820 resultados para Inappropriate Prescribing
Resumo:
Accelerating rates of environmental change and the continued loss of global biodiversity threaten functions and services delivered by ecosystems. Much ecosystem monitoring and management is focused on the provision of ecosystem functions and services under current environmental conditions, yet this could lead to inappropriate management guidance and undervaluation of the importance of biodiversity. The maintenance of ecosystem functions and services under substantial predicted future environmental change (i.e., their ‘resilience’) is crucial. Here we identify a range of mechanisms underpinning the resilience of ecosystem functions across three ecological scales. Although potentially less important in the short term, biodiversity, encompassing variation from within species to across landscapes, may be crucial for the longer-term resilience of ecosystem functions and the services that they underpin.
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We use sunspot group observations from the Royal Greenwich Observatory (RGO) to investigate the effects of intercalibrating data from observers with different visual acuities. The tests are made by counting the number of groups RB above a variable cut-off threshold of observed total whole-spot area (uncorrected for foreshortening) to simulate what a lower acuity observer would have seen. The synthesised annual means of RB are then re-scaled to the full observed RGO group number RA using a variety of regression techniques. It is found that a very high correlation between RA and RB (rAB > 0.98) does not prevent large errors in the intercalibration (for example sunspot maximum values can be over 30 % too large even for such levels of rAB). In generating the backbone sunspot number (RBB), Svalgaard and Schatten (2015, this issue) force regression fits to pass through the scatter plot origin which generates unreliable fits (the residuals do not form a normal distribution) and causes sunspot cycle amplitudes to be exaggerated in the intercalibrated data. It is demonstrated that the use of Quantile-Quantile (“Q Q”) plots to test for a normal distribution is a useful indicator of erroneous and misleading regression fits. Ordinary least squares linear fits, not forced to pass through the origin, are sometimes reliable (although the optimum method used is shown to be different when matching peak and average sunspot group numbers). However, other fits are only reliable if non-linear regression is used. From these results it is entirely possible that the inflation of solar cycle amplitudes in the backbone group sunspot number as one goes back in time, relative to related solar-terrestrial parameters, is entirely caused by the use of inappropriate and non-robust regression techniques to calibrate the sunspot data.
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The personalised conditioning system (PCS) is widely studied. Potentially, it is able to reduce energy consumption while securing occupants’ thermal comfort requirements. It has been suggested that automatic optimised operation schemes for PCS should be introduced to avoid energy wastage and discomfort caused by inappropriate operation. In certain automatic operation schemes, personalised thermal sensation models are applied as key components to help in setting targets for PCS operation. In this research, a novel personal thermal sensation modelling method based on the C-Support Vector Classification (C-SVC) algorithm has been developed for PCS control. The personal thermal sensation modelling has been regarded as a classification problem. During the modelling process, the method ‘learns’ an occupant’s thermal preferences from his/her feedback, environmental parameters and personal physiological and behavioural factors. The modelling method has been verified by comparing the actual thermal sensation vote (TSV) with the modelled one based on 20 individual cases. Furthermore, the accuracy of each individual thermal sensation model has been compared with the outcomes of the PMV model. The results indicate that the modelling method presented in this paper is an effective tool to model personal thermal sensations and could be integrated within the PCS for optimised system operation and control.
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Previous versions of the Consortium for Small-scale Modelling (COSMO) numerical weather prediction model have used a constant sea-ice surface temperature, but observations show a high degree of variability on sub-daily timescales. To account for this, we have implemented a thermodynamic sea-ice module in COSMO and performed simulations at a resolution of 15 km and 5 km for the Laptev Sea area in April 2008. Temporal and spatial variability of surface and 2-m air temperature are verified by four automatic weather stations deployed along the edge of the western New Siberian polynya during the Transdrift XIII-2 expedition and by surface temperature charts derived from Moderate Resolution Imaging Spectroradiometer (MODIS) satellite data. A remarkable agreement between the new model results and these observations demonstrates that the implemented sea-ice module can be applied for short-range simulations. Prescribing the polynya areas daily, our COSMO simulations provide a high-resolution and high-quality atmospheric data set for the Laptev Sea for the period 14-30 April 2008. Based on this data set, we derive a mean total sea-ice production rate of 0.53 km3/day for all Laptev Sea polynyas under the assumption that the polynyas are ice-free and a rate of 0.30 km3/day if a 10-cm-thin ice layer is assumed. Our results indicate that ice production in Laptev Sea polynyas has been overestimated in previous studies.
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Mechanisms and consequences of the effects of estrogen on the brain have been studied both at the fundamental level and with therapeutic applications in mind. Estrogenic hormones binding in particular neurons in a limbic-hypothalamic system and their effects on the electrophysiology and molecular biology of medial hypothalamic neurons were central in establishing the first circuit for a mammalian behavior, the female-typical mating behavior, lordosis. Notably, the ability of estradiol to facilitate transcription from six genes whose products are important for lordosis behavior proved that hormones can turn on genes in specific neurons at specific times, with sensible behavioral consequences. The use of a gene knockout for estrogen receptor alpha (ERalpha) revealed that homozygous mutant females simply would not do lordosis behavior and instead were extremely aggressive, thus identifying a specific gene as essential for a mammalian social behavior. In dramatic contrast, ERbeta knockout females can exhibit normal lordosis behavior. With the understanding, in considerable mechanistic detail, of how the behavior is produced, now we are also studying brain mechanisms for the biologically adaptive influences which constrain reproductive behavior. With respect to cold temperatures and other environmental or metabolic circumstances which are not consistent with successful reproduction, we are interested in thyroid hormone effects in the brain. Competitive relations between two types of transcription factors - thyroid hormone receptors and estrogen receptors have the potential of subserving the blocking effects of inappropriate environmental circumstances on female reproductive behaviors. TRs can compete with ERalpha both for DNA binding to consensus and physiological EREs and for nuclear coactivators. In the presence of both TRs and ERs, in transfection studies, thyroid hormone coadministration can reduce estrogen-stimulated transcription. These competitive relations apparently have behavioral consequences, as thyroid hormones will reduce lordosis, and a TRbeta gene knockout will increase it. In sum, we not only know several genes that participate in the selective control of this sex behavior, but also, for two genes, we know the causal routes. Estrogenic hormones are also the foci of widespread attention for their potential therapeutic effects improving, for example, certain aspects of mood and cognition. The former has an efficient animal analog, demonstrated by the positive effects of estrogen in the Porsolt forced swim test. The latter almost certainly depends upon trophic actions of estrogen on several fundamental features of nerve cell survival and growth. The hypothesis is raised that the synaptic effects of estrogens are secondary to the trophic actions of this type of hormone in the nucleus and nerve cell body.
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The human population is exposed to aluminium (Al) from diet, antacids and vaccine adjuvants, but frequent application of Al-based salts to the underarm as antiperspirant adds a high additional exposure directly to the local area of the human breast. Coincidentally the upper outer quadrant of the breast is where there is also a disproportionately high incidence of breast cysts and breast cancer. Al has been measured in human breast tissues/fluids at higher levels than in blood, and experimental evidence suggests that at physiologically relevant concentrations, Al can adversely impact on human breast epithelial cell biology. Gross cystic breast disease is the most common benign disorder of the breast and evidence is presented that Al may be a causative factor in formation of breast cysts. Evidence is also reviewed that Al can enable the development of multiple hallmarks associated with cancer in breast cells, in particular that it can cause genomic instability and inappropriate proliferation in human breast epithelial cells, and can increase migration and invasion of human breast cancer cells. In addition, Al is a metalloestrogen and oestrogen is a risk factor for breast cancer known to influence multiple hallmarks. The microenvironment is established as another determinant of breast cancer development and Al has been shown to cause adverse alterations to the breast microenvironment. If current useage patterns of Al-based antiperspirant salts contribute to causation of breast cysts and breast cancer, then reduction in exposure would offer a strategy for prevention, and regulatory review is now justified.
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An inappropriate prosthetic fit could cause stress over the interface implant/bone. The objective of this study was to compare stresses transmitted to implants from frameworks cast using different materials and to investigate a possible correlation between vertical misfits and these stresses. Fifteen one-piece cast frameworks simulating bars for fixed prosthesis in a model with five implants were fabricated and arranged into three different groups according to the material used for casting: CP Ti (commercially pure titanium), Co-Cr (cobalt-chromium) or Ni-Cr-Ti (nickel-chromium-titanium) alloys. Each framework was installed over the metal model with all screws tightened to a 10 N cm torque and then, vertical misfits were measured using an optical microscope. The stresses transmitted to implants were measured using quantitative photoelastic analysis in values of maximum shear stress (T), when each framework was tightened to the photoelastic model to a 10 N cm standardized torque. Stress data were statistically analyzed using one-way ANOVA and Tukey`s test and correlation tests were performed using Pearson`s rank correlation (alpha = 0.05). Mean and standard deviation values of vertical misfit are presented for CP Ti (22.40 +/- 9.05 mu m), Co-Cr (66.41 +/- 35.47 mu m) and Ni-Cr-Ti (32.20 +/- 24.47 mu m). Stresses generated by Co-Cr alloy (tau = 7.70 +/- 2.16 kPa) were significantly higher than those generated by CP Ti (tau = 5.86 +/- 1.55 kPa, p = 0.018) and Ni-Cr-Ti alloy (tau =5.74 +/- 3.05 kPa, p = 0.011), which were similar (p = 0.982). Correlations between vertical misfits and stresses around the implants were not significant as for any evaluated materials. (C) 2011 Elsevier Ltd. All rights reserved.
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The starting point for this work was a discussion between my supervisor and myself during my teaching training. The discussion concerned the appropriateness of allowing students make films with sexual content. Film gives young people the opportunity to express their feelings and broaden their views. If the film then disseminates to unknown people via in-ternet, which it most likely will do, maybe it is no longer so positive. The aim of this study is to shed light on various aspects of identity and ethics that are important to keep in mind when young people in school make films. These aspects are to avoid making young people vulnerable to abuse and improper influence. One aim is also to highlight the advantages of making films in school. The study is inspired by hermeneutic interpretive and based on qualitative interviews. The informants are four students at the age of 18-19 at two different schools in one municipality in Sweden.The results of the study show that it is important for the informants that the films are pro-duced in an aesthetically good way so that it appeals to the audience. Two of the infor-mants have a specific audience and make more conscious choices, so that the audience will understand what is said. The study shows that the more a filmmaker considers the audi-ence, the more consciously he or she uses film as communication. To get positive feedback is important, but it is mostly friends of the filmmakers that actually comment. To get nega-tive comments is regarded as a disadvantage when placing material on the internet. Howev-er, none of the informants in the study have received negative comments on what has been posted. The opinions about what the informants believe is inappropriate to post on inter-net or to make films about regards sexuality and violations. Earlier studies show that mate-rial can, because it is interesting to other people, become widespread. For this reason it is important for teachers to have conversations with students about their preferences and opinions on various issues. Adults need to interfere in the young people's world, while be-ing open to their opinions. Then the young people's value system will be built up and give them a safe tool that helps them to avoid improper influence.
Att främja ett ackomodativt lärande utifrån ettandragogiskt perspektiv : I en offentlig organisation
Resumo:
En upplevelse av att det finns begränsade kunskaper kring vuxna individers väg att lära utgörgrunden för denna undersökning. Utbildningar idag kommer ofta i form av föreläsningarvilket framför allt resulterar i ett assimilativt lärande, det vill säga ett ytligt lärande därindividen saknar förståelse för kunskapen. Pedagogik är ett begrepp som överlag i storutsträckning används när lärande är målet oavsett vem som ska lära sig något. Kursupplägg avpedagogisk karaktär vänder sig främst till barn och kan anses olämplig när vuxna individerska lära sig. Andragogik är begreppet för vuxenlärande, vilken bygger på kunskapen om attvuxna är självstyrande individer och behöver därför själva ta steget till att lära sig något nytt. Iden andragogiska modellen presenteras de förutsättningar som krävs för att en vuxen individska kunna tillägna sig nya kunskaper på en djupare nivå, få en förståelse, denna nivå avlärande kallas för ett ackomodativt lärande.Undersökningens syfte var att studera om de två processledarnas ledarskap och kursupplägggrundas i andragogik för att främja ett ackomodativt lärande i Landstinget Dalarnas Chef ochledarprogram.Undersökningen var en fallstudie där en deduktiv ansats förelåg. En kvalitativ metod i formav observation har använts för insamling av data. Processledarna för Chef ochledarprogrammet har observerats och filmats med filmkamera under en av fyra delar av ettintroduktionsblock. Ledarskap och kursupplägg är två områden som behandlas teoretiskt dåde anses kunna påverka lärandet för vuxna personer såväl kollektivt som individuellt.Processledarna för Landstinget Dalarnas Chef och ledarprogram tog i stor utsträckning hänsyntill de vuxna individernas behov, som kan förstås utifrån den andragogiska modellen. Genomsitt ledarskap och kursupplägg skapade de goda förutsättningar för deltagarnas möjlighet attkunna tillägna sig ett ackomodativt lärande. Processledarnas ledarskap grundar sig i känslor,relationer och med människosynen att alla människor har samma grundläggande behov.Kursupplägget bestod av övningar och dialoger där deltagarna involverades, vilketförespråkas i den andragogiska modellen för att kunna uppnå ett ackomodativt lärande
Resumo:
Inledning: Studier påvisar att livsstilsrelaterade sjukdomar ständigt ökar och att fysisk inaktivitet bidrar till detta, likaså att FaR ej används i den utsträckning som det skulle behövas. Syfte: Att belysa för distriktssköterskor vilka underlättande och försvårande faktorer sjukvårdspersonal kan uppleva vid förskrivning av fysisk aktivitet på recept, FaR. Metod: En empirisk fenomenografisk intervjustudie med kvalitativ ansats. Fokusgruppsintervjuer med nio deltagare utfördes på tre vårdcentraler. Huvudresultat: Underlättande och försvårande faktorer framkom inom organisation samt i mötet mellan sjukvårdspersonal och patient, exempelvis stöd från cheferna, utbildning och motiverade patienter var underlättande faktorer. Försvårande faktorer var exempelvis tidsbrist, avsaknad av teamarbete samt negativ inställning till FaR. Konklusion: Chefernas engagemang samt patienternas inställning till fysisk aktivitet och FaR var områden som framkom vara av stor betydelse när sjukvårdspersonal skulle förskriva FaR. Att chefer gav sjukvårdspersonalen resurser för att möjliggöra arbetet med FaR, i form av tid, utbildning och teamarbete ansågs vara en grundläggande faktor. Hälsofrämjande synsätt och prioritering av FaR hos cheferna ger spridning och förankring hos sjukvårdspersonalen. Patienternas inställning till egenvård och fysisk aktivitet var en betydande faktor vid förskrivning av FaR. Där har distriktssköterskor en huvuduppgift i att motivera patienterna till livsstilsförändringar och egenvård samt informera om fysisk aktivitets inverkan på hälsan.