843 resultados para Gains in selection


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Introduction: Weight gain is a common concern following breast cancer and has been associated with negative health outcomes. As such, prevention of weight gain is of clinical interest. This work describes weight change between 6- and 18-months following a breast cancer diagnosis and explores the personal, treatment and behavioural characteristics associated with gains in weight. Methods: Body mass index was objectively assessed, at three-monthly intervals, on a population-based sample of women newly diagnosed with unilateral breast cancer (n=185). Changes in BMI between 6- and 18-months post-diagnosis were calculated, with gains of one or more being considered clinically detrimental to future health. Results: Approximately 60% of participants were overweight or obese at 6-months post-diagnosis. While BMI remained relatively stable across the testing period (range=27.3-27.8), 24% of participants experienced clinically relevant gains in BMI (median gains=1.9). Following adjustment for potential confounders, younger age (<45 years; Odds ratio, OR=9.8), being morbidly obese at baseline (OR=4.6) and receiving hormone therapy (OR=4.8) were characteristics associated with an increased odds (p<0.05) of gaining BMI. Other characteristics associated with gains in BMI were more extensive surgery and having a history of smoking, although these relationships were not supported statistically. In contrast, caring for younger children was associated with reduced risk of gaining BMI (OR=0.3, p=0.20). Conclusions: Clinically relevant weight gain between 6- and 18-months post-breast cancer diagnosis is an issue for one in four women, with certain subgroups being particularly susceptible. However, the majority of women diagnosed with breast cancer are overweight or obese and gains in body weight are common. Thus, interventions that address the importance of achieving and sustaining a healthy body weight, delivered to all women with breast cancer, may have greater public health impact than interventions targeting any specific breast cancer subgroup.

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The case study of Lusoponte illustrates the concession awarded by the Portuguese Government to finance, design, build and operate two bridges over the Tagus in Lisbon, Portugal. It includes an overview of the project's background and an analysis of the main risk categories stating both the actual risks encountered and the mitigation measures adopted. Throughout the project a great attention was given to whole life cycle costs, and gains in efficiency and cost control. Among the lessons that can be learned from both the public and private sector is that a complete risk management analysis must include not only the technical factors but also a realistic assessment of environmental and social risks. These were the risks that were somewhat overseen and that caused the main problems to the project's development.

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Drivers are known to be optimistic about their risk of crash involvement, believing that they are less likely to be involved in a crash than other drivers. However, little comparative research has been conducted among other road users. In addition, optimism about crash risk is conceptualised as applying only to an individual’s assessment of his or her personal risk of crash involvement. The possibility that the self-serving nature of optimism about safety might be generalised to the group-level as a cyclist or a pedestrian, i.e., becoming group-serving rather than self-serving, has been overlooked in relation to road safety. This study analysed a subset of data collected as part of a larger research project on the visibility of pedestrians, cyclists and road workers, focusing on a set of questionnaire items administered to 406 pedestrians, 838 cyclists and 622 drivers. The items related to safety in various scenarios involving drivers, pedestrians and cyclists, allowing predictions to be derived about group differences in agreement with items based on the assumption that the results would exhibit group-serving bias. Analysis of the responses indicated that specific hypotheses about group-serving interpretations of safety and responsibility were supported in 22 of the 26 comparisons. When the nine comparisons relevant to low lighting conditions were considered separately, seven were found to be supported. The findings of the research have implications for public education and for the likely acceptance of messages which are inconsistent with current assumptions and expectations of pedestrians and cyclists. They also suggest that research into group-serving interpretations of safety, even for temporary roles rather than enduring groups, could be fruitful. Further, there is an implication that gains in safety can be made by better educating road users about the limitations of their visibility and the ramifications of this for their own road safety, particularly in low light.

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Observational seatbelt wearing studies are a valuable tool for obtaining up-to-date information about rates of use. Given that one quarter of vehicle occupants killed on Queensland roads in recent years were not wearing seatbelts, it is important that authorities are able to identify non-wearers and take steps to increase compliance with seatbelt laws to reduce the severity of crashes and, therefore, the road toll. An observational study of seatbelt use was conducted in metropolitan, regional and rural locations throughout Queensland in May and June, 2010. Trained observers took note of seatbelt use of all occupants of passenger vehicles, noting their gender, approximate age group, seating position, vehicle type, licence type (i.e. visible L or P plates), mobile phone use, and the date, time and location of the observation. Of 19,579 observations, 99.04% (19,391) of occupants were observed wearing seatbelts, as only 0.96% of occupants (188) were not wearing a seatbelt. There were differences in seatbelt wearing rates for a number of study variables, although most were very small. However, seatbelt wearing rates were 3.84% lower for drivers observed using a mobile phone than for those who were not. While compliance with seatbelt laws seems to be very high, it is still concerning that so few non-wearers represent a disproportionately large proportion of road fatalities and serious injuries in Queensland. Road safety authorities must therefore continue to find ways to improve seatbelt use, as small gains in wearing rates will translate into significant fatality reductions.

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A longitudinal study of grieving in family caregivers of people with dementia Recent research into dementia has identified the long term impact that the role of care giving for a relative with dementia has on family members This is largely due to the cognitive decline that characterises dementia and the losses that can be directly attributed to this. These losses include loss of memories, relationships and intimacy, and are often ambiguous so that the grief that accompanies them is commonly not recognised or acknowledged. The role and impact of pre-death or anticipatory grief has not previously been widely considered as a factor influencing health and well-being of family caregivers. Studies of grief in caregivers of a relative with dementia have concluded that grief is one of the greatest barriers to care giving and is a primary determinant of caregiver well-being. The accumulation of losses, in conjunction with experiences unique to dementia care giving, place family caregivers at risk of complicated grief. This occurs when integration of the death does not take place following bereavement and has been associated with a range of negative health outcomes. The aim of this research was to determine the influence of grief, in addition to other factors representing both positive and negative aspects of the role, on the health related quality of life of family caregivers of people with dementia, prior to and following the death of their relative with dementia. An exploratory research project underpinned by a conceptual framework of caregivers’ adaptation in the context of subjective appraisal of the strains and gains in their role was undertaken. The research comprised three studies. Study 1 was a scoping study that involved a series of semi-structured interviews with thirteen participants who were family caregivers of people with severe dementia or whose relative with dementia had died in the previous twelve months. The results of this study in conjunction with factors identified in the literature informed data collection for the further studies. Study 2 was a cross sectional survey of fifty caregivers recruited when their relative was in the moderate to severe stage of dementia. This study provided the baseline data for Study 3, a prospective cohort follow up study. Study 3 consisted of seventeen participants followed up at two time points after the death of their relative with dementia: six weeks and then six months following the death of the relative with dementia. The scoping study indicated that differences in appraisal of the care giving role and encounters with health professionals were related to levels of grief of caregivers prior to and following the death of the relative with dementia. This was supported in the baseline and follow up studies. In the baseline study, after adjusting for all variables in multivariate regression models, subjective appraisal of burden was found to make a significant contribution (p<.05) to mental health related quality of life. The two dependent variables, anticipatory grief and mental health related quality of life, were significantly (p<.01) correlated at a bivariate level. In the follow up study, linear mixed modelling and multiple regression analysis of data found that subjective appraisal of burden and resilience were significantly associated (p<.05 and p<.01, respectively) with mental health related quality of life over time. In addition, bereavement and complicated grief were significantly associated (p<.05) with mental health following the death of the relative. In this study social support and satisfaction with end of life care were found to be statistically associated (p<.05) with physical health related quality of life over time. The strong relationship between grief of caregivers and their health related quality of life over the entire care giving trajectory and period following the death of their relative highlights the urgent need for further research and interventions in this area. Overall results indicate that addressing the risk and protective factors including subjective appraisal of their care giving role, resilience, social support and satisfaction with end of life care of their relative, has the potential to both ameliorate negative health outcomes and to promote improved health for these caregivers. This research provides important information for development of targeted and appropriate interventions that aim to promote resilience and reduce the personal burden on caregivers of people with dementia.

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The pulse power characteristics of ultracapacitors appear well suited to electric vehicle applications, where they may supply the peak power more efficiently than the battery, and can prevent excessive over sizing of the battery pack due to peak power demands. Operation of ultracapacitors in battery electric vehicles is examined for possible improvements in system efficiency, vehicle driving range, battery pack lifetime, and potential reductions in system lifecycle cost. The lifecycle operation of these ultracapacitors is simulated using custom-built, dynamic simulation code constructed in Matlab. Despite apparent gains in system efficiency and driving range, the results strongly suggest that the inclusion of ultracapacitors in the electric vehicle does not make sense from a lifecycle cost perspective. Furthermore, a comparison with results from earlier work shows that this outcome is highly dependant upon the efficiency and cost of the battery under consideration. However, it is likely that the lifecycle cost benefits of ultracapacitors in these electric vehicles would be, at most, marginal and do not justify the additional capital costs and system complexity that would be incurred in the vehicle

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The pulse power characteristics of ultracapacitors appear well suited to electric vehicle applications, where they may supply the peak power more efficiently than the battery, and can prevent excessive over sizing of the battery pack due to peak power demands. Operation of ultracapacitors in battery electric vehicles (BEVs) is examined for possible improvements in system efficiency, vehicle driving range, battery pack lifetime, and potential reductions in system lifecycle cost. The lifecycle operation of these ultracapacitors is simulated using a custom-built, dynamic simulation code constructed in Matlab. Despite apparent gains in system efficiency and driving range, the lifecycle cost benefits as simulated appear to be marginal, and are heavily influenced by the incremental cost of power components. However, additional factors are identified which, in reality, will drive ultracapacitors towards viability in electric vehicle applications.

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A salient but rarely explicitly studied characteristic of interfirm relationships is that they can intentionally be formed for finite periods of time. What determines firms' intertemporal choices between different alliance time horizons? Shadow of the future theorists suggest that when an alliance has an explicitly set short-term time frame, there is an increased risk that partners may behave opportunistically. This does not readily explain the high incidence of time-bound alliances being formed. Reconciling insights from the shadow of the future perspective with nascent research on the flexibility of temporary organizations, and shifting the focus from the level of individual transactions to that of strategic alliance portfolios, we argue that firms may be willing to accept a higher risk of opportunism when there are offsetting gains in strategic flexibility in managing their strategic alliance portfolio. Consequently, we hypothesize that environmental factors that increase the need for strategic flexibility—namely, dynamism and complexity in the environment—are likely to increase the relative share of time-bound alliances in strategic alliance portfolios. Our analysis of longitudinal data on the intertemporal alliance choices of a large sample of small and medium-sized enterprises provides support for this argument. Our findings fill an important gap in theory about time horizons in interfirm relationships and temporary organizations and show the importance of separating planned terminations from duration-based performance measures.

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OBJECTIVE To compare the physical activity levels of overweight and non overweight 3- to 5-y-old children while attending preschool. A secondary aim was to evaluate weight-related differences in hypothesized parental determinants of child physical activity behavior. DESIGN Cross-sectional study. SUBJECTS A total of 245, 3- to 5-y-olds ( 127 girls, 118 boys) and their parent(s) ( 242 mothers, 173 fathers) recruited from nine preschools. Overweight status determined using the age- and sex-specific 85th percentile for body mass index (BMI) from CDC Growth Charts. MEASUREMENTS Physical activity during the preschool day was assessed on multiple days via two independent objective measures-direct observation using the observation system for recording activity in preschools (OSRAP) and real-time accelerometry using the MTI/CSA 7164 accelerometer. Parents completed a take-home survey assessing sociodemographic information, parental height and weight, modeling of physical activity, support for physical activity, active toys and sporting equipment at home, child's television watching, frequency of park visitation, and perceptions of child competence. RESULTS Overweight boys were significantly less active than their nonoverweight peers during the preschool day. No significant differences were observed in girls. Despite a strong association between childhood overweight status and parental obesity, no significant differences were observed for the hypothesized parental influences on physical activity behavior. CONCLUSIONS Our results suggest that a significant proportion of overweight children may be at increased risk for further gains in adiposity because of low levels of physical activity during the preschool day.

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Regular physical activity is an important component of a healthy lifestyle in children and adolescents. However, despite the noted short- and long-term health benefits associated with physical activity, monitoring and surveillance studies show that a significant percentage of children and adolescents fail to meet the recommended guideline of 60 minutes or more of moderate-to-vigorous physical activity daily. This review examines key evidence from the public health and health promotion literature on promotion of health-enhancing physical activity in children and adolescents. We describe best practice in three key behavior settings—schools, homes, and health care settings. In school-based settings, it has been shown that physical education programs can be modified to increase the percentage of class time engaged in moderate-to-vigorous physical activity. In the home setting, there is evidence that teaching parents to establish and monitor physical activity goals and provide appropriate rewards for meeting these goals results in gains in physical activity and/or physical fitness. In health care settings, evidence from two studies suggests that physician-based counseling coupled with stage appropriate written materials can be effective among adolescent youth.

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OBJECTIVE To compare the physical activity levels of overweight and non overweight 3- to 5-y-old children while attending preschool. A secondary aim was to evaluate weight-related differences in hypothesized parental determinants of child physical activity behavior. DESIGN Cross-sectional study. SUBJECTS A total of 245, 3- to 5-y-olds (127 girls, 118 boys) and their parent(s) (242 mothers, 173 fathers) recruited from nine preschools. Overweight status determined using the age- and sex-specific 85th percentile for body mass index (BMI) from CDC Growth Charts. MEASUREMENTS Physical activity during the preschool day was assessed on multiple days via two independent objective measures direct observation using the observation system for recording activity in preschools (OSRAP) and real-time accelerometry using the MTI/CSA 7164 accelerometer. Parents completed a take-home survey assessing sociodemographic information, parental height and weight, modeling of physical activity, support for physical activity, active toys and sporting equipment at home, child’s television watching, frequency of park visitation, and perceptions of child competence. RESULTS Overweight boys were significantly less active than their nonoverweight peers during the preschool day. No significant differences were observed in girls. Despite a strong association between childhood overweight status and parental obesity, no significant differences were observed for the hypothesized parental influences on physical activity behavior. CONCLUSIONS Our results suggest that a significant proportion of overweight children may be at increased risk for further gains in adiposity because of low levels of physical activity during the preschool day.

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OBJECTIVE To compare the physical activity levels of overweight and non overweight 3- to 5-y-old children while attending preschool. A secondary aim was to evaluate weight-related differences in hypothesized parental determinants of child physical activity behavior. DESIGN: Cross-sectional study. SUBJECTS A total of 245, 3- to 5-y-olds (127 girls, 118 boys) and their parent(s) (242 mothers, 173 fathers) recruited from nine preschools. Overweight status determined using the age- and sex-specific 85th percentile for body mass index (BMI) from CDC Growth Charts. MEASUREMENTS Physical activity during the preschool day was assessed on multiple days via two independent objective measuresFdirect observation using the observation system for recording activity in preschools (OSRAP) and real-time accelerometry using the MTI/CSA 7164 accelerometer. Parents completed a take-home survey assessing sociodemographic information, parental height and weight, modeling of physical activity, support for physical activity, active toys and sporting equipment at home, child’s television watching, frequency of park visitation, and perceptions of child competence. RESULTS Overweight boys were significantly less active than their nonoverweight peers during the preschool day. No significant differences were observed in girls. Despite a strong association between childhood overweight status and parental obesity, no significant differences were observed for the hypothesized parental influences on physical activity behavior. CONCLUSIONS Our results suggest that a significant proportion of overweight children may be at increased risk for further gains in adiposity because of low levels of physical activity during the preschool day.

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Seat belts are one of the most effective passive safety features in vehicles and there is a host of research literature attesting to the effectiveness of seat belts in protecting against death and injury. Even when use rates are high the potential gains in trauma reduction from further improvements in wearing rates are substantial. However, those currently most resistant to restraint use have also proven most difficult to target using conventional countermeasures. It is necessary to address the issues of non-wearing in order to achieve further gains in seat belt wearing. This study provide evidence-based recommendations for the way forward to tackle the problems of adult restraint non-use in light passenger vehicles in the short, medium and longer term in Australia. While there are substantial issues to be addressed for these groups, these are outside the scope of this study.

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The Archean Hollandaire volcanogenic massive sulfide deposit is a felsic–siliciclastic VMS deposit located in the Murchison Domain of the Youanmi Terrane, Yilgarn Craton, Western Australia. It is hosted in a succession of turbidites, mudstones and coherent rhyodacite sills and has been metamorphosed to upper greenschist/lower amphibolite facies and includes a pervasive S1 deformational fabric. The coherent rhyodacitic sills are interpreted as syndepositional based on geochemical similarities with well-known VMS-associated felsic rocks and similar foliations to the metasediments. We offer several explanations for the absence of textural evidence (e.g. breccias) for syn-depositional origins: 1) the subaqueous sediments were dehydrated by long-lived magmatism such that no pore-water remained to drive quench fragmentation; 2) pore-space occlusion by burial and/or, 3) alteration overprinting and obscuring of primary breccias at contact margins. Mineralisation occurs by sub-seafloor replacement of original host rocks in two ore bodies, Hollandaire Main (~125 x >500 m and ~8 m thick) and Hollandaire West (~100 x 470 m and ~5 m thick), and occurs in three main textural styles, massive sulfides, which are exclusively hosted in turbidites and mudstones, and stringer and disseminated sulfides, which are also hosted in coherent rhyodacite. Most sulfides have textures consistent with remobilisation and recrystallisation. Hydrothermal metamorphism has altered the hangingwall and footwall to similar degrees, with significant gains in Mg, Mn and K and losses in Na, Ca and Sr. Garnet and staurolite porphyryoblasts also exhibit a footprint around mineralisation, extending up to 30 m both above and below the ore zone. High precision thermal ionisation mass spectrometry of zircons extracted from the coherent rhyodacite yield an age of 2759.5 ± 0.9 Ma, which along with geochemical comparisons, places the succession within the 2760–2735 Ma Greensleeves Formation of the Polelle Group of the Murchison Supergroup. Geochemical and geochronological evidence link the coherent rhyodacite sills to the Peter Well Granodiorite pluton ~2 km to the W, which acted as the heat engine driving hydrothermal circulation during VMS mineralisation. This study highlights the importance of both: detailed physical volcanological studies from which an accurate assessment of timing relationships, particularly the possibility of intrusions dismembering ore horizons, can be made; and identifying synvolcanic plutons and other similar suites, for VMS exploration targets in the Youanmi Terrane and worldwide.

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The requirement of isolated relays is one of the prime obstacles in utilizing sequential slotted cooperative protocols for Vehicular Ad-hoc Networks (VANET). Significant research advancement has taken place to improve the diversity multiplexing trade-off (DMT) of cooperative protocols in conventional mobile networks without much attention on vehicular ad-hoc networks. We have extended the concept of sequential slotted amplify and forward (SAF) protocols in the context of urban vehicular ad-hoc networks. Multiple Input Multiple Output (MIMO) reception is used at relaying vehicular nodes to isolate the relays effectively. The proposed approach adds a pragmatic value to the sequential slotted cooperative protocols while achieving attractive performance gains in urban VANETs. We have analysed the DMT bounds and the outage probabilities of the proposed scheme. The results suggest that the proposed scheme can achieve an optimal DMT similar to the DMT upper bound of the sequential SAF. Furthermore, the outage performance of the proposed scheme outperforms the SAF protocol by 2.5 dB at a target outage probability of 10-4.