the dedicated positioning systems based on ngerprinting, but at the cost of accuracy. Therefore intelligent localization algorithms and signal processing techniques have to be applied to mitigate the lack of accuracy in distance estimates. Cooperation between nodes is used in cases where conventional positioning techniques do not perform well due to lack of existing infrastructure, or obstructed indoor environment. The objective is to concentrate on hybrid architecture where some nodes have points of attachment to an infrastructure, and simultaneously are interconnected via short-range ad hoc links. The availability of more capable handsets enables more innovative scenarios that take advantage of multiple radio access networks as well as peer-to-peer links for positioning. Link selection is used to optimize the tradeo between the power consumption of participating nodes and the quality of target localization. The Geometric Dilution of Precision and the Cramer-Rao Lower Bound can be used as criteria for choosing the appropriate set of anchor nodes and corresponding measurements before attempting location estimation itself. This work analyzes the existing solutions for node selection in order to improve localization performance, and proposes a novel method based on utility functions. The proposed method is then extended to mobile and heterogeneous environments. Simulations have been carried out, as well as evaluation with real measurement data. In addition, some speci c cases have been considered, such as localization in ill-conditioned scenarios and the use of negative information. The proposed approaches have shown to enhance estimation accuracy, whilst signi cantly reducing complexity, power consumption and signalling overhead.

Disparity energy model with keypoint disparity validation

A biological disparity energy model can estimate local depth information by using a population of V1 complex cells. Instead of applying an analytical model which explicitly involves cell parameters like spatial frequency, orientation, binocular phase and position difference, we developed a model which only involves the cells’ responses, such that disparity can be extracted from a population code, using only a set of previously trained cells with random-dot stereograms of uniform disparity. Despite good results in smooth regions, the model needs complementary processing, notably at depth transitions. We therefore introduce a new model to extract disparity at keypoints such as edge junctions, line endings and points with large curvature. Responses of end-stopped cells serve to detect keypoints, and those of simple cells are used to detect orientations of their underlying line and edge structures. Annotated keypoints are then used in the leftright matching process, with a hierarchical, multi-scale tree structure and a saliency map to segregate disparity. By combining both models we can (re)define depth transitions and regions where the disparity energy model is less accurate.

Biblioteca de navegação autónoma baseada em campos de potencial

Trabalho de Final de Mestrado para obtenção do grau de Mestre em Engenharia Informática e de Computadores

Antioxidant properties of hydroxycinnamic acids: a review of structure- activity relationships

Hydroxycinnamic acids (HCAs) are important phytochemicals possessing significant biological properties. Several investigators have studied in vitro antioxidant activity of HCAs in detail. In this review, we have gathered the studies focused on the structure-activity relationships (SARs) of these compounds that have used medicinal chemistry to generate more potent antioxidant molecules. Most of the reports indicated that the presence of an unsaturated bond on the side chain of HCAs is vital to their activity. The structural features that were reported to be of importance to the antioxidant activity were categorized as follows: modifications of the aromatic ring, which include alterations in the number and position of hydroxy groups and insertion of electron donating or withdrawing moieties as well as modifications of the carboxylic function that include esterification and amidation process. Furthermore, reports that have addressed the influence of physicochemical properties including redox potential, lipid solubility and dissociation constant on the antioxidant activity were also summarized. Finally, the pro-oxidant effect of HCAs in some test systems was addressed. Most of the investigations concluded that the presence of ortho-dihydroxy phenyl group (catechol moiety) is of significant importance to the antioxidant activity, while, the presence of three hydroxy groups does not necessarily improve the activity. Optimization of the structure of molecular leads is an important task of modern medicinal chemistry and its accomplishment relies on the careful assessment of SARs. SAR studies on HCAs can identify the most successful antioxidants that could be useful for management of oxidative stress-related diseases.

Observatório de favelas (Rio de Janeiro): a comunicação institucional e a comunicação para o desenvolvimento

Relatório de estágio apresentado à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Gestão Estratégica das Relações Públicas.

Standard commercial education robotic platform: intermediate solution to teaching robotics

Teaching robotics to students at the beginning of their studies has become a huge challenge. Simulation environments can be an effective solution to that challenge where students can interact with simulated robots and have the first contact with robotic constraints. From our previous experience with simulation environments it was possible to observe that students with lower background knowledge in robotics where able to deal with a limited number of constraints, implement a simulated robotic platform and study several sensors. The question is: after this first phase what should be the best approach? Should the student start developing their own hardware? Hardware development is a very important part of an engineer's education but it can also be a difficult phase that could lead to discouragement and loss of motivation in some students. Considering the previous constraints and first year engineering students’ high abandonment rate it is important to develop teaching strategies to deal with this problem in a feasible way. The solution that we propose is the integration of a low-cost standard robotic platform WowWee Rovio as an intermediate solution between the simulation phase and the stage where the students can develop their own robots. This approach will allow the students to keep working in robotic areas such as: cooperative behaviour, perception, navigation and data fusion. The propose approach proved to be a motivation step not only for the students but also for the teachers. Students and teachers were able to reach an agreement between the level of demand imposed by the teachers and satisfaction/motivation of the students.

How to invest as a private equity

This work project presents a road map for making deals under the umbrella support of a private equity investor. Fundraising, investment analysis, asset monitoring, and divestment are stages in the process that are covered in-depth and clarified in terms of action plan and procedures. Moreover, private equity brings tangible and intangible efficiency to the economy and companies, not only by providing finance to grow and expand but also by forcing superior organizational organics that foster sustainable business positions. In a world domain, Europe as been a second liner as compared to US in terms of size within the private equity sector, but it is quickly maturing and converging to US numbers. In this sense, Portugal has been improving in both numbers and regulations in order to leverage on its strategic location and position itself as a key player to address future business challenges coming from emerging markets such as Africa and Latin America.

Spatially selective implementation of the adiabatic T2 prep sequence for magnetic resonance angiography of the coronary arteries.

In coronary magnetic resonance angiography, a magnetization-preparation scheme for T2 -weighting (T2 Prep) is widely used to enhance contrast between the coronary blood-pool and the myocardium. This prepulse is commonly applied without spatial selection to minimize flow sensitivity, but the nonselective implementation results in a reduced magnetization of the in-flowing blood and a related penalty in signal-to-noise ratio. It is hypothesized that a spatially selective T2 Prep would leave the magnetization of blood outside the T2 Prep volume unaffected and thereby lower the signal-to-noise ratio penalty. To test this hypothesis, a spatially selective T2 Prep was implemented where the user could freely adjust angulation and position of the T2 Prep slab to avoid covering the ventricular blood-pool and saturating the in-flowing spins. A time gap of 150 ms was further added between the T2 Prep and other prepulses to allow for in-flow of a larger volume of unsaturated spins. Consistent with numerical simulation, the spatially selective T2 Prep increased in vivo human coronary artery signal-to-noise ratio (42.3 ± 2.9 vs. 31.4 ± 2.2, n = 22, P < 0.0001) and contrast-to-noise-ratio (18.6 ± 1.5 vs. 13.9 ± 1.2, P = 0.009) as compared to those of the nonselective T2 Prep. Additionally, a segmental analysis demonstrated that the spatially selective T2 Prep was most beneficial in proximal and mid segments where the in-flowing blood volume was largest compared to the distal segments. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.

What motivates registered nurses to participate in continuing education activities?

The study was undertaken to identify what motivates registered nurses to participate in continuing education activities. The primary questions were whether basic nursing education, employment status, clinical area, and position, as well as readiness for selfdirected learning influenced Canadian nurses' motivational orientations when deciding to participate in continuing education activities. Other individual differences (e.g., age) were also examined. The sample included 142 registered nurses employed at an urban community hospital. Three instruments were used for data collection: the Education Participation Scale, the Self-Directed Learning Readiness Scale, and a nursing survey consisting of demographic questions. Basic nursing education and employment status did not effect motivational orientation or self-directed learning readiness. Clinical area and level of position significantly influenced nurses' decisions to participate in continuing education activities. Motivational orientation had a significant relationship with selfdirected learning readiness. Implications for practice as a result of this study involves program planning and delivery. The identification of the motivational orientations of participants may assist in the development and delivery of continuing education programs that are beneficial, relevant, and address the identified learning needs of participants. Implications for future research also exist in relation to studying different groups of nurses, for example, registered nursing assistants, and investigating related issues, for example, what are the deterrents to participation in continuing education?