991 resultados para Structural intervention


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The ultramicrostructure of phases with n = 1, 2 and 3 in the hypothetical series Bi2WnO3n+3 has been investigated by high resolution electron microscopy and energy dispersive X-ray emission spectroscopy. For n = 1 and 2, well ordered phases with the predicted compositions have been obtained, but for n = 3, a severely disordered assemblage containing intergrowths of the two known structures and strips of the n = 3 member is produced. No evidence for ordered structures with n > 2 has yet been obtained.

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Aim To assess the effectiveness of a decision support intervention using a pragmatic single blind Randomized Controlled Trial. Background Worldwide the proportion of older people (aged 65 years and over) is rising. This population is known to have a higher prevalence of chronic diseases including chronic kidney disease. The resultant effect of the changing health landscape is seen in the increase in older patients (aged ≥65 years) commencing on dialysis. Emerging evidence suggests that for some older patients dialysis may provide minimal benefit. In a majority of renal units non-dialysis management is offered as an alternative to undertaking dialysis. Research regarding decision-making support that is required to assist this population in choosing between dialysis or non-dialysis management is limited. Design. A multisite single blinded pragmatic randomized controlled trial is proposed. Methods Patients will be recruited from four Queensland public hospitals and randomizd into either the control or intervention group. The decision support intervention is multimodal and includes counselling provided by a trained nurse. The comparator is standard decision-making support. The primary outcomes are decisional regret and decisional conflict. Secondary outcomes are improved knowledge and quality of life. Ethics approval obtained November 2014. Conclusion This is one of the first randomized controlled trials assessing a decision support intervention in older people with advance chronic kidney disease. The results may provide guidance for clinicians in future approaches to assist this population in decision-making to ensure reduced decisional regret and decisional conflict.

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CaH406P-.K +, M r = 206.10, is orthorhombic, space group Pbca (from systematic absences), a = 14.538(4), b = 13.364(5), c = 6.880 (6)A, U = 1383.9 A 3, D x = 2.07 Mg m -a, Z = 8, ~.(Mo Ka) = 0.7107/~, p(MO Ka) = 1.015 mm -1. The final R value is 0.042 for a total of 1397 reflections. The high energy P-O(13) and the enolic C(1)-O(13) bonds are 1.612 and 1.374 A respectively. The enolpyruvate moiety is essentially planar. The orientation of the phosphate with respect to the pyruvate group in PEP.K is distinctly different from that in the PEP-cyclohexylammonium salt, the torsion angle C (2)-C (1)-O(13)- P being -209.1 in the former and -90 ° in the latter. The K + ion binds simultaneously to both the phosphate and carboxyl ends of the same PEP molecule. The ester O(13) is also a binding site for the cation. The K + ion is coplanar with the pyruvate moiety and binds to 0(22) and O(13) almost along their lone-pair directions. The carbonyl 0(22) prefers to bind to the K + ion rather than take part in the formation of hydrogen bonds usually observed in carboxylic acid structures.

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The performance of optoelectronic devices critically depends on the quality of active layer. An effective way to obtain a high quality layers is by creating excess of metal atoms through various heat treatments. Recently, rapid thermal annealing (RTA) has proved a versatile technique for the post-treatment of semiconductor materials as compared to other techniques due to its precise control over the resources. Thus, we carried out a set of experiments on SnS films to explore the influence of RTA treatment on their properties. From these experiments we noticed that the films treated at 400 °C for 1 min in N2 atmosphere have a low electrical resistivity of ~5 Ωcm with relatively high Hall mobility and carrier density of 99 cm2/Vs and 1.3 × 1016 cm−3, respectively. The observed results, therefore, emphasise that it is possible to obtain good quality SnS films through RTA treatment without disturbing their crystal structure.

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Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age.

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- Objective To evaluate dietary intake impact outcomes up to 3.5 years after the NOURISH early feeding intervention (concealed allocation, assessor masked RCT). - Methods 698 first-time mothers with healthy term infants were allocated to receive anticipatory guidance on protective feeding practices or usual care. Outcomes were assessed at 2, 3.7 and 5 years (3.5 years post-intervention). Dietary intake was assessed by 24-hour recall and Child Dietary Questionnaire. Mothers completed a food preference questionnaire and Children’s Eating Behaviour Questionnaire. Linear mixed models assessed group, time and time x group effects. - Results There were no group or time x group effects for fruit, vegetables, discretionary food and non-milk sweetened beverages intake. Intervention children showed a higher preference for fruits (74.6% vs 69.0% liked, P<.001), higher Child Dietary Questionnaire score for fruit and vegetables (15.3 vs 14.5, target>18, P=0.03), lower food responsiveness (2.3 vs 2.4, of maximum 5, P=.04) and higher satiety responsiveness (3.1 vs 3.0, of maximum 5, P=.04). - Conclusions Compared to usual care, an early feeding intervention providing anticipatory guidance regarding positive feeding practices led to small improvements in child dietary score, food preferences and eating behaviours up to 5 years of age, but not in dietary intake measured by 24-hour recall.

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Background Malnutrition and unintentional weight loss are major clinical issues in people with dementia living in residential aged care facilities (RACFs) and are associated with serious adverse outcomes. However, evidence regarding effective interventions is limited and strategies to improve the nutritional status of this population are required. This presentation describes the implementation and results of a pilot randomised controlled trial of a multi-component intervention for improving the nutritional status of RACF residents with dementia. Method Fifteen residents with moderate-severe dementia living in a secure long-term RACF participated in a five week pilot study. Participants were randomly allocated to either an Intervention (n=8) or Control group (n=7). The intervention comprised four elements delivered in a separate dining room at lunch and dinner: the systematic reinforcement of residents’ eating behaviors using a specific communication protocol; family-style dining; high ambiance table presentation; and routine Dietary-Nutrition Champion supervision. Control group participants ate their meals according to the facility’s standard practice. Baseline and follow-up assessments of nutritional status, food consumption, and body mass index were obtained by qualified nutritionists. Additional assessments included measures of cognitive functioning, mealtime agitation, depression, wandering status and multiple measures of intervention fidelity. Results No participant was malnourished at study commencement and participants in both groups gained weight from follow-up to baseline which was not significantly different between groups (t=0.43; p=0.67). A high degree of treatment fidelity was evident throughout the intervention. Qualitative data from staff indicate the intervention was perceived to be beneficial for residents. Conclusions This multi-component nutritional intervention was well received and was feasible in the RACF setting. Participants’ sound nutritional status at baseline likely accounts for the lack of an intervention effect. Further research using this protocol in malnourished residents is recommended. For success, a collaborative approach between researchers and facility staff, particularly dietary staff, is essential.

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Kansainvälisen oikeuden alaan kuuluvassa tutkielmassa käsitellään humanitaarisen intervention oikeutusta ja laillisuutta. Tutkimuskysymyksenä on, missä määrin humanitaarisilla näkökohdilla perusteltuja sotilaallisia toimia tai niillä uhkaamista voi pitää kansainvälisoikeudellisesti hyväksyttävänä ja millainen painoarvo ennakkotapauksena olisi annettava NATO-maiden Kosovossa toteuttamalle väliintulolle. Tutkielmassa perehdytään ihmisoikeusajattelun tiettyjen taustaoletusten kritiikkiin. Tarkastelun kohteena ovat erityisesti kannanotot, joiden mukaan ihmisoikeuksia ei voi pitää luonteeltaan universaaleina, sekä kyseiseen kritiikkiin liittyvät väitteet siitä, että ns. hegemonisessa asemassa olevat valtiot hyödyntävät ihmisoikeusargumentteja oikeuttaakseen voimankäyttönsä. Universaalisuuskritiikkiä voidaan pitää pitkälti perusteltuna, mutta nykyinen kansainvälinen yhteisö tarvitsee kuitenkin tietynlaisia yleismaailmallisia normeja voidakseen toimia tehokkaasti. Kritiikin ei voikaan katsoa pätevän humanitaarisen intervention kannalta keskeisiin ihmisoikeusnormeihin kuten kansanmurhan kieltoon, sillä kyseiset velvoitteet suojaavat kansainvälisen yhteisön toimivuutta ja uskottavuutta. Humanitaarisiin argumentteihin liittyy kuitenkin muita ongelmia: niillä on esimerkiksi aika ajoin pyritty oikeuttamaan sotilaallisia toimia, joissa ihmisoikeusnäkökohdat eivät välttämättä ole olleet etusijalla. Ihmisoikeuksille ei ole syytä antaa kansainvälisessä oikeudessa asemaa universaaleina "superargumentteina", jotka eivät olisi kyseenalaistettavissa. YK:n peruskirjan ja kansainvälisen tapaoikeuden näkökulmasta humanitaarisen intervention kaltaiseen voimankäyttöön vaaditaan turvallisuusneuvoston hyväksyntä, jota ei Kosovo-operaatioon saatu. Interventiota voi tässä suhteessa pitää yksiselitteisesti laittomana, sillä sen tueksi esitetyt oikeudelliset argumentit eivät ole vakuuttavia. Tapaukseen liittyvät ihmisoikeusnäkökohdat ovat kuitenkin siinä määrin merkittäviä, että ongelmaan ei ole perusteltua suhtautua tiukan legalistisesti. Operaation hyväksyminen moraaliargumenttien nojalla voisi kuitenkin johtaa nykyisten voimankäyttörajoitusten marginalisoitumiseen, mikä olisi yllä käsitellyn kritiikin valossa ongelmallista. Tutkielmassa nostetaan suositeltavaksi ratkaisuksi lähestymistapa, jossa Kosovon tapaus ymmärretään yksittäisenä oikeudenvastaisena mutta samalla oikeudenulkoisena poikkeustapauksena. Tällöin peruskirjan mukainen voimankäytön sääntely säilyy entisellään ilman että humanitaariset näkökohdat jäisivät tyystin huomiotta. Ratkaisu ei sulje pois mahdollisuutta suhtautua positiivisesti Kosovo-operaation mahdollisesti luomaan "poliittiseen normiin": suuren mittakaavan ihmisoikeusloukkaukset eivät jää Euroopassa seurauksitta. Ilman turvallisuusneuvoston suostumusta toteutettaviin humanitaarisiin interventioihin liittyvien käytännöllisten ja kansainvälisoikeudellisten riskien vuoksi niihin on kuitenkin aihetta suhtautua suurella varauksella.

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The complex crystallizes in the space group P21/c with four formula units in a unit cell of dimensions a= 12.747, b= 7.416, c= 17.894 A and/3= 90.2 °. The structure has been solved by the symbolic addition procedure using three-dimensional photographic data and refined to an R value of 0.079 for 2019 observed reflexions. The pyramidal nature of the two hetero nitrogen atoms in the antipyrine molecule is inter:nediate between that observed in free antipyrine and in some of its metal complexes. The molecule is more polar than that in crystals of free antipyrine but less so compared with that in metal complexes. In the salicylic acid molecule, the hydroxyl group forms an internal hydrogen bond with one of the oxygen atoms in the carboxyl group. The association between the salicylic acid and the antipyrine molecules is achieved through an intermolecular hydrogen bond with the other carboxyl oxygen atom in the salicylic acid molecule as the proton donor and the carboxyl oxygen atom of the antipyrine molecule as the acceptor.

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Analysis of the 1H NMR spectra of several monothiocarbonohydrazones, some of them synthesized for the first time, shows that they exist as two structural isomers. Whereas, in general, the derivatives of aromatic aldehydes conform to a linear structure, the aliphatic carbonyl derivatives conform to heterocyclic or linear structures, depending on the size of the substituent groups. This dual behaviour is explained in terms of extended conjugation and steric hindrance.

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Ab initio RHF/4-31G level molecular orbital calculations have been carried out on dimethoxymethane as a model compound for the acetal moiety in methyl pyranosides. The calculations are consistent with the predictions of the anomeric effect and the exo-anomeric effect. They reproduce very successfully the differences in molecular geometry observed by x-ray and neutron diffraction of single crystals of the methyl cy-D- and methyl 0-D-pyranosides. Calculations carried out at the 6-3 1G* level for methanediol confirm the earlier calculations at the 4-31G level, with smaller energy differences between the four staggered conformations.

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This research investigated the efficacy of a post-discharge nurse-led clinic, for patients who underwent a cardiovascular interventional procedure in Australia. A randomised controlled clinical trial measured the effects of the clinic on patient confidence to self-manage and minimise psychological distress given the strong link between anxiety, depression and coronary heart disease. Hospitalisation for the procedure is short and stressful, and patients may wait up to 7-64 days for post-discharge review. This study provides preliminary quantitative and qualitative evidence that nurse-led clinics undertaken within the first week post-percutaneous coronary intervention may fill a much-needed gap for patients during a potentially vulnerable period.

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Amidopyrine (1-phenyl-2,3-dimethyl-4-dimethylaminopyrazolone), C13HzvN30, a dimethylamino derivative of antipyrine and an important analgesic and antipyretic agent, crystallizes in the triclinic space group P1 with four molecules in a unit cell of dimensions a= 7.458 (5), b = 10.744 (5), c= 17.486 (15)/~,, e=98.6 (2),/~= 85.6 (3), y= 108-6 (2) . The structure was solved by direct methods and refined to an R value of 0.055 for 3706 photographically observed reflexions. The dimensions of the two crystallographically independent molecules are very nearly the same. The pyrazolone moiety in the molecule has dimensions comparable to those in antipyrine. Unlike antipyrine, the molecular dimensions of amidopyrine in the free state (the present structure) are close to those found in some of its hydrogenbonded complexes. Thus it appears that the presence of the dimethylamino group makes the molecule more resistant to changes in its dimensions resulting from molecular association. An attempt has also been made to correlate the polar nature of the pyrazolone moiety and the hybridization state of the hetero nitrogen atoms in antipyrine, amidopyrine and their complexes.

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This paper investigates the challenges of delivering parent training intervention for autism over video. We conducted a qualitative field study of an intervention, which is based on a well-established training program for parents of children with autism, called Hanen More Than Words. The study was conducted with a Hanen Certified speech pathologist who delivered video based training to two mothers, each with a son having autism. We conducted observations of 14 sessions of the intervention spanning 3 months along with 3 semi-structured interviews with each participant. We identified different activities that participants performed across different sessions and analysed them based upon their implications on technology. We found that all the participants welcomed video based training but they also faced several difficulties, particularly in establishing rapport with other participants, inviting equal participation, and in observing and providing feedback on parent-child interactions. Finally, we reflect on our findings and motivate further investigations by defining three design sensitivities of Adaptation, Group Participation, and Physical Setup.

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Väitöskirjatutkimuksessa tarkastellaan Taiwanin politiikkaa ensimmäisen vaalien kautta tapahtuneen vallanvaihdon jälkeen (2000) yhteiskunnan rakenteellisen politisoitumisen näkökulmasta. Koska Taiwanilla siirryttiin verettömästi autoritaarisesta yksipuoluejärjestelmästä monipuoluejärjestelmään sitä on pidetty poliittisen muodonmuutoksen mallioppilaana. Aiempi optimismi Taiwanin demokratisoitumisen suhteen on sittemmin vaihtunut pessimismiin, pitkälti yhteiskunnan voimakkaasta politisoitumisesta johtuen. Tutkimuksessa haetaan selitystä tälle politisoitumiselle. Yhteiskunnan rakenteellisella politisoitumisella tarkoitetaan tilannetta, jossa ”poliittisen” alue kasvaa varsinaisia poliittisia instituutioita laajemmaksi. Rakenteellinen politisoituminen muuttuu helposti yhteiskunnalliseksi ongelmaksi, koska siitä usein seuraa normaalin poliittisen toiminnan (esim. lainsäädännän) jähmettyminen, yhteiskunnan jyrkkä jakautuminen, alhainen kynnys poliittisille konflikteille ja yleisen yhteiskunnallisen luottamuksen alentuminen. Toisin kuin esimerkiksi Itä-Euroopassa, Taiwanissa entinen valtapuolue ei romahtanut poliittisen avautumisen myötä vaan säilytti vahvan rakenteellisen asemansa. Kun valta vaihtui ensimmäisen kerran vaalien kautta, vanha valtapuolue ei ollut valmis luovuttamaan poliittisen järjestelmän ohjaksia käsistään. Alkoi vuosia kestänyt taistelu järjestelmän hallinnasta vanhan ja uuden valtapuolueen välillä, jossa yhteiskunta politisoitui voimakkaasti. Tutkimuksessa Taiwanin yhteiskunnan politisoituminen selitetään useiden rakenteellisten piirteiden yhteisvaikutuksen tuloksena. Tällaisia politisoitumista edistäviä rakentellisia piirteitä ovat hidas poliittinen muutos, joka säilytti vanhat poliittiset jakolinjat ja niihin liittyvät vahvat edut ja intressit; sopimaton perustuslaki; Taiwanin epäselvä kansainvälinen asema ja jakautunut identiteetti; sekä sosiaalinen rakenne, joka helpottaa ihmisten nopeaa mobilisointia poliittiisiin mielenilmauksiin. Tutkimuksessa kiinnitetään huomiota toistaiseksi vähän tutkittuun poliittiseen ilmiöön, joidenkin demokratisoituvien yhteiskuntien voimakkaaseen rakenteelliseen politisoitumiseen. Tutkimuksen pääasiallinen havainto on, että yksipuoluejärjestelmän demokratisoituminen kantaa sisällään rakenteellisen politisoitumisen siemenen, jos entinen valtapuolue ei romahda demokratisoitumisen myötä.