Headache complaints associated with psychiatric comorbidity in a population-based sample

The objective of the present study was to determine the frequency at which people complain of any type of headache, and its relationship with sociodemographic characteristics and psychiatric comorbidity in São Paulo, Brazil. A three-step cluster sampling method was used to select 1,464 subjects aged 18 years or older. They were mainly from families of middle and upper socioeconomic levels living in the catchment area of Instituto de Psiquiatria. However, this area also contains some slums and shantytowns. The subjects were interviewed using the Brazilian version of the Composite International Diagnostic Interview version 1.1. (CIDI 1.1) by a lay trained interviewer. Answers to CIDI 1.1 questions allowed us to classify people according to their psychiatric condition and their headaches based on their own ideas about the nature of their illness. The lifetime prevalence of "a lot of problems with" headache was 37.4% (76.2% of which were attributed to use of medicines, drugs/alcohol, physical illness or trauma, and 23.8% attributed to nervousness, tension or mental illness). The odds ratio (OR) for headache among participants with "nervousness, tension or mental illness" was elevated for depressive episodes (OR, 2.1; 95%CI, 1.4-3.4), dysthymia (OR, 3.4; 95%CI, 1.6-7.4) and generalized anxiety disorder (OR, 4.3; 95%CI, 2.1-8.6), when compared with patients without headache. For "a lot of problems with" headaches attributed to medicines, drugs/alcohol, physical illness or trauma, the risk was also increased for dysthymia but not for generalized anxiety disorder. These data show a high association between headache and chronic psychiatric disorders in this Brazilian population sample.

Pienet erikoiskaupat Big datan aikakaudella: Asiakastiedonjohtamisen edellyttämät strategiset orientaatiot.

This master’s thesis has examined how Entrepreneurial, Customer and Knowledge Management Orientations are needed in the use of Big data technology by small retail firms in their Customer Knowledge Management. A vision of the ability of small retailers to move to the Big data era is based on empirical evidence of owner-managers’ attitudes and the firms’ processes. Abductive content analysis was used as a research strategy and the qualitative data was collected through theme interviews of owner-managers of 11 small-size retail firms. The biggest obstacles to the use of Big data by small retail firms are: a lack of information about the new technology; a lack of Knowledge Management Orientation; and, a lack of proactive dimension in Entrepreneurial and Customer Orientations. A strong reactive customer-led orientation, and the ability of the owner-manager to system thinking will support Customer Knowledge Management development. The low stage of technology-use is preventing utilization of customer information. Co-operation between firms or with educational organizations may significantly enhance the use of Big data –technology by small retail firms.

Cardiorespiratory fitness, pulmonary function and C-reactive protein levels in nonsmoking individuals with diabetes

The objective of this study was to evaluate cardiorespiratory fitness and pulmonary function and the relationship with metabolic variables and C-reactive protein (CRP) plasma levels in individuals with diabetes mellitus (DM). Nineteen men with diabetes and 19 age- and gender-matched control subjects were studied. All individuals were given incremental cardiopulmonary exercise and pulmonary function tests. In the exercise test, maximal workload (158.3±22.3vs 135.1±25.2, P=0.005), peak heart rate (HRpeak: 149±12 vs 139±10, P=0.009), peak oxygen uptake (VO2peak: 24.2±3.2 vs18.9±2.8, P<0.001), and anaerobic threshold (VO2VT: 14.1±3.4 vs 12.2±2.2, P=0.04) were significantly lower in individuals with diabetes than in control subjects. Pulmonary function test parameters, blood pressure, lipid profile (triglycerides, HDL, LDL, and total cholesterol), and CRP plasma levels were not different in control subjects and individuals with DM. No correlations were observed between hemoglobin A1C (HbA1c), CRP and pulmonary function test and cardiopulmonary exercise test performance. In conclusion, the results demonstrate that nonsmoking individuals with DM have decreased cardiorespiratory fitness that is not correlated with resting pulmonary function parameters, HbA1c, and CRP plasma levels.

Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma

18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the predictive ability of different FDG standardized uptake values (SUVs) in 74 patients with newly diagnosed NSCLC. 18F-FDG PET/CT scans were performed and different SUV parameters (SUVmax, SUVavg, SUVT/L, and SUVT/A) obtained, and their relationship with clinical characteristics were investigated. Meanwhile, correlation and multiple stepwise regression analyses were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and tumor size significantly affected SUV parameters. The mean SUVs of squamous cell carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors exhibited higher SUVs than well-differentiated ones. Further analyses based on the pathologic type revealed that the SUVmax, SUVavg, and SUVT/L of poorly differentiated adenocarcinoma tumors were higher than those of moderately or well-differentiated tumors. Among these four SUV parameters, SUVT/Lwas the primary predictor for tumor differentiation. However, in adenocarcinoma, SUVmax was the determining factor for tumor differentiation. Our results showed that these four SUV parameters had predictive significance related to NSCLC tumor differentiation; SUVT/L appeared to be most useful overall, but SUVmax was the best index for adenocarcinoma tumor differentiation.

Troponin I serum levels predict the need of dialysis in incident sepsis patients with acute kidney injury in the intensive care unit

Abstract Introduction: Sepsis, an extremely prevalent condition in the intensive care unit, is usually associated with organ dysfunction, which can affect heart and kidney. Objective: To determine whether the cardiac dysfunction and the Troponin I forecast the occurrence of acute renal failure in sepsis. Methods: Cardiac dysfunction was assessed by echocardiography and by the serum troponin I levels, and renal impairment by AKIN criteria and the need of dialysis. Twenty-nine patients with incident sepsis without previous cardiac or renal dysfunction were enrolled. Results and Discussion: Patients averaged 75.3 ± 17.3 years old and 55% were male. Median APACHE II severity score at ICU admission was 16 (9.7 - 24.2) and mortality rate in 30 days was 45%. On the fifth day, 59% had ventricular dysfunction. Troponin serum levels on day 1 in the affected patients were 1.02 ± 0.6 ng/mL compared with 0.23 ± 0.18 ng/mL in patients without heart dysfunction (p = 0.01). Eighteen out of 29 patients (62%) underwent renal replacement therapy (RRT) and the percent of patients with ventricular dysfunction who required dialysis was higher (94% vs. 16%, p = 0.0001). Values of troponin at day 1 were used to develop a ROC curve to determine their ability to predict the need of dialysis. The area under the curve was 0.89 and the cutoff value was 0.4 ng/mL. Conclusion: We found that an elevation in serum troponin levels, while guarding a relationship with ventricular dysfunction, can be a precious tool to predict the need for dialysis in sepsis patients.

Underwater Remote Welding Technology for Offshore Structures

The construction of offshore structures, equipment and devices requires a high level of mechanical reliability in terms of strength, toughness and ductility. One major site for mechanical failure, the weld joint region, needs particularly careful examination, and weld joint quality has become a major focus of research in recent times. Underwater welding carried out offshore faces specific challenges affecting the mechanical reliability of constructions completed underwater. The focus of this thesis is on improvement of weld quality of underwater welding using control theory. This research work identifies ways of optimizing the welding process parameters of flux cored arc welding (FCAW) during underwater welding so as to achieve desired weld bead geometry when welding in a water environment. The weld bead geometry has no known linear relationship with the welding process parameters, which makes it difficult to determine a satisfactory weld quality. However, good weld bead geometry is achievable by controlling the welding process parameters. The doctoral dissertation comprises two sections. The first part introduces the topic of the research, discusses the mechanisms of underwater welding and examines the effect of the water environment on the weld quality of wet welding. The second part comprises four research papers examining different aspects of underwater wet welding and its control and optimization. Issues considered include the effects of welding process parameters on weld bead geometry, optimization of FCAW process parameters, and design of a control system for the purpose of achieving a desired bead geometry that can ensure a high level of mechanical reliability in welded joints of offshore structures. Artificial neural network systems and a fuzzy logic controller, which are incorporated in the control system design, and a hybrid of fuzzy and PID controllers are the major control dynamics used. This study contributes to knowledge of possible solutions for achieving similar high weld quality in underwater wet welding as found with welding in air. The study shows that carefully selected steels with very low carbon equivalent and proper control of the welding process parameters are essential in achieving good weld quality. The study provides a platform for further research in underwater welding. It promotes increased awareness of the need to improve the quality of underwater welding for offshore industries and thus minimize the risk of structural defects resulting from poor weld quality.

National exchange rate policies and international debt crises: how Brazil did not follow Argentina into a default in 2001-2002

This paper examines how exchange rate policies and IMF Stand-By Arrangements affect debt crises using econometrics and a comparison between Argentina and Brazil. It refines an existing diagram outlining crisis development to propose crisis prevention strategies. Flexible exchange rate policies reduce a country's probability of default by over 4%, but Stand-By Arrangements increase it by an inconsequential percentage. Unlike Argentina, Brazil avoided a default via a freely-floating exchange rate system, fiscal deficit reduction, and a cooperative and coordinated relationship with the IMF. The results provide policymakers from developing countries with lessons to manage their countries' default risks more effectively.

The Dynamic Relationship between Finnish Stock Market and Commodities

Since different stock markets have become more integrated during 2000s, investors need new asset classes in order to gain diversification benefits. Commodities have become popular to invest in and thus it is important to examine whether the investors should use commodities as a part for portfolio diversification. This master’s thesis examines the dynamic relationship between Finnish stock market and commodities. The methodology is based on Vector Autoregressive models (VAR). The long-run relationship between Finnish stock market and commodities is examined with Johansen cointegration while short-run relationship is examined with VAR models and Granger causality test. In addition, impulse response test and forecast error variance decomposition are employed to strengthen the results of short-run relationship. The dynamic relationships might change under different market conditions. Thus, the sample period is divided into two sub-samples in order to reveal whether the dynamic relationship varies under different market conditions. The results show that Finnish stock market has stable long-run relationship with industrial metals, indicating that there would not be diversification benefits among the industrial metals. The long-run relationship between Finnish stock market and energy commodities is not as stable as the long-run relationship between Finnish stock market and industrial metals. Long-run relationship was found in the full sample period and first sub-sample which indicate less room for diversification. However, the long-run relationship disappeared in the second sub-sample which indicates diversification benefits. Long-run relationship between Finnish stock market and agricultural commodities was not found in the full sample period which indicates diversification benefits between the variables. However, long-run relationship was found from both sub-samples. The best diversification benefits would be achieved if investor invested in precious metals. No long-run relationship was found from either sample. In the full sample period OMX Helsinki had short-run relationship with most of the energy commodities and industrial metals and the causality was mostly running from equities to commodities. During the first sub period the number of short-run relationships and causality shrunk but during the crisis period the number of short-run relationships and causality increased. The most notable result found was unidirectional causality from gold to OMX Helsinki during the crisis period.

Our future in geriatrics : an examination of the knowledge, attitudes and career choices of physical therapy students in Ontario : a pretest-posttest study /

There continues to be a shortage of health professionals interested in providing care for the older adult. Part of the problem seems to stem from the negative perceptions of geriatrics as a clinical speciality. This study examines the knowledge, attitudes and career decisions of physical therapy students in Ontario before and after an educational intervention. Surveys were conducted with 144 physical therapy students from five universities before and after their geriatrics course in order to measure their knowledge, attitudes and interest in working with older adults. The incoming class of physical therapy students (n = 1 86) acted as control subjects for the study. The Revised Palmore Facts On Aging Quiz measured the students' knowledge of aging (Miller & Dodder, 1980). The Revised Tuckman-Lorge (Axelrod & Eisdorfer, 1961) and the Kogan Old People Scales (Kogan, 1961) were used to examine attitude. An environmental scale was developed based on the work of Snape (1986) to measure the impact of the working conditions on the students' career choices. A 10-point Likert-type scale based on the work of Michlelutte & Diseker (1985) was modified and used to measure career interest in working with the elderly. On independent sample t-tests, positive attitudes were related to the demographic characteristic of gender; ethnicity was negatively related; and marital status was found to be unrelated to attitude (fi<.05). Having a relationship with an older adult and taking courses in gerontology were also found to be positively related to attitude (fi<.05). Results on a betweensubjects design which compared students before and after the course found that knowledge scores improved from pretest to posttest (fi<.05). In general, attitude scores improved from T1 to T2 on both measurement tools (b<.05). The environmental and vocational interest scales yielded statistically significant differences between the control and experimental groups during the intervention period (p<.05). The results of this research indicated that knowledge and attitudes improve after an educational intervention; however, there was little impact on the students' overall career decisions. Further research is indicated to examine the complex relationship between attitude and behaviour and its impact on students' career choices. In addition, the impact of geriatric clinical environment on students' attitudes and career decisions needs to be further explored.

Parental goals among Italian-Canadian and Anglo-Canadian families : their connection to socialization practices and the quality of parent-young adult relationship /

Parenting goals are the behavioral, cognitive, and affective outcomes that parents implicitly or explicitly strive to achieve during specific interactions with their children. In the present study, intergenerational parenting practices and goals in Italian-Canadian and Anglo-Canadian families were examined. The association between parenting goals, parents' socialization practices, and the quality of relationship between parent and child were investigated. Participants included individuals ranging in age from 1 8-26 years and their mothers from Anglo-Canadian (n= 31) and Italian-Canadian families (n= 50). The young adults and their mothers were asked to imagine how their respective parents would have reacted to five hypothetical vignettes depicting difficult parent-child interactions. Young adults and their mothers were also asked to rate the importance of parenting goals within these parent-child situations. In addition, young adults assessed the perceived quality of their present relationships with each parent. Cultural differences were revealed such that Italian-Canadian parents endorsed more authoritarian parenting strategies and relationship-centered goals than Anglo-Canadian parents. However, Italian-Canadian and Anglo-Canadian parents were not found to differ on their endorsement of parent-centered goals. Italian-Canadian parents' who did use authoritarian strategies were found to have young-adult children who perceived their relationship with their parents as less satisfying, intimate, affectionate and having relatively high levels of conflict than parents who did not use authoritarian strategies. Anglo-Canadian parents' authoritative strategies were correlated with a better perceived relationship quality by young-adult children.

Relationship between physical activity and resting secretory immunity in children

This study examined relationships among physical activity, body fat and salivary immonoglobulin A (sIgA) levels in adolescent children of Southern Ontario. Gender differences on these factors were also assessed. Sixty-one grade-five students (10-1 lyrs), males (n=29) and females (n=31), who had not received a flu vaccination in the past 12 months, participated in the study. They were assessed for: aerobic power (20-m shuttle run), relative body fat (bioelectrical impedance analysis), sIgA, sIgA/albumin ratio, and salivary Cortisol. Each subject completed the Habitual Activity Estimation Scale and the Participation Questioimaire. Students wore a pedometer for 48h to estimate their average total distance traveled per day. The results show 40% of the children were over 25% body fat and 50% of them spend less than five hours per day in any physical activities. Salivary IgA was not related to salivary Cortisol, physical activity, fitness level or body fat in this age group. There were no gender differences in sIgA and Cortisol levels. Boys had a significantly higher aerobic power and daily distance traveled, but reported similar organized and fi-ee time activity participation levels as the girls. The test-retest reproducibility for salivary Cortisol was 0.663 (p<0.01), while long term sIgA and sIgA/albumin ratio reproducibility was non-significant for repeated measurements taken after six weeks. It was found that salivary IgA has not been shovm to be a stable measure in children, in contrast to the results found in the literatiu-e that tested adults and the relationship with physical activity, fitness level and body fat.

An exploratory descriptive study of factors influencing students to seek or not to seek personal counselling on a college of applied arts and technology campus located in Southern Ontario /

This descriptive-exploratory study examined factors which were perceived by students at a College of Applied Arts and Technology (CAAT) campus as influencing them in choosing to come or not to come for personal counselling and why they would or would not retum. A total of 250 students selected through a sample of convenience were surveyed. A questionnaire survey was conducted with quantitative data collected using a 4-point, forced-choice Likert scale and yes/no questions and qualitative data collected using open-ended questions and invited comments. The responses were analyzed using means and modes for the Likert responses and percentages for the yes/no and check-off questions. The narrative responses were subjected to content analysis to identify themes. The mean score findings on factors influencing students to come for personal counselling were at or close to the mid- point of 2.5. Personal distress was the only variable found to have a negative response, meaning students would not come to counselling if they were in personal distress. On factors that would keep them from choosing to come to counselling, students seemed to trust counsellors and feel accepted by them and rejected the notion that peer pressure or the first session being unhelpful would keep them away from counselling. The counsellor's relationship with the student is the major determinant for repeat sessions. When asked what factors would influence students to not retum for personal counselling, students rejected the variables of peer pressure, the extra time needed for counselling, and not getting what they wanted in a session, but, in one instance, indicated that variables regarding the counselling relationship would keep them from returning.

Spiritual journeys in the classroom: elementary public school teachers' perspectives /

This thesis explored 5 public elementary school teachers ' perceptions of spirituality and its implications for classroom practice. A generic qualitative study was conducted where each teacher shared her experiences and perceptions in one audiotaped semistructured interview. Transcripts were generated and coded for themes which emerged, resulting in the findings of the study. Following this process, the participants verified the accuracy of the transcripts and findings through a member-checking system. The research found that each teacher has her own definition of spirituality. Furthermore, one's personal connection with spirituality can involve a relationship with religion, the self, a higher being, others, and nature. These spiritual relationships were nurtured through a variety of methods outlined by the teachers. This resulted in the creation of a personal spiritual profile for each teacher which contained each teacher's spiritual connections or facets and the methods used to develop these facets. The teachers identified spiritual needs in their students warranting the need for and importance of spiritual education. Given this, a number of classroom practices were identified with the intention of meeting the spiritual needs of students. Among these practices, the teacher as role model was identified as a significant practice for students' spiritual development in the classroom. The teachers further outlined a number of professional development initiatives with the intention to promote greater awareness for spiritual education and to provide resources for educators.

A narrative journey of teacher reflexivity and authenticity in technological environments /

This qualitative narrative inquiry was driven by my desire to further explore my personal discovery that my utilization of educational technologies in teaching and learning environments seemed to heighten a sense of creativity, which in turn increased reflective practice and authenticity in my teaching. A narrative inquiry approach was used as it offered the opportunity to uncover the deeper meanings of authenticity and reflection as participants' personal experiences were coconstructed and reconstructed in relationship with me and in relationship to a social milieu. To gain further insight into this potential phenomenon, I engaged in 2 conversational interviews with 2 other teachers from an Ontario College in a large urban centre who have utilized educational technologies in their teaching and learning communities and I maintained a research journal, constructed during the interview process, to record my own emerging narrative accounts, reflections, insights and further questions. The field texts consisted of transcriptions of the interviews and my reflective journal. Research texts were developed as field texts were listened to multiple times and texts were examined for meanings and themes. The educational technologies that both women focused on in the interview were digital video of children as they play, learn and develop and the use of an audible teacher voice in online courses. The invitation given to students to explore and discover meaning in videos of children as they watched them with the teacher seemed to be a catalyst for authenticity and a sense of synergy in the classroom. The power of the audible teacher voice came through as an essential component in online learning environments to offer students a sense of humanness and connection with the teacher. Relationships in both online and face to face classrooms emerged as a necessary and central component to all teaching and learning communities. The theme of paradox also emerged as participants recognized that educational technologies can be used in ways that enhance creativity, authenticity, reflection and relationships or in ways that hinder these qualities in the teaching and learning community. Knowledge of the common experiences of college educators who utilize educational technologies, specifically digital video of children to educate early childhood educators, might give meaning and insight to inform the practice of other teachers who seek authentic, reflexive practice in the classroom and in on line environments.

An Interactive Theorem Prover for First-Order Dynamic Logic

Dynamic logic is an extension of modal logic originally intended for reasoning about computer programs. The method of proving correctness of properties of a computer program using the well-known Hoare Logic can be implemented by utilizing the robustness of dynamic logic. For a very broad range of languages and applications in program veri cation, a theorem prover named KIV (Karlsruhe Interactive Veri er) Theorem Prover has already been developed. But a high degree of automation and its complexity make it di cult to use it for educational purposes. My research work is motivated towards the design and implementation of a similar interactive theorem prover with educational use as its main design criteria. As the key purpose of this system is to serve as an educational tool, it is a self-explanatory system that explains every step of creating a derivation, i.e., proving a theorem. This deductive system is implemented in the platform-independent programming language Java. In addition, a very popular combination of a lexical analyzer generator, JFlex, and the parser generator BYacc/J for parsing formulas and programs has been used.