900 resultados para Health belief model


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The paper discusses a wave propagation based method for identifying the damages in an aircraft built up structural component such as delamination and skin-stiffener debonding. First, a spectral finite element mode l (SFEM) is developed for modeling wave propagation in general built-up structures by using the concept of assembling 2D spectral plate elements. The developed numerical model is validated using conventional 2-D FEM. Studies are performed to capture the mode coupling,that is, the flexural-axial coupling present in the wave responses. Lastly, the damages in these built up structures are then identified using the developed SFEM model and the measured responses using the concept Damage Force Indicator (DFI) technique.

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This paper deals with modeling of the first damage mode, matrix micro-cracking, in helicopter rotor/wind turbine blades and how this effects the overall cross-sectional stiffness. The helicopter/wind turbine rotor system operates in a highly dynamic and unsteady environment leading to severe vibratory loads present in the system. Repeated exposure to this loading condition can induce damage in the composite rotor blades. These rotor/turbine blades are generally made of fiber-reinforced laminated composites and exhibit various competing modes of damage such as matrix micro-cracking, delamination, and fiber breakage. There is a need to study the behavior of the composite rotor system under various key damage modes in composite materials for developing Structural Health Monitoring (SHM) system. Each blade is modeled as a beam based on geometrically non-linear 3-D elasticity theory. Each blade thus splits into 2-D analyzes of cross-sections and non-linear 1-D analyzes along the beam reference curves. Two different tools are used here for complete 3-D analysis: VABS for 2-D cross-sectional analysis and GEBT for 1-D beam analysis. The physically-based failure models for matrix in compression and tension loading are used in the present work. Matrix cracking is detected using two failure criterion: Matrix Failure in Compression and Matrix Failure in Tension which are based on the recovered field. A strain variable is set which drives the damage variable for matrix cracking and this damage variable is used to estimate the reduced cross-sectional stiffness. The matrix micro-cracking is performed in two different approaches: (i) Element-wise, and (ii) Node-wise. The procedure presented in this paper is implemented in VABS as matrix micro-cracking modeling module. Three examples are presented to investigate the matrix failure model which illustrate the effect of matrix cracking on cross-sectional stiffness by varying the applied cyclic

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Wrist pulse signals contain important information about the health of a person and hence diagnosis based on pulse signals has assumed great importance. In this paper we demonstrate the efficacy of a two term Gaussian model to extract information from pulse signals. Results have been obtained by conducting experiments on several subjects to record wrist pulse signals for the cases of before exercise and after exercise. Parameters have been extracted from the recorded signals using the model and a paired t-test is performed, which shows that the parameters are significantly different between the two groups. Further, a recursive cluster elimination based support vector machine is used to perform classification between the groups. An average classification accuracy of 99.46% is obtained, along with top classifiers. It is thus shown that the parameters of the Gaussian model show changes across groups and hence the model is effective in distinguishing the changes taking place due to the two different recording conditions. The study has potential applications in healthcare.

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Extensive and indiscriminate use of synthetic compounds and natural compounds obtained from plant sources have resulted in serious threats to the aquatic ecosystem and human health. Aqueous extract of the root of the plant, Milletia pachycarpa Benth, is currently used for killing fish in the state of Manipur, India. Moreover, this plant is also used as traditional medicine in this region. Although it is widely used in traditional medicine, there is limited information available regarding the adverse effects and mechanism underlying its toxicity. This study examined the effects of exposure to aqueous extract of M. pachycarpa (AEMP) on early embryonic development of zebrafish embryos and mechanisms underlying toxicity. Zebrafish embryos treated with different concentrations of the AEMP produced embryonic lethality and developmental defects. The 96-hr-LC50 of AEMP was found to be 4.276 mu g/mL. Further, multiple developmental abnormalities such as pericardial edema, yolk sac edema, spinal curvature, swim bladder deflation, decreased heart rate, and delayed hatching were also observed in a dose-dependent manner. Zebrafish embryo showing moderate-to-severe developmental defects following AEMP exposure cannot swim properly. Further, this study examined oxidative stress and apoptosis in embryos exposed to AEMP. Enhanced production of ROS and apoptosis was found in brain, trunk, and tail of zebrafish embryos treated with AEMP. Data suggest that oxidative stress and apoptosis are associated with AEMP-induced embryonic lethality and developmental toxicity in zebrafish embryos.

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Anthropogenic aerosols play a crucial role in our environment, climate, and health. Assessment of spatial and temporal variation in anthropogenic aerosols is essential to determine their impact. Aerosols are of natural and anthropogenic origin and together constitute a composite aerosol system. Information about either component needs elimination of the other from the composite aerosol system. In the present work we estimated the anthropogenic aerosol fraction (AF) over the Indian region following two different approaches and inter-compared the estimates. We espouse multi-satellite data analysis and model simulations (using the CHIMERE Chemical transport model) to derive natural aerosol distribution, which was subsequently used to estimate AF over the Indian subcontinent. These two approaches are significantly different from each other. Natural aerosol satellite-derived information was extracted in terms of optical depth while model simulations yielded mass concentration. Anthropogenic aerosol fraction distribution was studied over two periods in 2008: premonsoon (March-May) and winter (November-February) in regard to the known distinct seasonality in aerosol loading and type over the Indian region. Although both techniques have derived the same property, considerable differences were noted in temporal and spatial distribution. Satellite retrieval of AF showed maximum values during the pre-monsoon and summer months while lowest values were observed in winter. On the other hand, model simulations showed the highest concentration of AF in winter and the lowest during pre-monsoon and summer months. Both techniques provided an annual average AF of comparable magnitude (similar to 0.43 +/- 0.06 from the satellite and similar to 0.48 +/- 0.19 from the model). For winter months the model-estimated AF was similar to 0.62 +/- 0.09, significantly higher than that (0.39 +/- 0.05) estimated from the satellite, while during pre-monsoon months satellite-estimated AF was similar to 0.46 +/- 0.06 and the model simulation estimation similar to 0.53 +/- 0.14. Preliminary results from this work indicate that model-simulated results are nearer to the actual variation as compared to satellite estimation in view of general seasonal variation in aerosol concentrations.

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Resumen: La salud mental y el bienestar son fundamentales para nuestra capacidad colectiva y individual como seres humanos de pensar, de exteriorizar los sentimientos, de establecer y mantener relaciones, para estudiar, para perseguir las actividades de ocio, para tomar decisiones diarias y para disfrutar de una vida plena. Una adolescencia saludable es un prerrequisito para una vida adulta saludable. Sin embargo, la realidad actual presenta un panorama preocupante. La formación del capital mental individual y colectivo - especialmente en las primeras etapas de la vida - está siendo retenida por una serie de riesgos evitables para la salud mental (World Health Organization [WHO], 2013). Los adolescentes del sur de Europa (región que ha sido más severamente afectada por la crisis financiera; e.g., Portugal) son señalados como un grupo extremadamente vulnerable, ya que su salud mental fácilmente podría ser influenciada por las dificultades económicas de sus padres y la escasez de solidaridad social (European Parliament, 2012). La promoción de la salud mental de los adolescentes es considerada como una preocupación fundamental (WHO, 2005a, 2013). En este ámbito, las intervenciones centradas en la promoción de la literacía de la salud mental han revelado importantes ventajas en la prevención, reconocimiento, intervención precoz y la reducción del estigma (Pinfold, Stuart, Thornicroft & Arboleda-Florez, 2005; Pinfold, Toulmin, Thornicroft, Huxley, Farmer & Graham, 2003; Schulze, Richter-Werling, Matschinger & Angermeyer, 2003; Stuart, 2006). En consonancia con los marcos de promoción de la salud mentales propuestos por la Organización Mundial de la Salud (2005a), tenemos que involucrar a jóvenes en los ambientes donde interactúan (Burns, 2011). Las escuelas son implícitamente uno de los locales más importantes para la promoción de la salud mental de los adolescentes (Barry, Clarke, Jenkins & Patel, 2013; WHO, 2001). El proyecto “Abrir Espacio para la Salud Mental – Promoción de la salud mental en adolescentes (12-14 años)” tiene como objetivo incrementar literacía de la salud mental en los jóvenes. En el primer año se ha desarrollado un instrumento de evaluación - Mental Health Literacy questionnaire (MHLq) - y la intervención para la promoción de la salud mental. La intervención consiste en 2 sesiones, 90 minutos cada una, implementadas con intervalo de una semana. Siguen una metodología interactiva, utilizando dinámicas de grupo, videos, música y discusión. El estudio de la eficacia de la intervención se lleva a cabo mediante un análisis pre y pos-test con el MHLq, utilizando un grupo experimental y un grupo de control. Este artículo presenta los resultados preliminares de la eficacia de la intervención de promoción de la salud mental en una muestra de 100 adolescentes portugueses (12-14 años). El pos-test mostró un incremento de los niveles de conocimientos de salud mental y estrategias de autoayuda. Los resultados sugieren que la intervención desarrollada parece ser adecuada al objetivo propuesto y refuerzan la creencia de que intervenciones escolares, sistemáticas y sostenibles, para la promoción de la salud mental con jóvenes, es un enfoque prometedor para la promoción de la literacía de la salud mental (Schulze et al., 2003; Rickwood et al., 2005; Corrigan et al., 2007; WHO, 2010).

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Revised 2008-08.-- Published as an article in: Journal of Public Economic Theory (2008), 10(4), 563-594.

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In this paper, an elastic and statistically brittle (ESB) model is applied to the process of damage evolution induced catastrophic rupture and the influence of localization and softening on catastrophic rupture is discussed. According to the analysis, the uncertainty of catastrophic rupture should be attributed to the unknown scale of localized zone. Based on the elastic and statistically brittle model but local mean field approximation, the relation between the scale of localized zone and catastrophic rupture is obtained and then justified with experiments. These results can not only give a deeper understanding of the mechanism governing catastrophic rupture, but also provide a possible tool to foresee the occurrence of catastrophic rupture.

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A Bayesian probabilistic methodology for on-line structural health monitoring which addresses the issue of parameter uncertainty inherent in problem is presented. The method uses modal parameters for a limited number of modes identified from measurements taken at a restricted number of degrees of freedom of a structure as the measured structural data. The application presented uses a linear structural model whose stiffness matrix is parameterized to develop a class of possible models. Within the Bayesian framework, a joint probability density function (PDF) for the model stiffness parameters given the measured modal data is determined. Using this PDF, the marginal PDF of the stiffness parameter for each substructure given the data can be calculated.

Monitoring the health of a structure using these marginal PDFs involves two steps. First, the marginal PDF for each model parameter given modal data from the undamaged structure is found. The structure is then periodically monitored and updated marginal PDFs are determined. A measure of the difference between the calibrated and current marginal PDFs is used as a means to characterize the health of the structure. A procedure for interpreting the measure for use by an expert system in on-line monitoring is also introduced.

The probabilistic framework is developed in order to address the model parameter uncertainty issue inherent in the health monitoring problem. To illustrate this issue, consider a very simplified deterministic structural health monitoring method. In such an approach, the model parameters which minimize an error measure between the measured and model modal values would be used as the "best" model of the structure. Changes between the model parameters identified using modal data from the undamaged structure and subsequent modal data would be used to find the existence, location and degree of damage. Due to measurement noise, limited modal information, and model error, the "best" model parameters might vary from one modal dataset to the next without any damage present in the structure. Thus, difficulties would arise in separating normal variations in the identified model parameters based on limitations of the identification method and variations due to true change in the structure. The Bayesian framework described in this work provides a means to handle this parametric uncertainty.

The probabilistic health monitoring method is applied to simulated data and laboratory data. The results of these tests are presented.

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O estudo analisa os discursos de homens e da revista Mens Health acerca do corpo, saúde e sexualidade. Para a construção dos discursos dos homens, realizamos entrevistas semi-estruturadas com 19 homens leitores e nove não leitores. E dois eventos de grupos focais que reuniram 11 homens no total. Foi entrevistado também o editor da revista. Os principais conceitos norteadores deste trabalho foram os de gênero, sexualidade, poder e masculinidades hegemônicas e subalternas. Evidenciou-se que a revista está fortemente atrelada à sociedade de consumo ao estimular a inserção dos homens em um mercado de produtos e serviços até então estranhos a esse gênero. E que suas concepções sobre saúde estão relacionadas a de bem-estar e de individualização que se articulam com os discursos hegemônicos que vêm dando sentido às concepções de saúde e doença atualmente. A publicação investe fortemente na ideia de um corpo musculoso que proporcionará ganhos sociais, sexuais e profissionais aos sujeitos, nem sempre atrelado às questões de saúde. Ela ratifica a heterossexualidade do leitor projetado, expondo o corpo feminino e o sexo heterossexual e silenciando sobre outras formas de sexualidade. Por isso consideramos que a revista se vincula a uma concepção tradicional da masculinidade. Seus discursos, no entanto, não são monolíticos ou isentos de contradição, e também manifestam nuances relativas a um modelo mais contemporâneo de masculinidade, como quando apresenta a ideia de uma nova pedagogia da sexualidade e a valorização dos cuidados estéticos e de saúde com o corpo, aspectos considerados pouco próximos da masculinidade tradicional. Com relação aos discursos dos homens, evidenciou-se que a classe social e a geração são as variáveis mais importantes nas suas concepções sobre corpo, saúde e sexualidade masculina. Que, entre os não leitores, de modo geral, há evidências mais fortes de flexibilização com relação aos padrões mais tradicionais entre os homens mais jovens e/ou de classes mais altas. Enquanto os homens com idade acima dos 30 anos e das classes populares estão mais atrelados às concepções tradicionais. Entre os leitores, observou-se uma grande reflexividade com relação aos discursos da revista demonstrando que eles vêm se apropriando de forma importante dos discursos da revista e ressignificando suas concepções e práticas sobre os três temas da pesquisa a partir desses discursos. E, assim como os discursos da revista, os discursos dos homens, leitores ou não, também apresentaram aspectos contraditórios, ora demonstrando mais afiliação a um novo modelo de masculinidade, ora ao modelo mais tradicional.

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Objective: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). Method: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. Results: the Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. Conclusion: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures.

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A study was conducted, in association with the Alabama and Mississippi National Estuarine Research Reserves (NERRs) in the Gulf of Mexico (GoM) as well as the Georgia, South Carolina, and North Carolina NERRs in the Southeast (SE), to evaluate the impacts of coastal development on tidal creek sentinel habitats, including potential impacts to human health and well-being. Uplands associated with Southeast and Gulf of Mexico tidal creeks, and the salt marshes they drain, are popular locations for building homes, resorts, and recreational facilities because of the high quality of life and mild climate associated with these environments. Tidal creeks form part of the estuarine ecosystem characterized by high biological productivity, great ecological value, complex environmental gradients, and numerous interconnected processes. This research combined a watershed-level study integrating ecological, public health and human dimension attributes with watershed-level land cover data. The approach used for this research was based upon a comparative watershed and ecosystem approach that sampled tidal creek networks draining developed watersheds (e.g., suburban, urban, and industrial) as well as undeveloped sites (Holland et al. 2004, Sanger et al. 2008). The primary objective of this work was to define the relationships between coastal development with its concomitant land cover changes, and non-point source pollution loading and the ecological and human health and wellbeing status of tidal creek ecosystems. Nineteen tidal creek systems, located along the Southeastern United States coast from southern North Carolina to southern Georgia, and five Gulf of Mexico systems from Alabama and Mississippi were sampled during summer (June-August) 2005, 2006 (SE) and 2008 (GoM). Within each system, creeks were divided into two primary segments based upon tidal zoning: intertidal (i.e., shallow, narrow headwater sections) and subtidal (i.e., deeper and wider sections), and watersheds were delineated for each segment. In total, we report findings on 29 intertidal and 24 subtidal creeks. Indicators sampled throughout each creek included water quality (e.g., dissolved oxygen, salinity, nutrients, chlorophyll-a levels), sediment quality (e.g., characteristics, contaminant levels including emerging contaminants), pathogen and viral indicators (e.g., fecal coliform, enterococci, F+ coliphages, F- coliphages), and abundance and tissue contamination of biological resources (e.g., macrobenthic and nektonic communities, shellfish tissue contaminants). Tidal creeks have been identified as a sentinel habitat to assess the impacts of coastal development on estuarine areas in the southeastern US. A conceptual model for tidal creeks in the southeastern US identifies that human alterations (stressors) of upland in a watershed such as increased impervious cover will lead to changes in the physical and chemical environment such as microbial and nutrient pollution (exposures), of a receiving water body which then lead to changes in the living resources (responses). The overall objective of this study is to evaluate the applicability of the current tidal creek classification framework and conceptual model linking tidal creek ecological condition to potential impacts of development and urban growth on ecosystem value and function in the Gulf of Mexico US in collaboration with Gulf of Mexico NERR sites. The conceptual model was validated for the Gulf of Mexico US tidal creeks. The tidal creek classification system developed for the southeastern US could be applied to the Gulf of Mexico tidal creeks; however, some differences were found that warrant further examination. In particular, pollutants appeared to translate further downstream in the Gulf of Mexico US compared to the southeastern US. These differences are likely the result of the morphological and oceanographic differences between the two regions. Tidal creeks appear to serve as sentinel habitats to provide an early warning of the ensuing harm to the larger ecosystem in both the Southeastern and Gulf of Mexico US tidal creeks.

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This article presents a novel algorithm for learning parameters in statistical dialogue systems which are modeled as Partially Observable Markov Decision Processes (POMDPs). The three main components of a POMDP dialogue manager are a dialogue model representing dialogue state information; a policy that selects the system's responses based on the inferred state; and a reward function that specifies the desired behavior of the system. Ideally both the model parameters and the policy would be designed to maximize the cumulative reward. However, while there are many techniques available for learning the optimal policy, no good ways of learning the optimal model parameters that scale to real-world dialogue systems have been found yet. The presented algorithm, called the Natural Actor and Belief Critic (NABC), is a policy gradient method that offers a solution to this problem. Based on observed rewards, the algorithm estimates the natural gradient of the expected cumulative reward. The resulting gradient is then used to adapt both the prior distribution of the dialogue model parameters and the policy parameters. In addition, the article presents a variant of the NABC algorithm, called the Natural Belief Critic (NBC), which assumes that the policy is fixed and only the model parameters need to be estimated. The algorithms are evaluated on a spoken dialogue system in the tourist information domain. The experiments show that model parameters estimated to maximize the expected cumulative reward result in significantly improved performance compared to the baseline hand-crafted model parameters. The algorithms are also compared to optimization techniques using plain gradients and state-of-the-art random search algorithms. In all cases, the algorithms based on the natural gradient work significantly better. © 2011 ACM.

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The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.