Perception of dysphagia: lack of correlation with objective measurements of esophageal function

Background The mechanism underlying increased perception of food bolus passage in the absence of esophageal mechanical obstruction has not been completely elucidated. A correlation between the intensity of the symptom and the severity of esophageal dysfunction, either motility (manometry) or bolus transit (impedance) has not been clearly demonstrated. The aim of this study was to analyze the correlation between objective esophageal function assessment (with manometry and impedance) and perception of bolus passage in healthy volunteers (HV) with normal and pharmacologically-induced esophageal hypocontractility, and in patients with gastro-esophageal reflux disease (GERD) with and without ineffective esophageal motility (IEM). Methods Combined manometry-impedance was performed in 10 HV, 19 GERD patients without IEM and nine patients with IEM. Additionally, nine HV were studied after 50 mg sildenafil, which induced esophageal peristaltic failure. Perception of each 5 mL viscous swallow was evaluated using a 5-point scale. Manometry identified hypocontractility (contractions lower than 30 mmHg) and impedance identified incomplete bolus clearance. Key Results In HV and in GERD patients with and without IEM, there was no association between either manometry or impedance and perception on per swallow analysis (OR: 0.842 and OR: 2.017, respectively), as well as on per subject analysis (P = 0.44 and P = 0.16, respectively). Lack of correlation was also found in HV with esophageal hypocontractility induced by sildenafil. Conclusions & Inferences There is no agreement between objective measurements of esophageal function and subjective perception of bolus passage. These results suggest that increased bolus passage perception in patients without mechanical obstruction might be due to esophageal hypersensitivity.

Economic incentives for global conservation of wildlife: New international policy directions

Growing economic globalisation by extending the operation of markets is a two-edged sword as far as nature conservation is concerned. In some circumstances, it threatens the conservation of nature and in other cases, it provides economic incentives that foster the conservation of biodiversity. This article shows how global policy directions have altered in that regard. Initially the World Conservation Union (IUCN) favoured bans on trade in endangered species. This view was enshrined in the Convention on International Trade in Endangered Species (CITES). Subsequently, with the upsurge of support for market-based economic liberalism, IUCN recognised that economic and market incentives, if linked to appropriate property rights, could foster biodiversity conservation. This is reflected in the International Convention on Biological Diversity. While there is conflict between this convention and CITES, its extent has been exaggerated. As explained, in certain cases, trade restrictions of the type adopted in CITES are appropriate for nature conservation whereas the market-oriented policy of the Convention on Biological Diversity can be effective in some different situations. Whether or not the extension of markets in wildlife and wildlife products and growing economic globalisation favours nature conservation varies according to the circumstances.

Holocene sediments of Wistari Reef: towards a global quantification of coral reef related neritic sedimentation in the Holocene

Wistari Reef. within the southern Great Barrier Reef. is a shallow coral reef platform featuring a very clearly defined leeward accretionary wedge of carbonate sediments. The total global area of shallowly submerged coral reef has been quantified as 255 000 km(2). The question then becomes: What additional area of sediment of significant thickness is associated with the measured shallow reef areas T At Wistari Reef, the leeward sedimentary wedge has an area and a thickness that are roughly equal to the Holocene sediments that have accumulated on the platform. Several important observations can be made from these data. Firstly. the area of significant neritic carbonate sedimentation ( > 1 m/ka) associated with coral reefs is near 500000 km(2). Secondly, the production rate of neritic carbonates at Wistari Reef is almost 50%, less than the accumulation rate needed to obtain the volume of Holocene reef sediments observed. This implies that both production and accumulation neritic carbonate must have been more than a factor of two higher in the early to mid Holocene. (C) 2001 Elsevier Science B.V. All rights reserved.

An exploratory study of gendered differences in young tourists perception of danger within London

This paper studies young tourists' perception of danger within the urban holiday environment of London, England. The study of perceived danger is important not only in its own right, but also because of the influence it may have on use of leisure spaces and times. This research assesses gender and group composition differences in perception of danger, addressing the relatively neglected issues of men's perception and the relationship between the genders. For the purpose of this paper 'danger' was assessed by studying how safe, relaxed, vulnerable, threatened, and at risk people felt while in London. The study found a number of similarities and differences between the men and women studied, in terms of how they perceived danger and their group composition during the day and nigh-time. These results indicate that gender may not be the only influence on perception and behaviour, and that men and women should not be regarded as-homogenous cohorts. (C) 2001 Elsevier Science Ltd. All rights reserved.

The effect of videoconferencing on the depth perception of observers

The ability of the human eye to perceive depth was measured using a specially designed instrument. Visual acuity and both monocular and binocular stereoacuity were measured when viewing the instrument directly and via a videoconferencing link. Ten subjects with an average age of 32.5 years (range 24-50) took part in the study. The group mean visual acuity using both eyes under normal test conditions was -0.04 logMAR (Snellen 6/5) compared with 0.18 logMAR (Snellen 6/10) for the video-link. The mean stereoacuity using both eyes was 37 (SD 18) under normal test conditions. When a videoconferencing link was used, the mean stereoacuity fell to 1218 (SD 1203) using one eye and to 1651 (SD 1419) using both eyes. The ability to perceive depth remotely via a video-link was significantly decreased compared with normal test conditions.

When emergent countries reform global governance of climate change: Brazil under Lula

Due to its recent economic success, Brazil is considered an emerging country, but is it an emerging power concerning global environmental governance? This article argues that although Brazil has a sui generis profile, it can only be considered an emerging power in some environmental regimes, such as global climate change. Thus, international relations theory needs more analytical instruments to assess the impact of emerging powers in global environmental governance

Residents’ perception of the benefits of cultural tourism: the case of Guimarães

In many cities throughout Europe and the rest of the world, cultural tourism plays a major role in local economic development. Tourism also acts to preserve cultural heritage, as it provides a way to acquire the revenue needed to restore and preserve historical buildings, and encourages local people to value their traditions and festivals. However, tourism success can be a double-edged sword with tourist flows having a strong impact on the quality of life of residents when certain tourist thresholds are surpassed. This paper aims to address local residents’ perception of the benefits of cultural tourism. To capture their perception, a survey was implemented, addressed to both the city centre inhabitants and the non-urban residents of the Guimarães municipality.

The impact of improvement of water supply and sanitation facilities on diarrhea and intestinal parasites: a Brazilian experience with children in two low-income urban communities

During the second half of 1986 the impact of the improvement of water supply and excreta disposal facilities on diarrheal diseases and intestinal parasitosis was studied in 254 children up to six years of age from two favelas (shanty towns) of Belo Horizonte, Brazil. The estimated incidence of diarrhea was 6.2 episodes/child year and the estimated period prevalence reached 31.0 episode days/ child/ year. The point prevalence of parasitosis was 70.7% (Ascaris lumbricoides: 55.4%, Trichuris trichiura: 19.6%, Giardia lamblia: 17.9%). The estimated prevalence of diarrhea decreased with improvement of water supply and sanitation facilities to 45% and 44% respectively, but no statistically significant impact was observed in the case of parasitosis. School education and weaning practice were found to be other important determinants of diarrhea.

Implications of the Intervention Program for Physical Activity (IPPA) in the perception of illness and wellbeing in people with Multiple Sclerosis (MS)

The aim of this study is to examine the implications of the IPPA in the perception of illness and wellbeing in MS patients. Methods - This is a quasi experimental study non-randomized study with 24 MS patients diagnosed at least 1 year before, and with an EDSS score of under 7. We used the IPPA in 3 groups of eight people in 3 Portuguese hospitals (Lisbon, Coimbra, and Porto). The sessions were held once a week for 90 minutes, over a period of 7 weeks. The instruments used were: We asked the subjects the question “Please classify the severity of your disease?” and used the Personal Wellbeing Scale (PWS) at the beginning (time A) and end (time B) of the IPPA. We used the SPSS version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. Results – The results suggest that there are differences between time A and B, the perception of illness decreased (p<0.08), while wellbeing increased (p<0.01). Conclusions: The IPPA can play an important role in modifying the perception of disease severity and personal wellbeing.

Dynamic global scheduling of parallel real-time tasks

High-level parallel languages offer a simple way for application programmers to specify parallelism in a form that easily scales with problem size, leaving the scheduling of the tasks onto processors to be performed at runtime. Therefore, if the underlying system cannot efficiently execute those applications on the available cores, the benefits will be lost. In this paper, we consider how to schedule highly heterogenous parallel applications that require real-time performance guarantees on multicore processors. The paper proposes a novel scheduling approach that combines the global Earliest Deadline First (EDF) scheduler with a priority-aware work-stealing load balancing scheme, which enables parallel realtime tasks to be executed on more than one processor at a given time instant. Experimental results demonstrate the better scalability and lower scheduling overhead of the proposed approach comparatively to an existing real-time deadline-oriented scheduling class for the Linux kernel.

A synchronous transition protocol with periodicity for global scheduling of multimode real-time systems on multiprocessors

We consider the global scheduling problem of multimode real-time systems upon identical multiprocessor platforms. During the execution of a multimode system, the system can change from one mode to another such that the current task set is replaced with a new task set. Thereby, ensuring that deadlines are met requires not only that a schedulability test is performed on tasks in each mode but also that (i) a protocol for transitioning from one mode to another is specified and (ii) a schedulability test for each transition is performed. In this paper, we extend the synchronous transition protocol SM-MSO in order to take into account mode-independent tasks [1], i.e., tasks of which the execution pattern must not be jeopardized by the mode changes.