947 resultados para TDP-43
Resumo:
Large trucks are involved in a disproportionately small fraction of the total crashes but a disproportionately large fraction of fatal crashes. Large truck crashes often result in significant congestion due to their large physical dimensions and from difficulties in clearing crash scenes. Consequently, preventing large truck crashes is critical to improving highway safety and operations. This study identifies high risk sites (hot spots) for large truck crashes in Arizona and examines potential risk factors related to the design and operation of the high risk sites. High risk sites were identified using both state of the practice methods (accident reduction potential using negative binomial regression with long crash histories) and a newly proposed method using Property Damage Only Equivalents (PDOE). The hot spots identified via the count model generally exhibited low fatalities and major injuries but large minor injuries and PDOs, while the opposite trend was observed using the PDOE methodology. The hot spots based on the count model exhibited large AADTs, whereas those based on the PDOE showed relatively small AADTs but large fractions of trucks and high posted speed limits. Documented site investigations of hot spots revealed numerous potential risk factors, including weaving activities near freeway junctions and ramps, absence of acceleration lanes near on-ramps, small shoulders to accommodate large trucks, narrow lane widths, inadequate signage, and poor lighting conditions within a tunnel.
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BACKGROUND: In Bangladesh, poor infant and young child feeding practices are contributing to the burden of infectious diseases and malnutrition. Objective. To estimate the determinants of selected feeding practices and key indicators of breastfeeding and complementary feeding in Bangladesh. METHODS: The sample included 2482 children aged 0 to 23 months from the Bangladesh Demographic and Health Survey of 2004. The World Health Organization (WHO)-recommended infant and young child feeding indicators were estimated, and selected feeding indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses. RESULTS: Only 27.5% of mothers initiated breastfeeding within the first hour after birth, 99.9% had ever breastfed their infants, 97.3% were currently breastfeeding, and 22.4% were currently bottle-feeding. Among infants under 6 months of age, 42.5% were exclusively breastfed, and among those aged 6 to 9 months, 62.3% received complementary foods in addition to breastmilk. Among the risk factors for an infant not being exclusively breastfed were higher socioeconomic status, higher maternal education, and living in the Dhaka region. Higher birth order and female sex were associated with increased rates of exclusive breastfeeding of infants under 6 months of age. The risk factors for bottle-feeding were similar and included having a partner with a higher educational level (OR = 2.17), older maternal age (OR for age > or = 35 years = 2.32), and being in the upper wealth quintiles (OR for the richest = 3.43). Urban mothers were at higher risk for not initiating breastfeeding within the first hour after birth (OR = 1.61). Those who made three to six visits to the antenatal clinic were at lower risk for not initiating breastfeeding within the first hour (OR = 0.61). The rate of initiating breastfeeding within the first hour was higher in mothers from richer households (OR = 0.37). CONCLUSIONS: Most breastfeeding indicators in Bangladesh were below acceptable levels. Breastfeeding promotion programs in Bangladesh need nationwide application because of the low rates of appropriate infant feeding indicators, but they should also target women who have the main risk factors, i.e., working mothers living in urban areas (particularly in Dhaka).
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Objective: With growing recognition of the role of inflammation in the development of chronic and acute disease, fish oil is increasingly used as a therapeutic agent, but the nature of the intervention may pose barriers to adherence in clinical populations. Our objective was to investigate the feasibility of using a fish oil supplement in hemodialysis patients. ---------- Design: This was a nonrandomized intervention study.---------- Setting: Eligible patients were recruited at the Hemodialysis Unit of Wesley Hospital, Brisbane, Queensland, Australia. Patients The sample included 28 maintenance hemodialysis patients out of 43 eligible patients in the unit. Exclusion criteria included patients regularly taking a fish oil supplement at baseline, receiving hemodialysis for less than 3 months, or being unable to give informed consent.---------- Intervention: Eicosapentaenoic acid (EPA) was administered at 2000 mg/day (4 capsules) for 12 weeks. Adherence was measured at baseline and weekly throughout the study according to changes in plasma EPA, and was further measured subjectively by self-report.---------- Results: Twenty patients (74%) adhered to the prescription based on changes in plasma EPA, whereas an additional two patients self-reported good adherence. There was a positive relationship between fish oil intake and change in plasma EPA. Most patients did not report problems with taking the fish oil. Using the baseline data, it was not possible to characterize adherent patients.---------- Conclusions: Despite potential barriers, including the need to take a large number of prescribed medications already, 74% of hemodialysis patients adhered to the intervention. This study demonstrated the feasibility of using fish oil in a clinical population.
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The increasing scarcity of water in the world, along with rapid population increase in urban areas, gives reason for concern and highlights the need for integrating water and wastewater management practices. The uncontrolled growth in urban areas has made planning, management and expansion of water and wastewater infrastructure systems very difficult and expensive. In order to achieve sustainable wastewater treatment and promote the conservation of water and nutrient resources, this chapter advocates the need for a closed-loop treatment system approach, and the transformation of the traditional linear treatment systems into integrated cyclical treatment systems. The recent increased understanding of integrated resource management and a shift towards sustainable management and planning of water and wastewater infrastructure are also discussed.
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Burkholderia pseudomallei, the causative agent of melioidosis is associated with soil. This study used a geographic information system (GIS) to determine the spatial distribution of clinical cases of melioidosis in the endemic suburban region of Townsville in Australia. A total of 65 cases over the period 1996–2008 were plotted using residential address. Two distinct groupings were found. One was around the base of a hill in the city centre and the other followed the old course of a major waterway in the region. Both groups (accounting for 43 of the 65 cases examined) are in areas expected to have particularly wet topsoils following intense rainfall, due to soil type or landscape position.
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Of the numerous factors that play a role in fatal pedestrian collisions, the time of day, day of the week, and time of year can be significant determinants. More than 60% of all pedestrian collisions in 2007 occurred at night, despite the presumed decrease in both pedestrian and automobile exposure during the night. Although this trend is partially explained by factors such as fatigue and alcohol consumption, prior analysis of the Fatality Analysis Reporting System database suggests that pedestrian fatalities increase as light decreases after controlling for other factors. This study applies graphical cross-tabulation, a novel visual assessment approach, to explore the relationships among collision variables. The results reveal that twilight and the first hour of darkness typically observe the greatest frequency of pedestrian fatal collisions. These hours are not necessarily the most risky on a per mile travelled basis, however, because pedestrian volumes are often still high. Additional analysis is needed to quantify the extent to which pedestrian exposure (walking/crossing activity) in these time periods plays a role in pedestrian crash involvement. Weekly patterns of pedestrian fatal collisions vary by time of year due to the seasonal changes in sunset time. In December, collisions are concentrated around twilight and the first hour of darkness throughout the week while, in June, collisions are most heavily concentrated around twilight and the first hours of darkness on Friday and Saturday. Friday and Saturday nights in June may be the most dangerous times for pedestrians. Knowing when pedestrian risk is highest is critically important for formulating effective mitigation strategies and for efficiently investing safety funds. This applied visual approach is a helpful tool for researchers intending to communicate with policy-makers and to identify relationships that can then be tested with more sophisticated statistical tools.
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Because of the greenhouse gas emissions implications of the market dominating electric hot water systems, governments in Australia have implemented policies and programs to encourage the uptake of solar water heaters (SWHs) in the residential market as part of climate change adaptation and mitigation strategies. The cost-benefit analysis that usually accompanies all government policy and program design could be simplistically reduced to the ratio of expected greenhouse gas reductions of SWH to the cost of a SWH. The national Register of Solar Water Heaters specifies how many renewable energy certificates (RECs) are allocated to complying SWHs according to their expected performance, and hence greenhouse gas reductions, in different climates. Neither REC allocations nor rebates are tied to actual performance of systems. This paper examines the performance of instantaneous gas-boosted solar water heaters installed in new residences in a housing estate in south-east Queensland in the period 2007 – 2010. The evidence indicates systemic failures in installation practices, resulting in zero solar performance or dramatic underperformance (estimated average 43% solar contribution). The paper will detail the faults identified, and how these faults were eventually diagnosed and corrected. The impacts of these system failures on end-use consumers are discussed before concluding with a brief overview of areas where further research is required in order to more fully understand whole of supply chain implications.
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Background Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Purpose Within a 12-month, telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. Methods A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive telephone counseling or usual care. Results Those receiving telephone counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. Conclusions For patients with chronic conditions, telephone counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.
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A composite line source emission (CLSE) model was developed to specifically quantify exposure levels and describe the spatial variability of vehicle emissions in traffic interrupted microenvironments. This model took into account the complexity of vehicle movements in the queue, as well as different emission rates relevant to various driving conditions (cruise, decelerate, idle and accelerate), and it utilised multi-representative segments to capture the accurate emission distribution for real vehicle flow. Hence, this model was able to quickly quantify the time spent in each segment within the considered zone, as well as the composition and position of the requisite segments based on the vehicle fleet information, which not only helped to quantify the enhanced emissions at critical locations, but it also helped to define the emission source distribution of the disrupted steady flow for further dispersion modelling. The model then was applied to estimate particle number emissions at a bi-directional bus station used by diesel and compressed natural gas fuelled buses. It was found that the acceleration distance was of critical importance when estimating particle number emission, since the highest emissions occurred in sections where most of the buses were accelerating and no significant increases were observed at locations where they idled. It was also shown that emissions at the front end of the platform were 43 times greater than at the rear of the platform. Although the CLSE model is intended to be applied in traffic management and transport analysis systems for the evaluation of exposure, as well as the simulation of vehicle emissions in traffic interrupted microenvironments, the bus station model can also be used for the input of initial source definitions in future dispersion models.
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To date, biodegradable networks and particularly their kinetic chain lengths have been characterized by analysis of their degradation products in solution. We characterize the network itself by NMR analysis in the solvent-swollen state under magic angle spinning conditions. The networks were prepared by photoinitiated cross-linking of poly(dl-lactide)−dimethacrylate macromers (5 kg/mol) in the presence of an unreactive diluent. Using diffusion filtering and 2D correlation spectroscopy techniques, all network components are identified. By quantification of network-bound photoinitiator fragments, an average kinetic chain length of 9 ± 2 methacrylate units is determined. The PDLLA macromer solution was also used with a dye to prepare computer-designed structures by stereolithography. For these networks structures, the average kinetic chain length is 24 ± 4 methacrylate units. In all cases the calculated molecular weights of the polymethacrylate chains after degradation are maximally 8.8 kg/mol, which is far below the threshold for renal clearance. Upon incubation in phosphate buffered saline at 37 °C, the networks show a similar mass loss profile in time as linear high-molecular-weight PDLLA (HMW PDLLA). The mechanical properties are preserved longer for the PDLLA networks than for HMW PDLLA. The initial tensile strength of 47 ± 2 MPa does not decrease significantly for the first 15 weeks, while HMW PDLLA lost 85 ± 5% of its strength within 5 weeks. The physical properties, kinetic chain length, and degradation profile of these photo-cross-linked PDLLA networks make them most suited materials for orthopedic applications and use in (bone) tissue engineering.
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The relationship between participation in civic and political activities and membership of voluntary associations is now well established. What is less clear is the relative impacts of how much time people spend on group activities (associational intensity), and the number and type of groups that individuals are involved with (associational scope). Does it matter in terms of civic engagement, for example, whether one is a member of a quilting-circle or trade union? Does it matter whether association ‘membership’ is simply an annual payment or a major commitment of time and energy? In this article, we use a large survey to explore these questions empirically by focusing on the membership patterns and civic engagement practices of 4,001 citizens drawn from eight suburbs across Greater Melbourne, Australia. Our findings indicate that, while associational intensity is positively related to civic engagement, associational scope (the number of group memberships per person), is a more influential determinant of the level of civic and political participation. The results also suggest that while all forms of associationalism are important in terms of fostering greater levels of civic activity, not all forms have the same impact.
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There are only two ways to implement reform in an education system, namely through inservice education of existing teachers and preservice teacher education. Implementing the Australian Curriculum will require targeting both teachers and preservice teachers. Classroom teachers in their roles as mentors have a significant role to play for developing preservice teachers. What mentors do in their mentoring practices and what mentors think about mentoring will impact on the mentoring processes and ultimately reform outcomes. What are mentors’ reports on their mentoring of preservice teachers in science and mathematics? This mixed-method study presents mentors’ reports on their mentoring of primary preservice teachers (mentees) in mathematics (n=43) and science (n=29). Drawing upon a previously validated instrument (Hudson, 2007), this instrument was amended to allow mentors to report on their perceptions of their mentoring. A questionnaire elicited extended written responses that focused on: (1) the mentors’ rapport with their mentees, (2) successful mentoring strategies, (3) aspects that may lead the mentee to feel unsuccessful, and (4) ways to enhance their mentoring skills. Mentors claimed they mentored teaching mathematics more than science. However, 20% or more indicated they did not provide mentoring practices for 25 out of 34 survey items in the science and 9 out of 34 items in the mathematics. Educational reform will necessity mentors to be educated on effective mentoring practices so the mentoring process can be more purposeful. Indeed, mentors who have knowledge of such practices may address the potential issues of more than 20% of mentees not receiving these practices. These mentors also claimed that professional development on effective mentoring can enhance their skills. To ensure the greatest success for an Australian Curriculum will require targeting mentors for professional development in order to assist mentees’ development into the profession.
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Background: Thirst and dry mouth are common among hemodialysis (HD) patients. This paper reports a study to evaluate the impact of an acupressure program on HD patients’ thirst and salivary flow rates. Methods: The acupressure program included placebo, followed by true acupressure each applied for 4 weeks. Twenty-eight patients (mean age 57.6, SD = 16.13 years) first received a sticker as placebo acupressure at two acupoints CV23 and TE17 three times a week for 4 weeks, and then received true acupressure in the same area for the next 4 weeks. Salivary flow rate and thirst intensity were measured at baseline, during and after treatment completion for both the placebo and true acupressure program. Results: The true acupressure program was associated with significantly increased salivary flow rate (0.09 ± 0.08 ml/min at baseline to 0.12 ± 0.08 ml/min after treatments completion, p = 0.04). The mean thirst intensity also improved from 4.21 ± 2.66 at baseline to 2.43 ± 2.32 (p = 0.008) after treatment completion in HD patients. There was no statistically significant difference in pre-post program salivary flow rate; however, significant improvement in thirst intensity scores was observed (p = 0.009) in the placebo acupressure program. Conclusion: This study provides preliminary evidence that acupressure may be effective in improving salivary flow rates and thirst intensity.
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Purpose: The aim of this study was to investigate the capabilities of laser scanning confocal microscopy (LSCM) for undertaking qualitative and quantitative investigations of the response of the bulbar conjunctiva to contact lens wear. Methods: LSCM was used to observe and measure morphological characteristics of the bulbar conjunctiva of 11 asymptomatic soft contact lens wearers and 11 healthy volunteer subjects (controls). Results: The appearance of the bulbar conjunctiva is consistent with known histology of this tissue based on light and electron microscopy. The thickness of the bulbar conjunctival epithelium of lens wearers (30.9 ± 1.1 μm) was less than that of controls (32.9 ± 1.1 μm) (P < 0.0001). Superficial and basal bulbar conjunctival epithelial cell densities in contact lens wearers were 91% and 79% higher, respectively, than that in controls (P < 0.0001). No difference was observed in goblet and Langerhans cell density between lens wearers and controls. Conjunctival microcysts were observed in greater numbers, and were larger in size, in lens wearers compared with controls. Conclusions: The effects of contact lens wear on the human bulbar conjunctiva can be investigated effectively at a cellular level using LSCM. The observations in this study suggest that contact lens wear can induce changes in the bulbar conjunctiva such as epithelial thinning and accelerated formation and enlargement of microcysts, increased epithelial cell density, but has no impact on goblet or Langerhans cell density.