938 resultados para post mortem interval


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PURPOSE: The purpose of this study was to examine the influence of three different high-intensity interval training (HIT) regimens on endurance performance in highly trained endurance athletes. METHODS: Before, and after 2 and 4 wk of training, 38 cyclists and triathletes (mean +/- SD; age = 25 +/- 6 yr; mass = 75 +/- 7 kg; VO(2peak) = 64.5 +/- 5.2 mL x kg(-1) min(-1)) performed: 1) a progressive cycle test to measure peak oxygen consumption (VO(2peak)) and peak aerobic power output (PPO), 2) a time to exhaustion test (T(max)) at their VO(2peak) power output (P(max)), as well as 3) a 40-km time-trial (TT(40)). Subjects were matched and assigned to one of four training groups (G(2), N = 8, 8 x 60% T(max) at P(max), 1:2 work:recovery ratio; G(2), N = 9, 8 x 60% T(max) at P(max), recovery at 65% HR(max); G(3), N = 10, 12 x 30 s at 175% PPO, 4.5-min recovery; G(CON), N = 11). In addition to G(1), G(2), and G(3) performing HIT twice per week, all athletes maintained their regular low-intensity training throughout the experimental period. RESULTS: All HIT groups improved TT(40) performance (+4.4 to +5.8%) and PPO (+3.0 to +6.2%) significantly more than G(CON) (-0.9 to +1.1%; P < 0.05). Furthermore, G(1) (+5.4%) and G(2) (+8.1%) improved their VO(2peak) significantly more than G(CON) (+1.0%; P < 0.05). CONCLUSION: The present study has shown that when HIT incorporates P(max) as the interval intensity and 60% of T(max) as the interval duration, already highly trained cyclists can significantly improve their 40-km time trial performance. Moreover, the present data confirm prior research, in that repeated supramaximal HIT can significantly improve 40-km time trial performance.

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Anisotropic damage distribution and evolution have a profound effect on borehole stress concentrations. Damage evolution is an irreversible process that is not adequately described within classical equilibrium thermodynamics. Therefore, we propose a constitutive model, based on non-equilibrium thermodynamics, that accounts for anisotropic damage distribution, anisotropic damage threshold and anisotropic damage evolution. We implemented this constitutive model numerically, using the finite element method, to calculate stress–strain curves and borehole stresses. The resulting stress–strain curves are distinctively different from linear elastic-brittle and linear elastic-ideal plastic constitutive models and realistically model experimental responses of brittle rocks. We show that the onset of damage evolution leads to an inhomogeneous redistribution of material properties and stresses along the borehole wall. The classical linear elastic-brittle approach to borehole stability analysis systematically overestimates the stress concentrations on the borehole wall, because dissipative strain-softening is underestimated. The proposed damage mechanics approach explicitly models dissipative behaviour and leads to non-conservative mud window estimations. Furthermore, anisotropic rocks with preferential planes of failure, like shales, can be addressed with our model.

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This thoughtful book is a much needed contribution to feminist ethics that is brimming with detailed and insightful analyses of the positioning of women in contemporary health care and particularly in relation to new reproductive technologies (NRTs). The clearly written and structured chapters provide accessible points to modern ethics, post-modernism, and feminist ethics. Margrit Shildrick takes on these areas with authority and vigour, building an argument for women to enter the relations of reproduction on terms more expressive of feminine desire...

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It has been known since Rhodes Fairbridge’s first attempt to establish a global pattern of Holocene sea-level change by combining evidence from Western Australia and from sites in the northern hemisphere that the details of sea-level history since the Last Glacial Maximum vary considerably across the globe. The Australian region is relatively stable tectonically and is situated in the ‘far-field’ of former ice sheets. It therefore preserves important records of post-glacial sea levels that are less complicated by neotectonics or glacio-isostatic adjustments. Accordingly, the relative sea-level record of this region is dominantly one of glacio-eustatic (ice equivalent) sea-level changes. The broader Australasian region has provided critical information on the nature of post-glacial sea level, including the termination of the Last Glacial Maximum when sea level was approximately 125 m lower than present around 21,000–19,000 years BP, and insights into meltwater pulse 1A between 14,600 and 14,300 cal. yr BP. Although most parts of the Australian continent reveals a high degree of tectonic stability, research conducted since the 1970s has shown that the timing and elevation of a Holocene highstand varies systematically around its margin. This is attributed primarily to variations in the timing of the response of the ocean basins and shallow continental shelves to the increased ocean volumes following ice-melt, including a process known as ocean siphoning (i.e. glacio-hydro-isostatic adjustment processes). Several seminal studies in the early 1980s produced important data sets from the Australasian region that have provided a solid foundation for more recent palaeo-sea-level research. This review revisits these key studies emphasising their continuing influence on Quaternary research and incorporates relatively recent investigations to interpret the nature of post-glacial sea-level change around Australia. These include a synthesis of research from the Northern Territory, Queensland, New South Wales, South Australia and Western Australia. A focus of these more recent studies has been the re-examination of: (1) the accuracy and reliability of different proxy sea-level indicators; (2) the rate and nature of post-glacial sea-level rise; (3) the evidence for timing, elevation, and duration of mid-Holocene highstands; and, (4) the notion of mid- to late Holocene sea-level oscillations, and their basis. Based on this synthesis of previous research, it is clear that estimates of past sea-surface elevation are a function of eustatic factors as well as morphodynamics of individual sites, the wide variety of proxy sea-level indicators used, their wide geographical range, and their indicative meaning. Some progress has been made in understanding the variability of the accuracy of proxy indicators in relation to their contemporary sea level, the inter-comparison of the variety of dating techniques used and the nuances of calibration of radiocarbon ages to sidereal years. These issues need to be thoroughly understood before proxy sea-level indicators can be incorporated into credible reconstructions of relative sea-level change at individual locations. Many of the issues, which challenged sea-level researchers in the latter part of the twentieth century, remain contentious today. Divergent opinions remain about: (1) exactly when sea level attained present levels following the most recent post-glacial marine transgression (PMT); (2) the elevation that sea-level reached during the Holocene sea-level highstand; (3) whether sea-level fell smoothly from a metre or more above its present level following the PMT; (4) whether sea level remained at these highstand levels for a considerable period before falling to its present position; or (5) whether it underwent a series of moderate oscillations during the Holocene highstand.

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There has been much discussion and controversy in the media recently regarding metal toxicity following large head metal on metal (MoM) total hip replacement (THR). Patients have been reported as having hugely elevated levels of metal ions with, at times, devastating systemic, neurolgical and/or orthopaedic sequelae. However, no direct correlation between metal ion level and severity of metallosis has yet been defined. Normative levels of metal ions in well functioning, non Cobalt-Chrome hips have also not been defined to date. The Exeter total hip replacement contains no Cobalt-Chrome (Co-Cr) as it is made entirely from stainless steel. However, small levels of these metals may be present in the modular head of the prosthesis, and their effect on metal ion levels in the well functioning patient has not been investigated. We proposed to define the “normal” levels of metal ions detected by blood test in 20 well functioning patients at a minimum 1 year post primary Exeter total hip replacement, where the patient had had only one joint replaced. Presently, accepted normal levels of blood Chromium are 10–100 nmol/L and plasma Cobalt are 0–20 nmol/L. The UK Modern Humanities Research Association (MHRA) has suggested that levels of either Cobalt or Chromium above 7 ppb (equivalent to 135 nmol/L for Chromium and 120 nmol/L for Cobalt) may be significant. Below this level it is indicated that significant soft tissue reaction and tissue damage is less likely and the risk of implant failure is reduced. Hips were a mixture of cemented and hybrid procedures performed by two experienced orthopaedic consultants. Seventy percent were female, with a mixture of head sizes used. In our cohort, there were no cases where the blood Chromium levels were above the normal range, and in more than 70% of cases, levels were below recordable levels. There were also no cases of elevated plasma Cobalt levels, and in 35% of cases, levels were negligible. We conclude that the implantation with an Exeter total hip replacement does not lead to elevation of blood metal ion levels.

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BACKGROUND: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. METHODS: Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. RESULTS: A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following 'failed DAIR' cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. CONCLUSIONS: As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings.

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Genomics and genetic findings have been hailed with promises of unlocked codes and new frontiers of personalized medicine. Despite cautions about gene hype, the strong cultural pull of genes and genomics has allowed consideration of genomic personhood. Populated by the complicated records of mass spectrometer, proteomics, which studies the human protein, has not achieved either the funding or the popular cultural appeal proteomics scientists had hoped it would. While proteomics, being focused on the proteins that actually indicate and create disease states, has a more direct potential for clinical applications than genomic risk predictions, culturally, it has not provided the material for identity creation. In our ethnographic research, we explore how proteomic scientists attempting to shape an appeal to personhood through which legitimacy may be defined.

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Purpose The neuromuscular mechanisms determining the mechanical behaviour of the knee during landing impact remain poorly understood. It was hypothesised that neuromuscular preparation is subject-specific and ranges along a continuum from passive to active. Methods A group of healthy men (N = 12) stepped-down from a knee-high platform for 60 consecutive trials. Surface EMG of the quadriceps and hamstrings was used to determine pre-impact onset timing, activation amplitude and cocontraction for each trial. Partial least squares regression was used to associate pre-impact preparation with post-impact knee stiffness and coordination. Results The group analysis revealed few significant changes in pre-impact preparation across trial blocks. Single-subject analyses revealed changes in muscle activity that varied in size and direction between individuals. Further, the association between pre-impact preparation and post-impact knee mechanics was subject-specific and ranged along a continuum of strategies. Conclusion The findings suggest that neuromuscular preparation during step landing is subject-specific and its association to post-impact knee mechanics occurs along a continuum, ranging from passive to active control strategies. Further work should examine the implications of these strategies on the distribution of knee forces in-vivo.

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When a community already torn by an event such as a prolonged war, is then hit by a natural disaster, the negative impact of this subsequent disaster in the longer term can be extremely devastating. Natural disasters further damage already destabilised and demoralised communities, making it much harder for them to be resilient and recover. Communities often face enormous challenges during the immediate recovery and the subsequent long term reconstruction periods, mainly due to the lack of a viable community involvement process. In post-war settings, affected communities, including those internally displaced, are often conceived as being completely disabled and are hardly ever consulted when reconstruction projects are being instigated. This lack of community involvement often leads to poor project planning, decreased community support, and an unsustainable completed project. The impact of war, coupled with the tensions created by the uninhabitable and poor housing provision, often hinders the affected residents from integrating permanently into their home communities. This paper outlines a number of fundamental factors that act as barriers to community participation related to natural disasters in post-war settings. The paper is based on a statistical analysis of, and findings from, a questionnaire survey administered in early 2012 in Afghanistan.

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The findings presented in this paper are part of a research project designed to provide a preliminary indication of the support needs of postdiagnosis women with breast cancer in remote and isolated areas in Queensland. This discussion will present data that focuses on the women’s expressed personal concerns. For participants in this research a diagnosis of breast cancer involves a confrontation with their own mortality and the possibility of a reduced life span. This is a definite life crisis, creating shock and needing considerable adjustment. Along with these generic issues the participants also articulated significant issues in relation to their experience as women in a rural setting. These concerns centred around worries about how their partner and families cope during their absences for treatment, the additional burden on the family of having to cope with running the property or farm during the participant’s absence or illness, added financial strain brought about by the cost of travel for treatment, maintenance of properties during absences, and problems created by time off from properties or self-employment. These findings accord with other reports of health and welfare services for rural Australian and the generic literature on psycho-oncology studies of breast cancer.

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This PhD practice-led research inquiry sets out to examine and describe how the fluid interactions between memory and time can be rendered via the remediation of my painting and the construction of a digital image archive. My abstract digital art and handcrafted practice is informed by Deleuze and Guattari’s rhizomics of becoming. I aim to show that the technological mobility of my creative strategies produce new conditions of artistic possibility through the mobile principles of rhizomic interconnection, multiplicity and diversity. Subsequently through the ongoing modification of past painting I map how emergent forms and ideas open up new and incisive engagements with the experience of a ‘continual present’. The deployment of new media and cross media processes in my art also deterritorialises the modernist notion of painting as a static and two dimensional spatial object. Instead, it shows painting in a postmodern field of dynamic and transformative intermediality through digital formats of still and moving images that re-imagines the relationship between memory, time and creative practice.

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The increasing prevalence of obesity in society has been associated with a number of atherogenic risk factors such as insulin resistance. Aerobic training is often recommended as a strategy to induce weight loss, with a greater impact of high-intensity levels on cardiovascular function and insulin sensitivity, and a greater impact of moderate-intensity levels on fat oxidation. Anaerobic high-intensity (supramaximal) interval training has been advocated to improve cardiovascular function, insulin sensitivity and fat oxidation. However, obese individuals tend to have a lower tolerance of high-intensity exercise due to discomfort. Furthermore, some obese individuals may compensate for the increased energy expenditure by eating more and/or becoming less active. Recently, both moderate- and high-intensity aerobic interval training have been advocated as alternative approaches. However, it is still uncertain as to which approach is more effective in terms of increasing fat oxidation given the issues with levels of fitness and motivation, and compensatory behaviours. Accordingly, the objectives of this thesis were to compare the influence of moderate- and high-intensity interval training on fat oxidation and eating behaviour in overweight/obese men. Two exercise interventions were undertaken by 10-12 overweight/obese men to compare their responses to study variables, including fat oxidation and eating behaviour during moderate- and high-intensity interval training (MIIT and HIIT). The acute training intervention was a methodological study designed to examine the validity of using exercise intensity from the graded exercise test (GXT) - which measured the intensity that elicits maximal fat oxidation (FATmax) - to prescribe interval training during 30-min MIIT. The 30-min MIIT session involved 5-min repetitions of workloads 20% below and 20% above the FATmax. The acute intervention was extended to involve HIIT in a cross-over design to compare the influence of MIIT and HIIT on eating behaviour using subjective appetite sensation and food preference through the liking and wanting test. The HIIT consisted of 15-sec interval training at 85 %VO2peak interspersed by 15-sec unloaded recovery, with a total mechanical work equal to MIIT. The medium term training intervention was a cross-over 4-week (12 sessions) MIIT and HIIT exercise training with a 6-week detraining washout period. The MIIT sessions consisted of 5-min cycling stages at ±20% of mechanical work at 45 %VO2peak, and the HIIT sessions consisted of repetitive 30-sec work at 90 %VO2peak and 30-sec interval rests, during identical exercise sessions of between 30 and 45 mins. Assessments included a constant-load test (45 %VO2peak for 45 mins) followed by 60-min recovery at baseline and the end of 4-week training, to determine fat oxidation rate. Participants’ responses to exercise were measured using blood lactate (BLa), heart rate (HR) and rating of perceived exertion (RPE) and were measured during the constant-load test and in the first intervention training session of every week during training. Eating behaviour responses were assessed by measuring subjective appetite sensations, liking and wanting and ad libitum energy intake. Results of the acute intervention showed that FATmax is a valid method to estimate VO2 and BLa, but is not valid to estimate HR and RPE in the MIIT session. While the average rate of fat oxidation during 30-min MIIT was comparable with the rate of fat oxidation at FATmax (0.16 ±0.09 and 0.14 ±0.08 g/min, respectively), fat oxidation was significantly higher at minute 25 of MIIT (P≤0.01). In addition, there was no significant difference between MIIT and HIIT in the rate of appetite sensations after exercise, but there was a tendency towards a lower rate of hunger after HIIT. Different intensities of interval exercise also did not affect explicit liking or implicit wanting. Results of the medium-term intervention indicated that current interval training levels did not affect body composition, fasting insulin and fasting glucose. Maximal aerobic capacity significantly increased (P≤0.01) (2.8 and 7.0% after MIIT and HIIT respectively) during GXT, and fat oxidation significantly increased (P≤0.01) (96 and 43% after MIIT and HIIT respectively) during the acute constant-load exercise test. RPE significantly decreased after HIIT greater than MIIT (P≤0.05), and the decrease in BLa was greater during the constant-load test after HIIT than MIIT, but this difference did not reach statistical significance (P=0.09). In addition, following constant-load exercise, exercise-induced hunger and desire to eat decreased after HIIT greater than MIIT but were not significant (p value for desire to eat was 0.07). Exercise-induced liking of high-fat sweet (HFSW) and high-fat non-sweet (HFNS) foods increased after MIIT and decreased after HIIT (p value for HFNS was 0.09). The intervention explained 12.4% of the change in fat intake (p = 0.07). This research is significant in that it confirmed two points in the acute study. While the rate of fat oxidation increased during MIIT, the average rate of fat oxidation during 30-min MIIT was comparable with the rate of fat oxidation at FATmax. In addition, manipulating the intensity of acute interval exercise did not affect appetite sensations and liking and wanting. In the medium-term intervention, constant-load exercise-induced fat oxidation significantly increased after interval training, independent of exercise intensity. In addition, desire to eat, explicit liking for HFNS and fat intake collectively confirmed that MIIT is accompanied by a greater compensation of eating behaviour than HIIT. Findings from this research will assist in developing exercise strategies to provide obese men with various training options. In addition, the finding that overweight/obese men expressed a lower RPE and decreased BLa after HIIT compared with MIIT is contrary to the view that obese individuals may not tolerate high-intensity interval training. Therefore, high-intensity interval training can be advocated among the obese adult male population. Future studies may extend this work by using a longer-term intervention.

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Objective: To examine the extent to which socio-demographics, modifiable lifestyle, and physical health status influence the mental health of post-menopausal Australian women. Methods: Cross-sectional data on health status, chronic disease and modifiable lifestyle factors were collected from a random cross-section of 340 women aged 60-70 years, residing in Queensland, Australia. Structural equation modelling (SEM) was used to measure the effect of a range of socio-demographic characteristics, modifiable lifestyle factors, and health markers (self-reported physical health, history of chronic illness) on the latent construct of mental health status. Mental health was evaluated using the Medical Outcomes Study Short Form 12 (SF-12®) which examined and Center for Epidemiologic Studies Depression Scale (CES-D). Results: The model was a good fit for the data (χ2=4.582, df=3, p=0.205) suggesting that mental health is negatively correlated with sleep disturbance (β = -0.612, p <0.001), and a history of depression (β = -0.141, p = 0.024).While mental health was associated with poor sleep, it was not correlated with most lifestyle factors (BMI, alcohol consumption, or cigarette smoking) or socio-demographics like age, income or employment category and they were removed from the final model. Conclusion: Research suggests that it is important to engage in a range of health promoting behaviours to preserve good health. We found that predictors of current mental health status included sleep disturbance, and past mental health problems, while socio-demographics and modifiable lifestyle had little impact. It may be however, that these factors influenced other variables associated with the mental health of post-menopausal women, and these relationships warrant further investigation.