716 resultados para Managing Arthritis


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Objective: To examine the prospective dose–response relationships between both leisure-time physical activity (LTPA) and walking with self-reported arthritis in older women. Design, setting and participants: Data came from women aged 73–78 years who completed mailed surveys in 1999, 2002 and 2005 for the Australian Longitudinal Study on Women’s Health. Women reported their weekly minutes of walking and moderate to vigorous physical activities. They also reported on whether they had been diagnosed with, or treated for, arthritis since the previous survey. General estimating equation analyses were performed to examine the longitudinal relationship between LTPA and arthritis and, for women who reported walking as their only physical activity, the longitudinal relationship between walking and arthritis. Women who reported arthritis or a limited ability to walk in 1999 were excluded, resulting in data from 3613 women eligible for inclusion in these analyses. Main results: ORs for self-reported arthritis were lowest for women who reported “moderate” levels of LTPA (OR 0.78; 95% CI 0.67 to 0.92), equivalent to 75 to <150 minutes of moderate-intensity LTPA per week. Slightly higher odds ratios were found for women who reported “high” (OR 0.81; 95% CI 0.69 to 0.95) or “very high” (OR 0.84; 95% CI 0.72 to 0.98) LTPA levels, indicating no further benefit from increased activity. For women whose only activity was walking, an inverse dose–response relationship between walking and arthritis was seen. Conclusions: The results support an inverse association between both LTPA and walking with self-reported arthritis over 6 years in older women who are able to walk.

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Background: Physical activity (PA) is recommended for managing osteoarthritis (OA). However, few people with OA are physically active. Understanding the factors associated with PA is necessary to increase PA in this population. This cross-sectional study examined factors associated with leisure-time PA, stretching exercises, and strengthening exercises in people with OA. Methods: For a mail survey, 485 individuals, aged 68.0 y (SD=10.6) with hip or knee OA, were asked about factors that may influence PA participation, including use of non-PA OA management strategies and both psychological and physical health-related factors. Associations between factors and each PA outcome were examined in multivariable logistic regression models. Results: Non-PA management strategies were the main factors associated with the outcomes. Information/education courses, heat/cold treatments, and paracetamol were associated with stretching and strengthening exercises (P<0.05). Hydrotherapy and magnet therapy were associated with leisure-time PA; using orthotics and massage therapy, with stretching exercises; and occupational therapy, with strengthening exercises (P<0.05). Few psychological or health15 related factors were associated with the outcomes. Conclusions: Some management strategies may make it easier for people with OA to be physically active, and could be promoted to encourage PA. Providers of strategies are potential avenues for recruiting people with OA into PA programs.

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Background: Methotrexate alone or in combination with other agents is the standard treatment for moderate-to-severe rheumatoid arthritis. As the biological agents are expensive, they are not usually used until methotrexate has failed to give a good response. Thus, there is scope for the development of cheaper drugs that can be used instead of methotrexate or in addition to methotrexate. Objectives/methods: Pamapimod is a p38α inhibitor being developed for use in the treatment of rheumatoid arthritis. The objective was to evaluate the recent clinical trials of pamapimod in subjects with rheumatoid arthritis. Results: There is no clear cut evidence that pamapimod alone or in the presence of methotrexate is efficacious in subjects with rheumatoid arthritis, but it does cause adverse effects. Conclusion: It is unlikely that pamapimod will be useful in the treatment of rheumatoid arthritis.

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Urban infrastructure along the hard forms such as roads, electricity, water and sewers also includes the soft forms such as research, training, innovation and technology. Knowledge and creativity are keys to soft infrastructure and socioeconomic development. Many city administrations around the world adjust their endogenous development strategies increasingly by investing in soft infrastructure and aiming for a knowledge-based development. At this point, the mapping and management of knowledge asset of cities has become a critical issue for promoting creative urban regions. The chapter scrutinizes the relations between knowledge assets and urban infrastructures and examines the management model to improve soft infrastructure provision.

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As organizations reach higher levels of Business Process Management maturity, they tend to collect numerous business process models. Such models may be linked with each other or mutually overlap, supersede one another and evolve over time. Moreover, they may be represented at different abstraction levels depending on the target audience and modeling purpose, and may be available in multiple languages (e.g. due to company mergers). Thus, it is common that organizations struggle with keeping track of their process models. This demonstration introduces AProMoRe (Advanced Process Model Repository) which aims to facilitate the management of (large) process model collections.

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Fatigue has been recognised as the primary contributing factor in approximately 15% of all fatal road crashes in Australia. To develop effective countermeasures for managing fatigue, this study investigates why drivers continue to drive when sleepy, and driver perceptions and behaviours in regards to countermeasures. Based on responses from 305 Australian drivers, it was identified that the major reasons why these participants continued to drive when sleepy were: wanting to get to their destination; being close to home; and time factors. Participants’ perceptions and use of 18 fatigue countermeasures were investigated. It was found that participants perceived the safest strategies, including stopping and sleeping, swapping drivers and stopping for a quick nap, to be the most effective countermeasures. However, it appeared that their knowledge of safe countermeasures did not translate into their use of these strategies. For example, although the drivers perceived stopping for a quick nap to be an effective countermeasure, they reported more frequent use of less safe methods such as stopping to eat or drink and winding down the window. This finding suggests that, while practitioners should continue educating drivers, they may need a greater focus on motivating drivers to implement safe fatigue countermeasures.

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Background: Violence in health care has been widely reported and health care workers, particularly nurses in acute care settings, are ill-equipped to manage patients who exhibit aggressive traits. Aim: The aim of this systematic review was to establish best practice in the prevention and management of aggressive behaviours in patients admitted to acute hospital settings. Data Sources: An extensive search of the major databases was conducted from 1990 to 2007. The search included published and unpublished studies and papers in English. Review Methods: This review considered any quantitative research study design that evaluated the effectiveness of interventions in the prevention and management of patients who exhibit aggressive behaviours in an acute hospital setting. Each included study was quality assessed by two independent reviewers and data were extracted using the relevant tools developed by the Joanna Briggs Institute. Results: Ten studies met the inclusion criteria and were included in the review. The evidence identified from the studies includes: the benefit of education and training of acute care nurses in aggression management techniques; use of “as required” medications is effective in minimising harm to patients and staff; and that specific interventions such as physical restraint may play a role in managing aggressive behaviours from patients in the acute care setting. Conclusions: This review makes several recommendations for the prevention and management of aggressive behaviours in acute hospital patients. However, due to the lack of high-quality studies conducted in the acute care setting there is huge scope for future research in this area.

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Efficient and effective urban management systems for Ubiquitous Eco Cities require having intelligent and integrated management mechanisms. This integration includes bringing together economic, socio-cultural and urban development with a well orchestrated, transparent and open decision making mechanism and necessary infrastructure and technologies. In the Ubiquitous Eco Cities, telecommunication technologies plan an important role in monitoring and managing activities over wired, wireless and fibre-optic networks. particularly technology convergence creates new ways in which the information and telecommunication technologies are used and formed the back bone or urban management systems. The research paper reports and introduces recent approaches on urban management systems, such as intelligent urban management systems, that are suitable for Ubiquitous Eco Cities.

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Purpose: The purpose of this paper is to illustrate the various types of paradoxes underlying the nature of creativity, which in turn affect the foundations of organizations and organization change in the 21 st century. The film industry best illustrate the interaction of such paradoxes, creativity and organizational change. This paper examines how small and medium-sized finns in the emerging Singapore film industry stay competitive by managing or not managing these paradoxes. Design/methodology/approach: The study reported in this paper explores the opinions, attitudes and experiences of key decision-makers in the Singaporean film industry. Findings: This paper introduces the idea that an analysis of the various paradoxes driven by creativity in today's society provides hints on a deeper understanding of organizational change and development in the 21" century. Practical implications: The findings indicate that managers need practical tools that will enable them to comprehend and better manage these emerging contradictions and fully understand the implications of paradoxical situations and organizational change. Research limitations: The distinctive nature of the Singaporean firms means that certain factors examined may be more or less significant in the film industry in other countries. Originality/value: The value of this paper lies in the knowledge that paradox considerations are becoming significant in understanding pluralism and the processes of organizational change.

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While Business Process Management (BPM) is an established discipline, the increased adoption of BPM technology in recent years has introduced new challenges. One challenge concerns dealing with the ever-growing complexity of business process models. Mechanisms for dealing with this complexity can be classified into two categories: 1) those that are solely concerned with the visual representation of the model and 2) those that change its inner structure. While significant attention is paid to the latter category in the BPM literature, this paper focuses on the former category. It presents a collection of patterns that generalize and conceptualize various existing mechanisms to change the visual representation of a process model. Next, it provides a detailed analysis of the degree of support for these patterns in a number of state-of-the-art languages and tools. This paper concludes with the results of a usability evaluation of the patterns conducted with BPM practitioners.

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In December 2006, the Engineering and Technology Group of Queensland’s Department of Main Roads entered into a three-year skid resistance management research project with QUT Faculty of Built Environment and Engineering researchers and the QUT-based CRC for Integrated Engineering Asset Management (CIEAM). CIEAM undertakes a broad range of asset management research in the areas of defence, utilities, transportation and industrial processes. “The research project is an important activity of Main Roads’ Skid Resistance Management Plan published in June 2006.” said Main Roads project leader Mr Justin Weligamage. “The intended project output is a decision-support model for use by Road Asset Managers throughout a road network. The research objective is to enable road asset managers to better manage the surfacing condition of the road asset with specific focus on skid resistance,” said QUT project leader Professor Arun Kumar. The research project will review existing skid resistance investigatory levels, develop a risk-based method to establish skid resistance investigatory levels and improve the decision support methodology in order to minimise crashes. The new risk-based approach will be used to identify locations on the Queensland state-controlled road network that may have inadequate skid resistance. Once a high risk site is identified, the appropriate remedial action will be decided on. This approach will allow road asset managers to target optimal remedial actions, reducing the incidence and severity of crashes where inadequate skid resistance is a contributing cause.

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In recent years, there is a dramatic growth in number and popularity of online social networks. There are many networks available with more than 100 million registered users such as Facebook, MySpace, QZone, Windows Live Spaces etc. People may connect, discover and share by using these online social networks. The exponential growth of online communities in the area of social networks attracts the attention of the researchers about the importance of managing trust in online environment. Users of the online social networks may share their experiences and opinions within the networks about an item which may be a product or service. The user faces the problem of evaluating trust in a service or service provider before making a choice. Recommendations may be received through a chain of friends network, so the problem for the user is to be able to evaluate various types of trust opinions and recommendations. This opinion or recommendation has a great influence to choose to use or enjoy the item by the other user of the community. Collaborative filtering system is the most popular method in recommender system. The task in collaborative filtering is to predict the utility of items to a particular user based on a database of user rates from a sample or population of other users. Because of the different taste of different people, they rate differently according to their subjective taste. If two people rate a set of items similarly, they share similar tastes. In the recommender system, this information is used to recommend items that one participant likes, to other persons in the same cluster. But the collaborative filtering system performs poor when there is insufficient previous common rating available between users; commonly known as cost start problem. To overcome the cold start problem and with the dramatic growth of online social networks, trust based approach to recommendation has emerged. This approach assumes a trust network among users and makes recommendations based on the ratings of the users that are directly or indirectly trusted by the target user.

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Competitive markets are increasingly driving new initiatives for shorter cycle times resulting in increased overlapping of project phases. This, in turn, necessitates improving the interfaces between the different phases to be overlapped (integrated), thus allowing transfer of processes, information and knowledge from one individual or team to another. This transfer between phases, within and between projects, is one of the basic challenges to the philosophy of project management. To make the process transfer more transparent with minimal loss of momentum and project knowledge, this paper draws upon Total Quality Management (TQM) and Business Process Re-engineering (BPR) philosophies to develop a Best Practice Model for managing project phase integration. The paper presents the rationale behind the model development and outlines its two key parts; (1) Strategic Framework and (2) Implementation Plan. Key components of both the Strategic Framework and the Implementation Plan are presented and discussed.

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Technology-oriented young firms play an important role for innovation and commercialisation of new ideas. These firms are often founded by engineers, scientists or academics who posses great scientific/technological knowledge, but limited know-how in other aspects of managing a business including knowledge management. Successful managing and integrating their specialised knowledge is of particular importance when it comes to developing a new product or process. This article therefore focuses on the particularities of the knowledge management process in technopreneurial firms. Using a qualitative investigation from a sample of Australian SMEs, a number of key observations are derived which show the challenges of managing knowledge and how important knowledge management is as a management tool for R&D and innovation process in technology-oriented SMEs. Findings suggest that knowledge management and integration processes in these firms are very much project focused and mainly based on ad hoc and informal processes and not embedded within the overall organisational routines.

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The ways in which a society set standards of behaviour and of conduct for its members vary hugely. For example, accepted practices, recognised customs, spiritually or morally inspired norms, judicially declared rules, executively formulated edicts, formal legislative enactments or constitutionally embedded rights and duties. Whatever form they assume, these standards are the artificial construction of the human mind. Accordingly the law - whatever its form - can do no more and no less than regulate or set standards for human behaviour, human conduct, and human decision-making. The law cannot regulate the environment. It can only regulate human activities that impact directly or indirectly upon the environment. This applies as much to wetlands as components of the environment as it does to any other components of the environment or the environment at large. The capacity of the law to protect the environment and therefore wetlands is thus totally dependent upon the capacity of the law to regulate human behaviour, human conduct and human decision-making. At the same time the law needs to reflect the specific nature, functions and locations of wetlands. A wetland is an ecosystem by itself; it comprises a range of ecosystems within it; and it is part of a wider set of ecosystems. Hence, the significant ecological functions performed by wetlands. Then there are the benefits flowing to humans from wetlands. These may be social, economic, cultural, aesthetic, or a combination of some or of all of these. It is a challenge for a society acting through its legal system to find the appropriate balance between these ecological and these human values. But that is what sustainability requires.The ways in which a society set standards of behaviour and of conduct for its members vary hugely. For example, accepted practices, recognised customs, spiritually or morally inspired norms, judicially declared rules, executively formulated edicts, formal legislative enactments or constitutionally embedded rights and duties. Whatever form they assume, these standards are the artificial construction of the human mind. Accordingly the law - whatever its form - can do no more and no less than regulate or set standards for human behaviour, human conduct, and human decision-making. The law cannot regulate the environment. It can only regulate human activities that impact directly or indirectly upon the environment. This applies as much to wetlands as components of the environment as it does to any other components of the environment or the environment at large. The capacity of the law to protect the environment and therefore wetlands is thus totally dependent upon the capacity of the law to regulate human behaviour, human conduct and human decision-making. At the same time the law needs to reflect the specific nature, functions and locations of wetlands. A wetland is an ecosystem by itself; it comprises a range of ecosystems within it; and it is part of a wider set of ecosystems. Hence, the significant ecological functions performed by wetlands. Then there are the benefits flowing to humans from wetlands. These may be social, economic, cultural, aesthetic, or a combination of some or of all of these. It is a challenge for a society acting through its legal system to find the appropriate balance between these ecological and these human values. But that is what sustainability requires.