943 resultados para end-state comfort


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Background: The majority of studies investigating the neural mechanisms underlying treatment in people with aphasia have examined task-based brain activity. However, the use of resting-state fMRI may provide another method of examining the brain mechanisms responsible for treatment-induced recovery, and allows for investigation into connectivity within complex functional networks Methods: Eight people with aphasia underwent 12 treatment sessions that aimed to improve object naming. Half the sessions employed a phonologically-based task, and half the sessions employed a semantic-based task, with resting-state fMRI conducted pre- and post-treatment. Brain regions in which the amplitude of low frequency fluctuations (ALFF) correlated with treatment outcomes were used as seeds for functional connectivity (FC) analysis. FC maps were compared from pre- to post-treatment, as well as with a group of 12 healthy older controls Results: Pre-treatment ALFF in the right middle temporal gyrus (MTG) correlated with greater outcomes for the phonological treatment, with a shift to the left MTG and supramarginal gyrus, as well as the right inferior frontal gyrus, post-treatment. When compared to controls, participants with aphasia showed both normalization and up-regulation of connectivity within language networks post-treatment, predominantly in the left hemisphere Conclusions: The results provide preliminary evidence that treatments for naming impairments affect the FC of language networks, and may aid in understanding the neural mechanisms underlying the rehabilitation of language post-stroke.

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In recent years, rapid advances in information technology have led to various data collection systems which are enriching the sources of empirical data for use in transport systems. Currently, traffic data are collected through various sensors including loop detectors, probe vehicles, cell-phones, Bluetooth, video cameras, remote sensing and public transport smart cards. It has been argued that combining the complementary information from multiple sources will generally result in better accuracy, increased robustness and reduced ambiguity. Despite the fact that there have been substantial advances in data assimilation techniques to reconstruct and predict the traffic state from multiple data sources, such methods are generally data-driven and do not fully utilize the power of traffic models. Furthermore, the existing methods are still limited to freeway networks and are not yet applicable in the urban context due to the enhanced complexity of the flow behavior. The main traffic phenomena on urban links are generally caused by the boundary conditions at intersections, un-signalized or signalized, at which the switching of the traffic lights and the turning maneuvers of the road users lead to shock-wave phenomena that propagate upstream of the intersections. This paper develops a new model-based methodology to build up a real-time traffic prediction model for arterial corridors using data from multiple sources, particularly from loop detectors and partial observations from Bluetooth and GPS devices.

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In 2007 the National Framework for Energy Efficiency provided funding for the first survey of energy efficiency education across all Australian universities teaching engineering education. The survey asked the question, ‘What is the state of education for energy efficiency in Australian engineering education?’. There was an excellent response to the survey, with 48 course responses from lecturers across 27 universities from every state and territory in Australia, and 260 student responses from 18 courses across 8 universities from all 6 states. It is concluded from the survey findings that the state of education for energy efficiency in Australian engineering education is currently highly variable and ad hoc across universities and engineering disciplines.

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Review Objectives: This systematic review seeks to establish what best practice is for: Interventions which promote self-management for patients with End Stage Renal Disease (ERSD) undergoing Haemodialysis. Review questions: 1) Do education interventions improve self-management for patients with end stage renal disease? 2) Do psychosocial interventions such as Cognitive Behavioural Therapy, behavioural therapy or other counselling therapies and social support, improve self-management for patients with end stage renal disease? Criteria for considering studies for this review: Types of participants: This component of the review will consider studies with: • All adults over the age of 18 years • Patients with end stage renal disease • Undergoing haemodialysis Types of interventions/Phenomena of Interest: All studies evaluating the following interventions will be considered for inclusion in the review such as: Interventions which promote self management including: • Education interventions. • Psychosocial interventions such as cognitive behavioural therapy and other behavioural therapies, counselling and social support. Types of outcome measures/anticipated outcomes: This component of the review will consider studies that include the following outcomes: • Adherence with haemodialysis treatment, • Depression and/or anxiety, • Quality of life, • Carer burnout, • Social support • Patient satisfaction • Adverse events potentially attributable to the intervention or control treatment • Cost effectiveness of home haemodialysis Keywords chronic kidney failure; renal failure; end stage renal disease; chronic kidney disease

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Background: The critical care context presents important opportunities for nurses to deliver skilled, comprehensive care to patients at the end of life and their families. Limited research has identified the actual end-of-life care practices of critical care nurses. Objective: To identify the end-of-life care practices of critical care nurses. Design: A national cross-sectional online survey. Methods: The survey was distributed to members of an Australian critical care nursing association and 392 critical care nurses (response rate 25%) completed the survey. Exploratory factor analysis using principal axis factoring with oblique rotation was undertaken on survey responses to identify the domains of end-of-life care practice. Descriptive statistics were calculated for individual survey items. Results: Exploratory factor analysis identified six domains of end-of-life care practice: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management and spiritual support. Descriptive statistics identified a high level of engagement in information sharing and environmental modification practices and less frequent engagement in items from the emotional support and symptom management practice areas. Conclusions: The findings of this study identified domains of end-of-life care practice, and critical care nurse engagement in these practices. The findings highlight future training and practice development opportunities, including the need for experiential learning targeting the emotional support practice domain. Further research is needed to enhance knowledge of symptom management practices during the provision of end-of-life care to inform and improve practice in this area.

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Australia has shown outstanding leadership on tobacco control - but it could do more. The next step is surely for the Future Fund to quit its addiction to tobacco investments.

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Lateralization of temporal lobe epilepsy (TLE) is critical for successful outcome of surgery to relieve seizures. TLE affects brain regions beyond the temporal lobes and has been associated with aberrant brain networks, based on evidence from functional magnetic resonance imaging. We present here a machine learning-based method for determining the laterality of TLE, using features extracted from resting-state functional connectivity of the brain. A comprehensive feature space was constructed to include network properties within local brain regions, between brain regions, and across the whole network. Feature selection was performed based on random forest and a support vector machine was employed to train a linear model to predict the laterality of TLE on unseen patients. A leave-one-patient-out cross validation was carried out on 12 patients and a prediction accuracy of 83% was achieved. The importance of selected features was analyzed to demonstrate the contribution of resting-state connectivity attributes at voxel, region, and network levels to TLE lateralization.

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Background Context There are differences in definitions of end plate lesions (EPLs), often referred to as Schmorl’s nodes, that may, to some extent, account for the large range of reported prevalence (3.8 to 76%). Purpose To develop a technique to measure the size, prevalence and location of EPLs in a consistent manner. Study Design/Setting This study proposed a method using a detection algorithm which was applied to five adolescent females (average age 15.1 years, range 13.0 to 19.2 years) with idiopathic scoliosis (average major Cobb angle 60°, range 55 to 67°). Methods Existing low-dose, computed tomography scans were segmented semi-automatically to extract 3D morphology of each vertebral endplate. Any remaining attachments to the posterior elements of adjacent vertebrae or endplates were then manually sectioned. An automatic algorithm was used to determine the presence and position of EPLs. Results EPLs were identified in 15 of the 170 (8.8%) endplates analysed with an average depth of 3.1mm. 11/15 of the EPLs were seen in the lumbar spine. The algorithm was found to be most sensitive to changes in the minimum EPL gradient at the edges of the EPL. Conclusions This study describes an imaging analysis technique for consistent measurement of the prevalence, location and size of EPLs. The technique can be used to analyse large populations without observer errors in EPL definitions.

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This study investigates friendships between gay sales associates and heterosexual female customers in luxury retail settings. By employing grounded theory methodology, the study integrates theories and findings from diverse literature streams into an original conceptual framework to illustrate the resources gay sales associates and straight female customers receive from and provide to each other during retail exchanges. The study explains why gay male–straight female friendships are uniquely suited for luxury consumption settings. Female customers characterize their friendships with gay sales associates as providing honesty, security, trust, and comfort, which stems from the absence of sexual interest and a lack of inter-female competition. Gay sales associates receive acceptance for who they are and for their displays of unconventional masculinity in retail settings. They also obtain a temporary rite from their female customers, a so-called mandate of privacy, which permits both parties to ignore the bounds of modesty and accept a degree of intimacy. Such intimacy facilitates transactions that require both personalization and customer–employee closeness, such as the selling of high-end apparel, accessories, and jewelry.

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Although it seems reasonable to assume that activating patriotism might motivate citizens to cooperate with the state in reaching societal goals, the empirical evidence supporting this contention is based mostly on correlational rather than experimental studies. In addition, little is known on whether patriotism can be manipulated without simultaneously triggering nationalism and on the psychological processes which determine the patriotism-cooperation relation. This current article reports results of one survey and three experiments that manipulate patriotism by displaying either a national flag or national landscapes or by priming national achievements. The outcomes indicate that reported and manipulated patriotism indirectly increase tax compliance, although the national flag also increases nationalism. National achievements, on the other hand, seemingly increases trust in national public institutions and the voluntary motivation to cooperate, whereas national landscapes only increase the voluntary motivation to cooperate. Hence, it is possible to increase social capital in the form of trust and cooperation through patriotism without fostering nationalism as well.

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INTRODUCTION There is a large range in the reported prevalence of end plate lesions (EPLs), sometimes referred to as Schmorl's nodes in the general population (3.8-76%). One possible reason for this large range is the differences in definitions used by authors. Previous research has suggested that EPLs may potentially be a primary disturbance of growth plates that leads to the onset of scoliosis. The aim of this study was to develop a technique to measure the size, prevalence and location of EPLs on Computed Tomography (CT) images of scoliosis patients in a consistent manner. METHODS A detection algorithm was developed and applied to measure EPLs for five adolescent females with idiopathic scoliosis (average age 15.1 years, average major Cobb 60°). In this algorithm, the EPL definition was based on the lesion depth, the distance from the edge of the vertebral body and the gradient of the lesion edge. Existing low-dose, CT scans of the patients' spines were segmented semi-automatically to extract 3D vertebral endplate morphology. Manual sectioning of any attachments between posterior elements of adjacent vertebrae and, if necessary, endplates was carried out before the automatic algorithm was used to determine the presence and position of EPLs. RESULTS EPLs were identified in 15 of the 170 (8.8%) endplates analysed with an average depth of 3.1mm. 73% of the EPLs were seen in the lumbar spines (11/15). A sensitivity study demonstrated that the algorithm was most sensitive to changes in the minimum gradient required at the lesion edge. CONCLUSION An imaging analysis technique for consistent measurement of the prevalence, location and size of EPLs on CT images has been developed. Although the technique was tested on scoliosis patients, it can be used to analyse other populations without observer errors in EPL definitions.

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This project was a step forward in applying statistical methods and models to provide new insights for more informed decision-making at large spatial scales. The model has been designed to address complicated effects of ecological processes that govern the state of populations and uncertainties inherent in large spatio-temporal datasets. Specifically, the thesis contributes to better understanding and management of the Great Barrier Reef.

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Introduction: The receptor for advanced glycation end products (RAGE) is a member of the immunoglobulin superfamily of cell surface receptor molecules. High concentrations of three of its putative proinflammatory ligands, S100A8/A9 complex (calprotectin), S100A8, and S100A12, are found in rheumatoid arthritis (RA) serum and synovial fluid. In contrast, soluble RAGE (sRAGE) may prevent proinflammatory effects by acting as a decoy. This study evaluated the serum levels of S100A9, S100A8, S100A12 and sRAGE in RA patients, to determine their relationship to inflammation and joint and vascular damage. Methods: Serum sRAGE, S100A9, S100A8 and S100A12 levels from 138 patients with established RA and 44 healthy controls were measured by ELISA and compared by unpaired t test. In RA patients, associations with disease activity and severity variables were analyzed by simple and multiple linear regressions. Results: Serum S100A9, S100A8 and S100A12 levels were correlated in RA patients. S100A9 levels were associated with body mass index (BMI), and with serum levels of S100A8 and S100A12. S100A8 levels were associated with serum levels of S100A9, presence of anti-citrullinated peptide antibodies (ACPA), and rheumatoid factor (RF). S100A12 levels were associated with presence of ACPA, history of diabetes, and serum S100A9 levels. sRAGE levels were negatively associated with serum levels of C-reactive protein (CRP) and high-density lipoprotein (HDL), history of vasculitis, and the presence of the RAGE 82Ser polymorphism. Conclusions: sRAGE and S100 proteins were associated not just with RA inflammation and autoantibody production, but also with classical vascular risk factors for end-organ damage. Consistent with its role as a RAGE decoy molecule, sRAGE had the opposite effects to S100 proteins in that S100 proteins were associated with autoantibodies and vascular risk, whereas sRAGE was associated with protection against joint and vascular damage. These data suggest that RAGE activity influences co-development of joint and vascular disease in rheumatoid arthritis patients.