Case management in action: An examination of two cases in the area of alcohol related brain damage

‘Practice Forum’ provides a forum for social work practitioners to share their practice with others; to describe what they are doing and assess its effectiveness. The practice of case management is applied in a wide range of service delivery models to meet complex client needs. Unfortunately, cost containment and lack of clarity of the role of the case manager has blurred the definition and practice of case management for both the consumer and professional providers. This article examines two cases of a small non-government agency in Melbourne called Alcohol Related Brain Injury Assessment, Accommodation & Support Inc. (ARBIAS) where case management services are delivered to people with alcohol acquired brain damage. The analysis presented here supports the view that continuity of care and intensive relationship building with clients is vital for successful client outcomes and has application to a variety of programs which service chronically disabled clients.

Management of persistent pain in the older people

Persistent pain is a commonly experienced symptom. It affects 25% of community-dwelling older adults and up to 80% of nursing home residents, and can have a major impact on quality of life and functional capacity. Unfortunately pain in older patients is often undertreated and misunderstood. Assessment of pain type and severity is important. Most older people, even with moderately impaired cognition, are able to self-report pain. Validated assessment tools using non-verbal pain cues are available for people with more advanced cognitive impairment. Management of pain in older people can be challenging. Physiological changes may impact on pain perception and the pharmacodynamics and pharmacokinetics of medications. Older people are often more sensitive to the adverse effects of analgesic medications and are at risk of drug–drug interactions due to the presence of co-morbidities and polypharmacy. In general, analgesic medications should be commenced at low doses, titrated based on effect and tolerability, and regularly reviewed. Contemporary pain management often utilises multiple analgesics in lower doses to optimise efficacy and avoid dose-related toxicity. A bio-psycho-social approach to the management of persistent pain, utilising a multidisciplinary team and including non-drug strategies, may produce the best results. The goal of pain management is not always to eliminate pain, since this may not be attainable, but rather to enhance function and improve quality of life. This article discusses persistent non-cancer pain in older people, its assessment and management, and the risks and benefits of pharmacological treatment in this population.

Covalent tethering of the dimer interface annuls aggregation in thymidylate synthase

Thymidylate synthase (TS), a dimeric enzyme, forms large soluble aggregates at concentrations of urea (3.3-5 M), well below that required for complete denaturation, as established by fluorescence and size-exclusion chromatography. In contrast to the wild-type enzyme, an engineered mutant of TS (T155C/E188C/C244T), TSMox, in which two subunits are crosslinked by disulfide bridges between residues 155-188' and 188-155', does not show this behavior. Aggregation behavior is restored upon disulfide bond reduction in the mutant protein, indicating the involvement of interface segments in forming soluble associated species. Intermolecular disulfide crosslinking has been used as a probe to investigate the formation of larger non-native aggregates. The studies argue for the formation of large multimeric species via a sticky patch of polypeptide from the dimer interface region that becomes exposed on partial unfolding. Covalent reinforcement of relatively fragile protein-protein interfaces may be a useful strategy in minimizing aggregation of non-native structures in multimeric proteins.

Depression in / by / for women : agency, feminism and self-help in groups

Depression in / by / for Women: Agency, Feminism and Self-Help in Groups on ensimmäinen väitöstasoinen tutkimus feministisestä terapiasta Suomessa sijoittuen psykologian, sosiaalitieteellisen mielenterveystutkimuksen sekä feministisen tutkimuksen alueille. Perinteisen näkemyksen mukaan feministisen tutkimuksen tulee olla ”naisista, naisten tekemää ja naisille kohdistettua”. Naiset ja masennus -projektitutkimus keskittyy naisten kokemaan masennukseen sisältäen mahdollisen miesten sekä patriarkaalisen hyvinvointivaltion osuuden masennukseen. Masennusta kokevat naiset ovat tutkimuksessa sekä tutkimuksen kohteena että aktiivisia osanottajia, mikä tuo heidän äänensä kuuluville. Tutkimus perustuu vuosien 1994-2000 välisenä aikana kerättyyn 11 ryhmän osallistujia koskevaan kvalitatiivisiin ja kvantitatiivisiin aineistoon. Irmeli Laitinen on ollut suunnittelemassa, keräämässä ja analysoimassa sitä yhdessä projektin muiden jäsenten kanssa. Tutkimuksessa mitattiin kuinka ryhmiin osallistuvien seka masennuksen tunteet että toiminnat muuttuivat yhden vuoden aikana. Tutkimuksen tavoitteena oli sekä masennuksesta kärsivien naisten osallistuminen feministiseen toimintatutkimukseen että ammatillisesti ohjatun oma-apuryhmämenetelmän kehittäminen suomalaiseen mielenterveyspalveluun. Projektin tutkimustulosten mukaan siihen osallistuneet naiset voimaantuivat ymmärtämään itseään sekä saivat luottamusta sosiaaliisiin taitoihinsa. Pidemmällä aikavälillä naisten tunteet muuttuivat myönteisiksi, heidän suhteensa itseensä positiivisemmaksi ja he aktivoituivat fyysisesti. Lisäksi tutkimustulokset viittaavat siihen, että masennus voi johtua näkymättömästä, sukupuolisesti virittyneestä jännitteestä naisystävällisessä hyvinvointivaltiossa paljastaen ”hyvinvointimasennusoireilun”. Suomalaisen sosiologi Erik Allardtin hyvinvointitypologian - having, loving, being – mukaisesti nämä ryhmään osallistuvat naiset eivät koe puutteita niinkään materiaalisessa hyvinvoinnissa (having) vaan pikeminkin suhteiden, sosiaalisen ja emotionaalisen hyvinvoinnin ulottuvuuksilla (loving ja being). Se, että masentuneet naiset pystyvät tuomaan esille pitkään vaiennettuja kokemuksiaan, voi merkitä paljon heidän paranemisessaan ja voimaantumisessaan. Ammatillisesti ohjatut oma-apuryhmät ja naisystävälliset hoitokäytännöt mahdollistivat tämänkaltaisen paranemisprosessin alkamisen tutkimukseen osallistuneissa ryhmissä.

Theory of laminar flame propagation with non-normal diffusion.

A study has been made of the problem of steady, one-dimensional, laminar flame propagation in premixed gases, with the Lewis number differing from (and equal to) unity. Analytical solutions, using the method of matched asymptotic expansions, have been obtained for large activation energies. Numerical solutions have been obtained for a wide range of the reduced activation temperature parameter (n {geometrically equal to} E/RTb), and the Lewis number δ. The studies reveal that the flame speed eigenvalue is linear in Lewis number for first order and quadratic in Lewis number for second order reactions. For a quick determination of flame speeds, with reasonable accuracy, a simple rule, expressing the flame speed eigenvalue as a function of the Lewis number and the centroid of the reaction rate function, is proposed. Comparisons have been made with some of the earlier works, for both first and second order reactions.

A new approach to the study of non-linear non-autonomous systems

In this paper, a new approach to the study of non-linear, non-autonomous systems is presented. The method outlined is based on the idea of solving the governing differential equations of order n by a process of successive reduction of their order. This is achieved by the use of “differential transformation functions”. The value of the technique presented in the study of problems arising in the field of non-linear mechanics and the like, is illustrated by means of suitable examples drawn from different fields such as vibrations, rigid body dynamics, etc.

Comparative study of some constitutive equations characterising non-Newtonian fluids

This paper compares, in a general way, the predictions of the constitutive equations given by Rivlin and Ericksen, Oldroyd, and Walters. Whether we consider the rotational problems in cylindrical co-ordinates or in spherical polar co-ordinates, the effect of the non-Newtonicity on the secondary flows is collected in a single parameterα which can be explicitly expressed in terms of the non-Newtonian parameters that occur in each of the above-mentioned constitutive equations. Thus, for a given value ofα, all the three fluids will have identical secondary flows. It is only through the study of appropriate normal stresses that a Rivlin-Ericksen fluid can be distinguished from the other two fluids which are indistinguishable as long as this non-Newtonian parameter has the same value.

Worst inputs and a bound on the highest peak statistics of a class of non-linear systems

A method is developed by which the input leading to the highest possible response in an interval of time can be determined for a class of non-linear systems. The input, if deterministic, is constrained to have a known finite energy (or norm) in the interval under consideration. In the case of random inputs, the energy is constrained to have a known probability distribution function. The approach has applications when a system has to be put to maximum advantage by getting the largest possible output or when a system has to be designed to the highest maximum response with only the input energy or the energy distribution known. The method is also useful in arriving at a bound on the highest peak distribution of the response, when the excitation is a known random process.As an illustration the Duffing oscillator has been analysed and some numerical results have also been presented.

Natural modes of a coupled non-linear system

The natural modes of a non-linear system with two degrees of freedom are investigated. The system, which may contain either hard or soft springs, is shown to possess three modes of vibration one of which does not have any counterpart in the linear theory. The stability analysis indicates the existence of seven different modal stability patterns depending on the values of two parameters of non-linearity.

Belief Propagation Based Decoding of Large Non-Orthogonal STBCs

In this paper,we present a belief propagation (BP) based algorithm for decoding non-orthogonal space-time block codes (STBC) from cyclic division algebras (CDA) having large dimensions. The proposed approachinvolves message passing on Markov random field (MRF) representation of the STBC MIMO system. Adoption of BP approach to decode non-orthogonal STBCs of large dimensions has not been reported so far. Our simulation results show that the proposed BP-based decoding achieves increasingly closer to SISO AWGN performance for increased number of dimensions. In addition, it also achieves near-capacity turbo coded BER performance; for e.g., with BP decoding of 24 x 24 STBC from CDA using BPSK (i.e.,n576 real dimensions) and rate-1/2 turbo code (i.e., 12 bps/Hz spectral efficiency), coded BER performance close to within just about 2.5 dB from the theoretical MIMO capacity is achieved.

Circular elastic inclusions in cylindrical shells

The problem of a circular elastic inclusion in a cylindrical shell subjected to internal pressure or thermal loading is studied. The two shallow-shell equations governing the behaviour of a cylindrical shell are transformed into a single differential equation involving a curvature parameter and a complex potential function in a non-dimensional form. In the shell region, the solution is represented by Hankel functions of first kind, whereas in the inclusion region it is represented by Bessel functions of first kind. Boundary conditions at the shell-inclusion junction are expressed in a simple form involving in-plane strains and change in curvature. The effect of such inclusion parameters as extensional rigidity, bending rigidity, and thermal expansion coefficients on the stress concentrations has been determined. The results are presented in non-dimensional form for ready use.

Eläimen tuttuus ja vieraus : Fenomenologisen empatiateorian uudelleentulkinta ja sen sovellus vieraslajisia eläimiä koskevaan kokemukseen

Within the field of philosophy, animals have traditionally been studied from two perspectives: that of self-knowledge and that of ethics. The analysis of the differences between humans and animals has served our desire to understand our own specificity, whereas ethical discussions have ultimately aimed at finding the right way to treat animals. This dissertation proposes a different way of looking at non-human animals: it investigates the question of how non-human animals appear to us humans in our perceptual experience. The analysis focuses on the empathetic, embodied understanding of animals diverse movements and other expressions. The theoretical point of departure for the research is phenomenological philosophy, in particular Maurice Merleau-Ponty s phenomenology of the body. Edmund Husserl s and Edith Stein s analyses of empathy and embodiment are also crucial to the work. In this tradition, empathy means understanding the other s experience through her bodily expressions and seeing the other body as living, as well as motivated and directed towards the surrounding world. The dissertation both explicates and criticizes the earlier phenomenological notions of empathy and human specificity. In order to elucidate the fundamental structures of our experience of non-human animals, it also applies the phenomenological method, which consists of a phenomenological reduction and a free variation of the different aspects of experience. It is shown that our experiences of non-human animals involve a recognition of both similarities and differences. This recognition, however, is not primarily based on intellectual comparisons but is lived as an embodied relationship to another body, and its manifestations vary from one instant to the next. The analysis also reveals that the object of empathy is not the other s experience as such, not even as it is manifested by the other s movements, but rather the other s embodied situation, enriched by elements that remain outside the scope of the other s experience. The dissertation shows that human existence is intertwined with the existence of non-human animals on four levels: those of empathetic sensations, reciprocal communication, experience of the surrounding world and self-definitions. The animals different modes of perception prove to expand our understanding of what is perceivable and how things can be perceived. The presence of non-human animals in our perceptual world is revealed as something that both shows us the limits of our own embodiment and enables us to overcome these limits in empathetic acts. Finally, it is demonstrated that the life of non-human animals is intertwined with ours in a far more complex way than has been presupposed in traditional descriptions of human-animal differences.

Classification of Protein Kinases on the Basis of Both Kinase and Non-Kinase Regions

Background: Protein phosphorylation is a generic way to regulate signal transduction pathways in all kingdoms of life. In many organisms, it is achieved by the large family of Ser/Thr/Tyr protein kinases which are traditionally classified into groups and subfamilies on the basis of the amino acid sequence of their catalytic domains. Many protein kinases are multidomain in nature but the diversity of the accessory domains and their organization are usually not taken into account while classifying kinases into groups or subfamilies. Methodology: Here, we present an approach which considers amino acid sequences of complete gene products, in order to suggest refinements in sets of pre-classified sequences. The strategy is based on alignment-free similarity scores and iterative Area Under the Curve (AUC) computation. Similarity scores are computed by detecting common patterns between two sequences and scoring them using a substitution matrix, with a consistent normalization scheme. This allows us to handle full-length sequences, and implicitly takes into account domain diversity and domain shuffling. We quantitatively validate our approach on a subset of 212 human protein kinases. We then employ it on the complete repertoire of human protein kinases and suggest few qualitative refinements in the subfamily assignment stored in the KinG database, which is based on catalytic domains only. Based on our new measure, we delineate 37 cases of potential hybrid kinases: sequences for which classical classification based entirely on catalytic domains is inconsistent with the full-length similarity scores computed here, which implicitly consider multi-domain nature and regions outside the catalytic kinase domain. We also provide some examples of hybrid kinases of the protozoan parasite Entamoeba histolytica. Conclusions: The implicit consideration of multi-domain architectures is a valuable inclusion to complement other classification schemes. The proposed algorithm may also be employed to classify other families of enzymes with multidomain architecture.

Tax havens and their impacts on the non-haven countries

Tax havens have attracted increasing attention from the authorities of non-haven countries. The financial crisis exacerbates the negative attitude to tax havens. Offshore zones are now under strong pressure from the international, both financial and political institutions. Thus, the thesis will focus on the current problem of the modern economy, namely tax havens and their impact on the non-haven countries. This thesis will be based on the several articles, in particular “Tax Competition With Parasitic Tax Havens” by Joel Slemrod and John D. Wilson (University of Michigan, 2009) and “Do Havens Divert Economic Activity” by James R. Hines Jr., C. Fritz Foley and Mihir A. Desai (Ross School of Business, 2005). This paper provides two completely different and contradictory viewpoints on the problem of coexisting tax havens and non-haven countries. There are two models, examined in this work, present two important researches. The first one will be concentrated on the positive effect from tax havens whereas the last model will be focused on the completely negative effect from offshore jurisdictions. The first model gives us a good explanation and proof of its statement why tax havens can positively influence on nearby high-tax countries. It describes that the existence of offshore jurisdictions can stimulate the growth of operations and facilitates economic activity in non-haven countries. In contrast to above mentioned, the model with quite opposite view was presented. This economic model and its analysis confirms the undesirability of the existence of offshore areas. Taking into consideration, that the jurisdictions choose their optimal policy, the elimination of offshores will have positive impact on the rest of countries. The model proofs the statement that full or partial elimination of tax havens raises the equilibrium level of the public good and increases country welfare. According to the following study, it can be concluded that both of the models provide telling arguments to prove their assertions. Thereby both of these points of view have their right to exist. Nevertheless, the ongoing debate concerning this issue still will raise a lot of questions.