959 resultados para Course of study


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Event-related brain potentials (ERPs) provide high-resolution measures of the time course of neuronal activity patterns associated with perceptual and cognitive processes. New techniques for ERP source analysis and comparisons with data from blood-flow neuroimaging studies enable improved localization of cortical activity during visual selective attention. ERP modulations during spatial attention point toward a mechanism of gain control over information flow in extrastriate visual cortical pathways, starting about 80 ms after stimulus onset. Paying attention to nonspatial features such as color, motion, or shape is manifested by qualitatively different ERP patterns in multiple cortical areas that begin with latencies of 100–150 ms. The processing of nonspatial features seems to be contingent upon the prior selection of location, consistent with early selection theories of attention and with the hypothesis that spatial attention is “special.”

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Purpose: The primary goal of this exploratory study is to demonstrate that distress screening across the course of cancer treatment is possible and provides valuable information about patient needs over time. Distress screening is aligned with guidelines from national accrediting organizations and may lead to improved health-related quality of life, satisfaction with medical care, and possibly survival.Methods: Medical, surgical, and radiation oncology patients completed a screening instrument before their appointments during a six-month period. Patients indicated their level of distress on four domains (practical, emotional, health and social concerns). De-identified data was collected, aggregated and descriptive statistics were analyzed.Results: Approximately 3000 screens were collected and 1500 cancer patients were screened. Of patients who indicated distress, 54% demonstrated a distress level of five or greater. Distress level eight was the most frequent level of distress indicated. The Cancer Dietitian was the most commonly requested healthcare team provider. The Health Concern domain was most frequently endorsed.Conclusion: NCCN, IOM and COC guidelines recommend distress screening in all cancer treatment centers, however implementation has proven difficult. This study adds to the literature about distress in cancer patients, demonstrates the feasibility of repeated distress screening and provides a model program demonstrating the implementation of repeated distress screening at a community cancer center. Findings highlight the importance of supportive oncology services due to the prevalence of high levels of distress. Findings demonstrate the importance of the Cancer Dietitian in supportive cancer care. Additionally, the research reveals a potential perceived stigma in seeking psychosocial oncology services.

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The goal of this publication is to attempt to assess the thirteen years (2001- -2014) of the West’s military presence in the countries of post-Soviet Central Asia, closely associated with the ISAF and OEF-A (Operation Enduring Freedom – Afghanistan) missions in Afghanistan. There will also be an analysis of the actual challenges for the region’s stability after 2014. The current and future security architecture in Central Asia will also be looked at closely, as will the actual capabilities to counteract the most serious threats within its framework. The need to separately handle the security system in Central Asia and security as such is dictated by the particularities of political situation in the region, the key mechanism of which is geopolitics understood as global superpower rivalry for influence with a secondary or even instrumental role of the five regional states, while ignoring their internal problems. Such an approach is especially present in Russia’s perception of Central Asia, as it views security issues in geopolitical categories. Because of this, security analysis in the Central Asian region requires a broader geopolitical context, which was taken into account in this publication. The first part investigates the impact of the Western (primarily US) military and political presence on the region’s geopolitical architecture between 2001 and 2014. The second chapter is an attempt to take an objective look at the real challenges to regional security after the withdrawal of the coalition forces from Afghanistan, while the third chapter is dedicated to analysing the probable course of events in the security dimension following 2014. The accuracy of predictions time-wise included in the below publication does not exceed three to five years due to the dynamic developments in Central Asia and its immediate vicinity (the former Soviet Union, Afghanistan, Pakistan, Iran), and because of the large degree of unpredictability of policies of one of the key regional actors – Russia (both in the terms of its activity on the international arena, and its internal developments).

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Last year Kaliningrad became the subject of an international debate involving first of all the European Union, Russia, the USA, and the countries bordering the enclave, Poland and Lithuania. Such keen interest in a small region of less than a million inhabitants was mainly due to the fact that Kaliningrad has found itself in the very centre of two processes which are of paramount importance for Europe: EU and NATO enlargement. If Lithuania becomes a member of those units and Poland joins the EU, this Russian enclave will become an island surrounded on all land borders by a totally different, political, economic and military entity. In the course of the debate many questions were raised about the situation in the Oblast and how it affects neighbouring countries, the real interests and intentions of the parties involved in the debate, and the future of the region. The authors of this publication are attempting to answer these questions. The first part of this analysis is devoted to presenting the most important internal problems of the enclave, considering their influence on the surrounding world and the consequences of adopting the acquis communautaire in Poland and Lithuania. The second part characterises Moscow's policies towards Kaliningrad on the one hand, and those of Western countries on the other. Finally, the authors discuss the probable ways in which the situation in the enclave will develop.

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Comunicação apresentada no CYTEF 2016/VIII Congresso Ibérico | VI Congresso Ibero-Americano de Ciências e Técnicas do Frio, 3-6 maio 2016, Coimbra, Portugal

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"February 1912"--p. [95].

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"Founded upon a course of lectures (Lane Medical Lectures) delivered at Stanford University, California, in the summer of 1913."

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"The following pages had their origin in a course of lectures upon heredity, given at Brown University during the winter of 1911-1912, which were amplified and repeated in part the following summer at Cold Spring Harbor, Long Island, before the Biological Summer School of the Brooklyn Institute of Arts and Sciences."--Pref.

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Objectives : To provide a preliminary clinical profile of the resolution and outcomes of oral-motor impairment and swallowing function in a group of paediatric dysphagia patients post-traumatic brain injury (TBI). To document the level of cognitive impairment parallel to the return to oral intake, and to investigate the correlation between the resolution of impaired swallow function versus the resolution of oral-motor impairment and cognitive impairment. Participants : Thirteen children admitted to an acute care setting for TBI. Main outcome measures : A series of oral-motor (Verbal Motor Production Assessment for Children, Frenchay Dysarthria Assessment, Schedule for Oral Motor Assessment) and swallowing (Paramatta Hospital's Assessment for Dysphagia) assessments, an outcome measure for swallowing (Royal Brisbane Hospital's Outcome Measure for Swallowing), and a cognitive rating scale (Rancho Level of Cognitive Functioning Scale). Results : Across the patient group, oral-motor deficits resolved to normal status between 3 and 11 weeks post-referral (and at an average of 12 weeks post-injury) and swallowing function and resolution to normal diet status were achieved by 3-11 weeks post-referral (and at an average of 12 weeks post-injury). The resolution of dysphagia and the resolution of oral-motor impairment and cognitive impairment were all highly correlated. Conclusion : The provision of a preliminary profile of oral-motor functioning and dysphagia resolution, and data on the linear relationship between swallowing impairment and cognition, will provide baseline information on the course of rehabilitation of dysphagia in the paediatric population post-TBI. Such data will contribute to more informed service provision and rehabilitation planning for paediatric patients post-TBI.

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Hydrocephalus is a condition commonly encountered in paediatric and adult neurosurgery and cerebrospinal fluid (CSF) shunting remains the treatment of choice for many cases. Despite improvements in shunt technology and technique, morbidity and mortality remain. The incidence of early shunt obstruction is high with later failures seen less frequently. This review aims to examine mortality associated with mechanical failure of CSF shunts within Queensland. Neurosurgical and Intensive Care databases were reviewed for cases of mortality associated with shunt failure. Eight cases were identified between the years of 1992 and 2002 with the average age at death 7.7 years. Deaths occurred on average 2 years after last shunt revision. Seven of the eight patients lived outside the metropolitan area. Shunting remains an imperfect means of treating hydrocephalus. Mortality may be encountered at any time post surgery and delays to surgical intervention influence this. Alternative measures such as third ventriculostomy or the placement of a separate access device should be considered. In the event of emergency, a spinal needle could be used to access the ventricle along the course of the ventricular catheter. (C) 2004 Elsevier Ltd. All rights reserved.

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Objective. To investigate the efficacy and tolerability of a course of 5 injections of hyaluronan (HA) given at intervals of one week in patients with symptomatic, mild to moderate osteoarthritis (OA) of the knee. Methods: A double blind, randomized, parallel group, multicenter (17 centers), saline vehicle-controlled study was conducted over 18 weeks. Patients received either 25 mg (2.5 ml) HA in a phosphate buffered solution or 2.5 ml vehicle containing only the buffer by intraarticular injection. Five injections were given at one week intervals and the patients were followed for a further 13 weeks. The Western Ontario McMaster (WOMAC) OA instrument was used as the primary efficacy variable and repeated measures analysis of covariance was used to compare the 2 treatments over Weeks 6, 10, 14, and 18. Results. Of 240 patients randomized for inclusion in the study, 223 were evaluable for the modified intention to treat analysis. The active treatment and control groups were comparable for demographic details, OA history, and previous treatments. Scores for the pain and stiffness subscales of the WOMAC were modestly but significantly lower in the HA-treated group overall (Weeks 6 to 18; p < 0.05) and the statistically significant difference from the control was not apparent until after the series of injections was complete. The physical function subscale did not reach statistical significance (p = 0.064). Tolerability of the procedure was good and there were no serious adverse events that were considered to have a possible causal relationship with the study treatment. Conclusion. Intraarticular HA treatment was significantly more effective than saline vehicle in mild to moderate OA of the knee for the 13 week postinjection period of the study.

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Mechanosensitivity is a ubiquitous sensory mechanism found in living organisms. The simplest known mechanotransducing mechanism is found in bacteria in the form of the mechanosensitive membrane channel of large conductance, MscL. This channel has been studied extensively using a variety of methods at a functional and structural level. The channel is gated by membrane tension in the lipid bilayer alone. It serves as a safety valve protecting bacterial cells against hypoosmotic shock. MscL of Escherichia coli embedded in bilayers composed of asymmetric amounts of single-tailed and double-tailed lipids has been shown to gate spontaneously, even in the absence of membrane tension. To gain insight into the effect of the lipid membrane composition and geometry on MscL structure, a fully solvated, all-atom model of MscL in a stress-free curved bilayer composed of double- and single-tailed lipids was studied using a 9.5-ns molecular dynamics simulation. The bilayer was modeled as a domed structure accommodating the asymmetric composition of the monolayers. During the course of the simulation a spontaneous restructuring of the periplasmic loops occurred, leading to interactions between one of the loops and phospholipid headgroups. Previous experimental studies of the role of the loops agree with the observation that opening starts with a restructuring of the periplasmic loop, suggesting an effect of the curved bilayer. Because of limited resources, only one simulation of the large system was performed. However, the results obtained suggest that through the geometry and composition of the bilayer the protein structure can be affected even on short timescales.

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This action research (AR) study explores an alternative approach to vocabulary instruction for low-proficiency university students: a change from targeting individual words from the general service list (West, 1953) to targeting frequent verb + noun collocations. A review of the literature indicated a focus on collocations instead of individual words could potentially address the students’ productive challenges with targeted vocabulary. Over the course of four reflective cycles, this thesis addresses three main aspects of collocation instruction. First, it examines if the students believe studying collocations is more useful than studying individual lexical items. Second, the thesis investigates whether a focus on collocations will lead to improvements in spoken fluency. This is tested through a comparison of a pre-intervention spoken assessment task with the findings from the same task completed 15 weeks later, after the intervention. Third, the thesis explores different procedures for the instructing of collocations under the classroom constraints of a university teaching context. In the first of the four reflective cycles, data is collected which indicates that the students believe a focus on collocations is superior to only teaching individual lexical items, that in the students’ opinion their productive abilities with the targeted structures has improved, and that delexicalized verb collocations are problematic for low-proficiency students. Reflective cycle two produces evidence indicating that productive tasks are superior to receptive tasks for fluency development. In reflective cycle three, productively challenging classroom tasks are investigated further and the findings indicate that tasks with higher productive demands result in greater improvements in spoken fluency. The fourth reflective cycle uses a different type of collocation list: frequent adjective + noun collocations. Despite this change, the findings remain consistent in that certain types of collocations are problematic for low-proficiency language learners and that the evidence shows productive tasks are necessary to improve the students’ spoken ability.

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This thesis considers management decision making at the ward level in hospitals especially by ward sisters, and the effectiveness of the intervention of a decision support system. Nursing practice theories were related to organisation and management theories in order to conceptualise a decision making framework for nurse manpower planning and deployment at the ward level. Decision and systems theories were explored to understand the concepts of decision making and the realities of power in an organisation. In essence, the hypothesis was concerned with changes in patterns of decision making that could occur with the intervention of a decision support system and that the degree of change would be governed by a set of `difficulty' factors within wards in a hospital. During the course of the study, a classification of ward management decision making was created, together with the development and validation of measuring instruments to test the research hypothesis. The decision support system used was rigorously evaluated to test whether benefits did accrue from its implementation. Quantitative results from sample wards together with qualitative information collected, were used to test this hypothesis and the outcomes postulated were supported by these findings. The main conclusion from this research is that a more rational approach to management decision making is feasible, using information from a decision support system. However, wards and ward sisters that need the most assistance, where the `difficulty' factors in the organisation are highest, benefit the least from this type of system. Organisational reviews are needed on these identified wards, involving managers and doctors, to reduce the levels of un-coordinated activities and disruption.

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The HT-29 human colon adenocarcinoma cell line, like many epithelial cells, displays an undifferentiated phenotype when cultured on plastic substrata. Biochemical markers of differentiation, such as brush border associated enzymes and carcinoembryonic antigen were expressed at very low levels. The differentiation-inducing effects of the culture of HT-29 cells on collagen type I gels were evaluated, and were assessed by morphological appearance, brush border associated enzyme activities and the secretion of CEA. The effect that this more physiological environment had on their chemosensitivity to a panel of chemotherapeutic agents was determined, so as to indicate whether this system could be used to improve the selectivity of screening for novel anticancer agents. Initial studies were performed on HT-29 cells derived from cells seeded directly from plastic substrata onto the collagen gels (designated Non-PPC gels). Their time of exposure to the collagen was limited to the time course of a single experiment and the results suggested that a longer, more permanent exposure might produce a more pronounced differentiation. HT-29 cells were then passaged continuously on collagen gels for a minimum of 10 passages prior to experimentation (designated PPC gels). The same parameters were measured, and compared to those for the cells grown on plastic and on the non-passaged collagen gels (Non-PPC) from the original studies. Permanently passaged cells displayed a similar degree of morphological differentiation as the non-passaged cells, with both culture conditions resulting in a more pronounced differentiation than that achieved by culture on plastic. It was noted that the morphological differentiation observed was very heterogeneous, a situation also seen in xenografted tumours in vivo. The activity of alkaline phosphatase and the production of CEA was higher in the cells passaged on collagen (PPC) than the cells cultured on non-passaged collagen gel (Non-PPC) and plastic. The biochemical determination of aminopeptidase activity showed that collagen gel culture enhanced the activity in both non-passaged and passaged HT-29 cells above that of the cells cultured on plastic. However, immunocytochemical localization of aminopeptidase and sucrase-isomaltase of samples of cells grown on the various substrata for 7, 14, 21 and 28 days showed a reduction in both enzymes in the cells grown on collagen gels when compared to cells grown on plastic. The reason for the discrepancy between the two assays for aminopeptidase is at this stage unexplained. Although, there was evidence to suggest that the culture of HT-29 cells on collagen gels was capable of inducing morphological and biochemical markers of enterocytic differentiation, there were no differences in the chemosensitivity of the different cell groups to a panel of anticancer agents. Preliminary studies suggested that the ability of the cells to polarize by their culture on porous filter chambers without any exogenous ECM was sufficient to enhance HT-29 differentiation and the onset of differentiation was probably correlated with the production of ECM by the cells themselves.