Aggressive surgical interventions for severe stroke: Impact on quality of life, caregiver burden and family outcomes

Introduction: Decompressive hemicraniectomy, clot evacuation, and aneurysmal interventions are considered aggressive surgical therapeutic options for treatment of massive cerebral artery infarction (MCA), intracerebral hemorrhage (ICH), and severe subarachnoid hemorrhage (SAH) respectively. Although these procedures are saving lives, little is actually known about the impact on outcomes other than short-term survival and functional status. The purpose of this study was to gain a better understanding of personal and social consequences of surviving these aggressive surgical interventions in order to aid acute care clinicians in helping family members make difficult decisions about undertaking such interventions. Methods: An exploratory mixed method study using a convergent parallel design was conducted to examine functional recovery (NIHSS, mRS & BI), cognitive status (Montreal Cognitive Assessment Scale, MoCA), quality of life (Euroqol 5-D), and caregiver outcomes (Bakas Caregiver Outcome Scale, BCOS) in a cohort of patients and families who had undergone aggressive surgical intervention for severe stroke between the years 2000–2007. Data were analyzed using descriptive statistics, univariate and multivariate analysis of variance, and multivariate logistic regression. Content analysis was used to analyze the qualitative interviews conducted with stroke survivors and family members. Results: Twenty-seven patients and 13 spouses participated in this study. Based on patient MOCA scores, overall cognitive status was 25.18 (range 23.4-26.9); current functional outcomes scores: NIHSS 2.22, mRS 1.74, and BI 88.5. EQ-5D scores revealed no significant differences between patients and caregivers (p=0.585) and caregiver outcomes revealed no significant differences between male/female caregivers or patient diagnostic group (MCA, SAH, ICH; p=""0.103).<"/span><"/span> Discussion: Overall, patients and families were satisfied with quality of life and decisions made at the time of the initial stroke. There was consensus among study participants that formal community-based support (e.g., handibus, caregiving relief, rehabilitation assessments) should be continued for extended periods (e.g., years) post-stroke. Ongoing contact with health care professionals is valuable to help them navigate in the community as needs change over time.

The effect of post-weaning growth on the fertility of Brahman cross heifers

In the dry tropics of northern Australia heifers are generally weaned mid-year at about six months of age and experience two dry seasons and a wet season prior to first mating at 2 years of age when only 60% are likely to conceive (Entwistle 19830. Pre-mating liveweight (PMLW) explains much of the variation in conception rate, but year effects explain further variations (Rudder et al 1985).

Writing Otherwise than Seeing : Writing and Exteriority in Maurice Blanchot

Maurice Blanchot (1907-2003), the French writer and novelist, is one of the most important figures in post-war French literature and philosophy. The main intention of this study is to figure out his position and originality in the field of phenomenology. Since this thesis concentrates on the notion of vision in Blanchot s work, its primary context is the post-war discussion of the relation between seeing and thinking in France, and particularly the discussion of the conditions of non-violent vision and language. The focus will be on the philosophical conversation between Blanchot and his contemporary philosophers. The central premise is the following: Blanchot relates the criticism of vision to the criticism of the representative model of language. In this thesis, Blanchot s definition of literary language as the refusal to reveal anything is read as a reference pointing in two directions. First, to Hegel s idea of naming as negativity which reveals Being incrementally to man, and second, to Heidegger s idea of poetry as the simultaneity of revealing and withdrawal; the aim is to prove that eventually Blanchot opposes both Hegel s idea of naming as a gradual revelation of the totality of being and Heidegger s conception of poetry as a way of revealing the truth of Being. My other central hypothesis is that for Blanchot, the criticism of the privilege of vision is always related to the problematic of the exteriority. The principal intention is to trace how Blanchot s idea of language as infinity and exteriority challenges both the Hegelian idea of naming as conceptualizing things and Heidegger s concept of language as a way to truth (as aletheia). The intention is to show how Blanchot, with his concepts of fascination, resemblance and image, both affirms and challenges the central points of Heidegger s thinking on language. Blanchot s originality in, and contribution to, the discussion about the violence of vision and language is found in his answer to the question of how to approach the other by avoiding the worst violence . I claim that by criticizing the idea of language as naming both in Hegel and Heidegger, Blanchot generates an account of language which, since it neither negates nor creates Being, is beyond the metaphysical opposition between Being and non-Being.

Estimation of cosmological parameters from neutral hydrogen observations of the post-reionization epoch

The emission from neutral hydrogen (HI) clouds in the post-reionization era (z <= 6), too faint to be individually detected, is present as a diffuse background in all low frequency radio observations below 1420MHz. The angular and frequency fluctuations of this radiation (similar to 1 mK) are an important future probe of the large-scale structures in the Universe. We show that such observations are a very effective probe of the background cosmological model and the perturbed Universe. In our study we focus on the possibility of determining the redshift-space distortion parameter beta, coordinate distance r(nu), and its derivative with redshift r(nu)('). Using reasonable estimates for the observational uncertainties and configurations representative of the ongoing and upcoming radio interferometers, we predict parameter estimation at a precision comparable with supernova Ia observations and galaxy redshift surveys, across a wide range in redshift that is only partially accessed by other probes. Future HI observations of the post-reionization era present a new technique, complementing several existing ones, to probe the expansion history and to elucidate the nature of the dark energy.

Effect of soil burial depth and wetting on mortality of diapausing larvae and patterns of post-diapause adult emergence of sorghum midge, Stenodiplosis sorghicola (Coquillett) (Diptera: Cecidomyiidae)

In south-eastern Queensland, Australia, sorghum planted in early spring usually escapes sorghum midge, Stenodiplosis sorghicola, attack. Experiments were conducted to better understand the role of winter diapause in the population dynamics of this pest. Emergence patterns of adult midge from diapausing larvae on the soil surface and at various depths were investigated during spring to autumn of 1987/88–1989/90. From 1987/88 to 1989/90, 89%, 65% and 98% of adult emergence, respectively, occurred during November and December. Adult emergence from larvae diapausing on the soil surface was severely reduced due to high mortality attributed to surface soil temperatures in excess of 40°C, with much of this mortality occurring between mid-September and mid-October. Emergence of adults from the soil surface was considerably delayed in the 1988/89 season compared with larvae buried at 5 or 10 cm which had similar emergence patterns for all three seasons. In 1989/90, when a 1-cm-deep treatment was included, there was a 392% increase in adult emergence from this treatment compared with deeper treatments. Some diapausing larvae on the surface did not emerge at the end of summer in only 1 year (1989/90), when 28.0% of the larvae on the surface remained in diapause, whereas only 0.8% of the buried larvae remained in diapause. We conclude that the pattern of emergence explains why spring plantings of sorghum in south-eastern Queensland usually escape sorghum midge attack.

‘They rush you and push you too much … and you can't really get any good response off them’: A qualitative examination of family involvement in care of people with dementia in acute care

Aim: To explore the role and needs of the family carer across different acute care contexts and their level of involvement in the care of their relative with dementia in this setting. Method: A pragmatic, exploratory-descriptive qualitative approach. A convenience sample of 30 family carers across three sites completed semi-structured interviews. Results: Family carers wanted to be involved in the acute care of their family member with dementia. They acknowledged the importance of a central source of information, educated staff, guidelines on roles and processes, and positive communication, as well as respect from staff for the carer’s knowledge of the older person and their needs. They also highlighted the need for medical staff to discuss with them the family member’s treatment and care. Conclusion: There is a need for family-focused interventions to improve communication and involvement of family in the care of family members with dementia in the acute setting.

Investigation of movement and factors influencing post-release survival of line-caught coral reef fish using recreational tag-recapture data

Six species of line-caught coral reef fish (Plectropomus spp., Lethrinus miniatus, Lethrinus laticaudis, Lutjanus sebae, Lutjanus malabaricus and Lutjanus erythropterus) were tagged by members of the Australian National Sportsfishing Association (ANSA) in Queensland between 1986 and 2003. Of the 14,757 fish tagged, 1607 were recaptured and we analysed these data to describe movement and determine factors likely to impact release survival. All species were classified as residents since over 80% of recaptures for each species occurred within 1 km of the release site. Few individuals (range 0.8-5%) were recaptured more than 20 km from their release point. L. sebae had a higher recapture rate (19.9%) than the other species studied (range 2.1-11.7%). Venting swimbladder gases, regardless of whether or not fish appeared to be suffering from barotrauma, significantly enhanced (P < 0.05) the survival of L. sebae and L. malabaricus but had no significant effect (P > 0.05) on L. erythropterus. The condition of fish on release, subjectively assessed by anglers, was only a significant effect on recapture rate for L. sebae where fish in "fair" condition had less than half the recapture rate of those assessed as in "excellent" or "good" condition. The recapture rate of L. sebae and L. laticaudis was significantly (P < 0.05) affected by depth with recapture rate declining in depths exceeding 30 m. Overall, the results showed that depth of capture, release condition and treatment for barotrauma influenced recapture rate for some species but these effects were not consistent across all species studied. Recommendations were made to the ANSA tagging clubs to record additional information such as injury, hooking location and hook type to enable a more comprehensive future assessment of the factors influencing release survival.

A comparison of a blocking ELISA and a haemagglutination inhibition assay for the detection of antibodies to Avibacterium (Haemophilus) paragallinarum in sera from artificially infected chickens

The ability of blocking ELISAs and haemagglutination-inhibition (HI) tests to detect antibodies in sera from chickens challenged with either Avibacterium (Haemophilus) paragallinarum isolate Hp8 (serovar A) or H668 (serovar C) was compared. Serum samples were examined weekly over the 9 weeks following infection. The results showed that the positive rate of serovar A specific antibody in the B-ELISA remained at 100% from the second week to the ninth week. In chickens given the serovar C challenge, the highest positive rate of serovar C specific antibody in the B-ELISA appeared at the seventh week (60% positive) and was then followed by a rapid decrease. The B-ELISA gave significantly more positives at weeks 2, 3, 7, 8 and 9 post-infection for serovar A and at week 7 post-infection for serovar C. In qualitative terms, for both serovar A and serovar C infections, the HI tests gave a lower percentage of positive sera at all time points except at 9 weeks post-infection with serovar C. The highest positive rate for serovar A HI antibodies was 70% of sera at the fourth and fifth weeks post-infection. The highest rate of serovar C HI antibodies was 20% at the fifth and sixth weeks post-infection. The results have provided further evidence of the suitability of the serovar A and C B-ELISAs for the diagnosis of infectious coryza.

Nonlinear analysis for the pre- and post-yield behaviour of a composite structure with the refined plastic hinge approach

The computational technique of the full ranges of the second-order inelastic behaviour evaluation of steel-concrete composite structure is not always sought forgivingly, and therefore it hinders the development and application of the performance-based design approach for the composite structure. To this end, this paper addresses of the advanced computational technique of the higher-order element with the refined plastic hinges to capture the all-ranges behaviour of an entire steel-concrete composite structure. Moreover, this paper presents the efficient and economical cross-section analysis to evaluate the element section capacity of the non-uniform and arbitrary composite section subjected to the axial and bending interaction. Based on the same single algorithm, it can accurately and effectively evaluate nearly continuous interaction capacity curve from decompression to pure bending technically, which is the important capacity range but highly nonlinear. Hence, this cross-section analysis provides the simple but unique algorithm for the design approach. In summary, the present nonlinear computational technique can simulate both material and geometric nonlinearities of the composite structure in the accurate, efficient and reliable fashion, including partial shear connection and gradual yielding at pre-yield stage, plasticity and strain-hardening effect due to axial and bending interaction at post-yield stage, loading redistribution, second-order P-δ and P-Δ effect, and also the stiffness and strength deterioration. And because of its reliable and accurate behavioural evaluation, the present technique can be extended for the design of the high-strength composite structure and potentially for the fibre-reinforced concrete structure.

On a Two-Dimensional Problem in the End-Block Design of Post-Tensioned Prestressed Concrete Beams

Abstract is not available.

Stress Concentration in Post-Tensioned Prestressed Concrete Beams

The use of the multiple Fourier method to analyses the stress distribution in the and regions of as a post-tensioned prestressed concrete beam had shown. The multiple Fourier method demonstrated have is a relatively new method for solving those problems for which the “Saint Vansant principle” is not applicable, The actual three-dimensional problem and a two-dimensional simplified representation of it are treated. The two-dimensional case is treated first and rather completely to gain further experience with multiple Fourier procedure, the appropriate Galerkin Vector for the three-dimensional case is found and the required relations between the arbitrary functions are stated.

Re-thinking teacher quality in high-poverty schools in Australia

As is the case globally, Australian schools that serve high-poverty communities most often employ the least experienced, least prepared teachers. Beginning with a discussion of poverty in Australia this chapter draws on 6 years of learnings from Australia's National Exceptional Teachers for Disadvantaged Schools (NETDS) program to examine how social justice can be taught within a mainstream Initial Teacher Education program in an increasingly neoliberal climate where teacher education curriculum around social justice struggles to find a place within the current discourses of quality teaching and its preoccupations with standards, accountability, and high-stakes testing.

"Re-thinking" the influence of regulatory capture in the development of government regulation

On 30 March 2015 the Australian Federal Government launched its "Re-Think" initiative with the objective of achieving a better tax system which delivers taxes that are lower, simpler and fairer. The discussion paper released as part of the "Re:think" initiative is designed to start a national conversation on tax reform. However, inquiries into Australia's future tax system, subsequent reforms and the introduction of new taxes are nothing new. Unfortunately, recent history also demonstrates that reform initiatives arising from reviews of the Australian tax system are often deemed a failure. The most prominent of these failures in recent times is the Minerals Resource Rent Tax (MRRT), which lasted a mere 16 months before its announced repeal. Using the established theoretic framework of regulatory capture to interpret publically observable data, the purpose of this article is to explain the failure of this arguably sound tax. It concludes that the MRRT legislation itself, through the capture by the mining companies, provided internal subsidization in the form of reduced tax and minimal or no rents. In doing so, it offers an opportunity to understand and learn from past experiences to ensure that recommendations coming out of the Re:think initiative do not suffer the same fate.

Om naturens förvandlingar : Vetenskap, kunskap och frihet i Rudolf Steiners tidiga tänkande. Idéhistoriska perspektiv på Waldorfpedagogiken

TRANSFORMATIONS OF NATURE Science, Knowledge and Freedom in the Early Thinking of Rudolf Steiner. Perspectives on Waldorf Education in the light of the History of Ideas Waldorf Education is based on the worldview that Rudolf Steiner (1861-1925) developed to a wide-ranging anthroposophical movement in the first decades of the 20th century. This thesis takes as its departure the early thinking of Rudolf Steiner that precedes anthroposophy, and its main purpose is to uncover the tradition of ideas represented in Steiner´s early life and which, in different ways, have emerged in the practice of Waldorf Education. Through systematic analysis I attempt to bring to light different aspects of Steiner’s early thinking: his concept of science, his epistemological startingpoints and his philosophy of freedom. By departing from J. W. Goethe’s qualitative concept of science, Steiner strove in his early works to formulate a monistic worldview which appears to be closely related to the Romantic Movement and its philosophy of nature. Characteristic traits of his thinking are, on the one hand, a critique of a one-sided enlightenment and, on the other hand, an aspiration to see the world as a living organic unity. Human beings can, by developing our intuitive faculties, get a deeper understanding of the indissoluble relationship between man and nature. Against this background Steiner´s early thinking can be read as a special kind of romantic development narrative. Steiner’s early thinking also opens the way for romantic perspectives on Waldorf Education. It appears that many central aims and conceptions in Waldorf Education can be illuminated by the epistemological perspective upon which Steiner elaborated early in his life. An organic curriculum, phenomenological didactics and high ideal of freedom can be considered seen as educational applications of conceptions that played an important role in Goethe and his age. Thus, Waldorf Education provides in our contemporary society an exceptional set of educational values: a holistic education with romantic undertones.

Post-industrial Intervention : An Activity-Theoretical Expedition Tracing the Proximal Development of Forms of Conducting Interventions

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