888 resultados para end-to-end


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The ongoing, potentially worsening problem of sexual violence and harassment on university campuses has emerged in the last few years as an area of concern. Female students have been identified as one of the most likely groups to experience sexual violence and this violence is exacerbated by contemporary student cultures around alcohol consumption and gendered and sexual norms. University campuses have also become central to prevention efforts in many countries due to their relatively accessible populations and an ability to implement social policies at an institutional level.
Many of these measures are based around promoting or educating students about sexual consent, and particularly notions of affirmative consent, expressed as ‘Yes means Yes’. However, there exists little research around sexual ethics with students exploring whether consent is in fact the best way to tackle cultural problems of sexual violence on campus. This paper makes use of existing literature on sexual ethics and focus group research undertaken with Australian university students to argue for an approach to the problem of sexual ethics on campus that is broader than simply focusing on training programs in sexual consent. It identifies a number of limitations to the consent framework and argues that prevention efforts need to more seriously engage with broader cultural norms around heterosexuality and gendered relationships.

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We report the results of a three-year-long dedicated monitoring campaign of a restless luminous blue variable (LBV) in NGC 7259. The object, named SN 2009ip, was observed photometrically and spectroscopically in the optical and near-infrared domains. We monitored a number of erupting episodes in the past few years, and increased the density of our observations during eruptive episodes. In this paper, we present the full historical data set from 2009 to 2012 with multi-wavelength dense coverage of the two high-luminosity events between 2012 August and September. We construct bolometric light curves and measure the total luminosities of these eruptive or explosive events. We label them the 2012a event (lasting ~50 days) with a peak of 3 × 1041 erg s-1, and the 2012b event (14 day rise time, still ongoing) with a peak of 8 × 1042 erg s-1. The latter event reached an absolute R-band magnitude of about -18, comparable to that of a core-collapse supernova (SN). Our historical monitoring has detected high-velocity spectral features (~13,000 km s-1) in 2011 September, one year before the current SN-like event. This implies that the detection of such high-velocity outflows cannot, conclusively, point to a core-collapse SN origin. We suggest that the initial peak in the 2012a event was unlikely to be due to a faint core-collapse SN. We propose that the high intrinsic luminosity of the latest peak, the variability history of SN 2009ip, and the detection of broad spectral lines indicative of high-velocity ejecta are consistent with a pulsational pair-instability event, and that the star may have survived the last outburst. The question of the survival of the LBV progenitor star and its future fate remain open issues, only to be answered with future monitoring of this historically unique explosion.

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As an alternative to externally bonded FRP reinforcement, near-surface mounted (NSM) FRP reinforcement can be used to effectively improve the flexural performance of RC beams. In such FRP strengthened RC beams, end cover separation failure is one of the common failure modes. This failuremode involves the detachment of the NSM FRP reinforcement together with the concrete cover along the level of the tension steel reinforcement. This paper presents a new strength model for end cover separation failure in RC beams strengthened in flexure with NSM FRP strips (i.e. rectangular FRP bars with asectional height-to-thickness ratio not less than 5), which was formulated on the basis of extensive numerical results from a parametric study undertaken using an efficient finite element approach. The proposed strength model consists of an approximate equation for the debonding strain of the FRP reinforcement at the critical cracked section and a conventional section analysis to relate this debondingstrain to the moment acting on the same section (i.e. the debonding strain). Once the debonding strain is known, the load level at end cover separation of an FRP-strengthened RC beam can be easily determined for a given load distribution. Predictions from the proposed strength model are compared with those of two existing strength models of the same type and available test results, which shows that the proposed strength model is in close agreement with test results and is far more accurate than the existing strength models.

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The flexural performance of RC beams can be improved using the near-surface mounted (NSM) FRP strengthening technique. A likely failure mode of such FRP-strengthened RC beams is bar-end cover separation which involves the detachment of the NSM FRP reinforcement together with the concrete cover along the level of the steel tension reinforcement. This paper presents a new analytical strength model for this failure mode. The proposed strength model and two existing strength models for this failure mode are compared with test results to demonstrate the superior performance of the new analytical model.

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Background: Internationally concerns have been highlighted about the quality of palliative care that people with intellectual disability receive. It has also been evidenced that people with intellectual disabilities are seldom referred to hospice and palliative care services. 

Aims: This study aimed to explore the experience of health and social care professionals in providing palliative care to people with intellectual disabilities. 

Methods An exploratory, qualitative design was used. A purposive sample of thirty health and social care professionals, working in intellectual disability and palliative care services, who had provided end-of-life care to adults with intellectual disabilities, were recruited to the study following informed consent. They were asked to reflect on a case scenario of a person with intellectual disability to whom they had provided end of life care. A semi-structured interview technique, with open questions and prompts, was used to explore their experiences and insights. The narrative from the case scenarios were content analysed using a recognised framework. 

Results: Three themes emerged from the data within the case scenarios: Identifying end of life care needs, meeting support needs and empowerment in partnership. Examples of good practice and issues in practice were apparent. 

Conclusion/ Discussion: This study contributes to the developing international evidence base to enhance end of life care for people with intellectual disabilities and provides further insights into this area of practice. Funder: HSC Research and Development Doctoral Fellowship Scheme

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The discovery of somatic mutations, primarily JAK2V617F and CALR, in classic BCR-ABL1-negative myeloproliferative neoplasms (MPNs) has generated interest in the development of molecularly targeted therapies, whose accurate assessment requires a standardized framework. A working group, comprised of members from European LeukemiaNet (ELN) and International Working Group for MPN Research and Treatment (IWG-MRT), prepared consensus-based recommendations regarding trial design, patient selection and definition of relevant end points. Accordingly, a response able to capture the long-term effect of the drug should be selected as the end point of phase II trials aimed at developing new drugs for MPNs. A time-to-event, such as overall survival, or progression-free survival or both, as co-primary end points, should measure efficacy in phase III studies. New drugs should be tested for preventing disease progression in myelofibrosis patients with early disease in randomized studies, and a time to event, such as progression-free or event-free survival should be the primary end point. Phase III trials aimed at preventing vascular events in polycythemia vera and essential thrombocythemia should be based on a selection of the target population based on new prognostic factors, including JAK2 mutation. In conclusion, we recommended a format for clinical trials in MPNs that facilitates communication between academic investigators, regulatory agencies and drug companies.

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Demand Side Management (DSM) plays an important role in Smart Grid. It has large scale access points, massive users, heterogeneous infrastructure and dispersive participants. Moreover, cloud computing which is a service model is characterized by resource on-demand, high reliability and large scale integration and so on and the game theory is a useful tool to the dynamic economic phenomena. In this study, a scheme design of cloud + end technology is proposed to solve technical and economic problems of the DSM. The architecture of cloud + end is designed to solve technical problems in the DSM. In particular, a construct model of cloud + end is presented to solve economic problems in the DSM based on game theories. The proposed method is tested on a DSM cloud + end public service system construction in a city of southern China. The results demonstrate the feasibility of these integrated solutions which can provide a reference for the popularization and application of the DSM in china.

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Background: Music therapy during palliative and end-of-life care is well established and positive benefits for patients have been reported.
Aim: Assess the effectiveness of music therapy versus standard care alone or standard care in combination with other therapies for improving psychological, physiological and social outcomes among adult patients in any palliative care setting.
Data sources: In order to update an existing Cochrane systematic review, we searched MEDLINE, CINAHL, EMBASE, PsycINFO, CENTRAL, ClinicalTrials.gov register, and Current Controlled Trials register to identify randomised or quasi-randomised controlled trails published between 2009 and April 2015. Nine electronic music therapy journals were searched from 2009 until April 2015, along with reference lists and contact was made with key experts in music therapy. Only studies published in English were eligible for inclusion. Two reviewers independently screened titles, abstracts, assessed relevant studies for eligibility, extracted data and judged risk of bias for included studies. Disagreements were resolved through discussion with a third reviewer. Data were synthesised in Revman using the random effects model. Heterogeneity was assessed using l2.
Results: Three studies were included in the review. Findings suggest music therapy may be effective for helping to reduce pain in palliative care patients (standard mean deviation (SMD) = -0.42, 95% CI -0.68 to -0.17, P = 0.001).
Conclusions: Available evidence did not support the use of music therapy to improve overall quality-of-life in palliative care. While this review suggests music therapy may be effective for reducing pain, this is based on studies with a high risk of bias. Further high quality research is required.

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Over the last quarter-century, evangelicalism has become an important social and political force in modern America. Here, new voices in the field are brought together with leading scholars such as William E. Connolly, Michael Barkun, Simon Dalby, and Paul Boyer to produce a timely examination of the spatial dimensions of the movement, offering useful and compelling insights on the intersection between politics and religion. This comprehensive study discusses evangelicalism in its different forms, from the moderates to the would-be theocrats who, in anticipation of the Rapture, seek to impose their interpretations of the Bible upon American foreign policy. The result is a unique appraisal of the movement and its geopolitical visions, and the wider impact of these on America and the world at large.

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PURPOSE: Glaucoma patients are still at risk of becoming blind. It is of clinical significance to determine the risk of blindness and its causes to prevent its occurrence. This systematic review estimates the number of treated glaucoma patients with end-of-life visual impairment (VI) and blindness and the factors that are associated with this.

METHODS: A systematic literature search in relevant databases was conducted in August 2014 on end-of-life VI. A total of 2574 articles were identified, of which 5 on end-of-life VI. Several data items were extracted from the reports and presented in tables.

RESULTS: All studies had a retrospective design. A considerable number of glaucoma patients were found to be blind at the end of their life; with up to 24% unilateral and 10% bilateral blindness. The following factors were associated with blindness: (1) baseline severity of visual field loss: advanced stage of glaucoma or substantial visual field loss at the initial visit; (2) factors influencing progression: fluctuation of intraocular pressure (IOP) during treatment, presence of pseudoexfoliation, poor patient compliance, higher IOP; (3) longer time period: longer duration of disease and older age at death because of a longer life expectancy; and (4) coexistence of other ocular pathology.

CONCLUSIONS: Further prevention of blindness in glaucoma patients is needed. To reach this goal, it is important to address the risk factors for blindness identified in this review, especially those that can be modified, such as advanced disease at diagnosis, high and fluctuating IOP, and poor compliance.

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Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.

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The South Carolina Department of Natural Resources provides maps to recreational and state shellfish grounds, available to the public for recreational harvesting or to commercial harvest. This map shows the location of Last End Point / Pinckney Island PSG - R036/R0378 Recreational Shellfish Ground in Beaufort County.

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Phase and gain mismatches between the I and Q analog signal processing paths of a quadrature receiver are responsible for the generation of image signals which limit the dynamic range of a practical receiver. In this paper we analyse the effects these mismatches and propose a low-complexity blind adaptive algorithm to minimize this problem. The proposed solution is based on two, 2-tap adaptive filters, arranged in Adaptive Noise Canceller (ANC) set-up. The algorithm lends itself to efficient real-time implementation with minimal increase in modulator complexity.

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I and Q Channel phase and gain misniatches are of great concern in communications receiver design. In this paper we analyse the effects of I and Q channel mismatches and propose a low-complexity blind adaptive algorithm to minimize this problem. The proposed solution consists of two, 2-tap adaptive filters, arranged in Adaptive Noise Canceller (ANC) set-up, with the output of one cross-fed to the input of the other. The system works as a de-correlator eliminating I and Q mismatch errors.

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There are approximately 150 Admiral Nurses in the UK who work alongside other health and social care professionals to support people with dementia and their family carers. However, the stigma of the disease and the lack of recognition that dementia is a life limiting illness have led to neglect in addressing the end of life challenges. The small in-depth study reported here aimed to add to an extremely limited formal evidence base for the effectiveness of this approach and to develop a greater understanding of the range of knowledge and skills required of them in ensuring they are better able to support families in the later stages of the illness. Findings focus on the experiences of family carers, the impact of performing the Admiral Nurse role and the use of qualitative measures in this setting.