959 resultados para Hubbard, Thomas K.
Resumo:
In this paper, we will demonstrate the possibility of opening a new telecommunications transmission window around the 2 μm wavelength, in order to exploit the potential low loss of hollow-core photonic bandgap fibers, with the benefits of significantly lower non-linearity and latency. We will show recent efforts developing a dense wavelength division multiplexing testbed at this waveband, with 100 GHz spacing wavelength channels and 105 Gbit/s total capacity achieved.
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In this paper, we show for the first time the impact of decreasing DWDM channel spacing to 50GHz in the 2mm waveband, using 6x12.5Gbit/s and 2x8Gbit/s OOK signals.
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Aim: This study is going to assess the prevalance of prolonged grief diagnoses and it will evaluate the severity of the symptoms of depression, anxiety and complicated grief two months after a loved one is lost. We also intend to study which variables associated with the risk of grief could be more decisive when diagnosing it, its symptoms and the consequent emotional distress.Method: A total of 66 families of patients in the Palliative Care Unit (PCU) at Hospital San Cecilio in Granada have been evaluated. Measurements were taken two months after the death. This investigation has explored the existing emotional distress using the following questionnaires: Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Inventory of Complicated Grief (ICG) and Prolongued Grief Disorder (PG-12).Results: The results show that 33.3% and 21.21% of the sufferers had high levels of depression and clinical anxiety two months after the death. The prevalence of prolongued grief diagnoses, according to the PG-12, is 10.6% and 53.03% of the participants showed symptoms of complicated grief according to the ICG. Additionally, statistically significant differences are found in the sufferers with and without a prolongued grief diagnosis and scores in the ICG and BDI-II. The family’s financial situation is linked to the presence of symptoms of anxiety and depression and complicated grief, with the most determining variable being the risk of grief. Finally, the greater the age of the deceased and the longer the time spent in the PCU is linked to fewer symptoms of grief. However, important links have been found between the sufferers who have experienced stressful critical events prior to losing their loved one, with symptoms of depression, anxiety and complicated grief.Conclusions: The high numbers of cases of symptoms of complicated grief and levels of anxiety and clinical depression two months after a death suggests that early interventions should be carried out in those individuals with greater vulnerability.
Resumo:
BACKGROUND:
Palliative care focuses on supporting patients diagnosed with advanced, incurable disease; it is 'family centered', with the patient and their family (the unit of care) being core to all its endeavours. However, approximately 30-50% of carers experience psychological distress which is typically under recognised and consequently not addressed. Family meetings (FM) are recommended as a means whereby health professionals, together with family carers and patients discuss psychosocial issues and plan care; however there is minimal empirical research to determine the net effect of these meetings and the resources required to implement them systematically. The aims of this study were to evaluate: (1) if family carers of hospitalised patients with advanced disease (referred to a specialist palliative care in-patient setting or palliative care consultancy service) who receive a FM report significantly lower psychological distress (primary outcome), fewer unmet needs, increased quality of life and feel more prepared for the caregiving role; (2) if patients who receive the FM experience appropriate quality of end-of-life care, as demonstrated by fewer hospital admissions, fewer emergency department presentations, fewer intensive care unit hours, less chemotherapy treatment (in last 30 days of life), and higher likelihood of death in the place of their choice and access to supportive care services; (3) the optimal time point to deliver FM and; (4) to determine the cost-benefit and resource implications of implementing FM meetings into routine practice.
METHODS:
Cluster type trial design with two way randomization for aims 1-3 and health economic modeling and qualitative interviews with health for professionals for aim 4.
DISCUSSION:
The research will determine whether FMs have positive practical and psychological impacts on the family, impacts on health service usage, and financial benefits to the health care sector. This study will also provide clear guidance on appropriate timing in the disease/care trajectory to provide a family meeting.
Resumo:
Marketing and policy researchers seeking to increase the societal impact of their scholarship should engage directly with relevant stakeholders. For maximum societal effect, this engagement needs to occur both within the research process and throughout the complex process of knowledge transfer. A relational engagement approach to research impact is proposed as complementary and building upon traditional approaches. Traditional approaches to impact employ bibliometric measures and focus on the creation and use of journal articles by scholarly audiences, an important but incomplete part of the academic process. The authors suggest expanding the strategies and measures of impact to include process assessments for specific stakeholders across the entire course of impact: from the creation, awareness, and use of knowledge to societal impact. This relational engagement approach involves the co-creation of research with audiences beyond academia. The authors hope to begin a dialogue on the strategies researchers can make to increase the potential societal benefits of their research.
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Composite NiFe2O4–TiO2 magnetic catalysts were prepared by mechanochemical synthesis from a mixture of titania supported nickel ferrite nanoparticles and P25 titania (Evonic). The former provides fast and efficient heating under radiofrequency field, while the latter serves as an active catalyst or catalyst support. The highest heating rate was observed over a catalyst prepared for a milling time of 30 min. The catalytic activity was measured over the sulfated composite catalysts in the condensation of aniline and 3-phenylbutyric acid in a stirred tank reactor and in a continuous RF heated flow reactor in the 140–170 °C range. The product yield of 47% was obtained over the sulfated P25 titania catalyst in the flow reactor.
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Background: Cellulitis of the lower leg accounts for 2-3% of hospital admissions (Cox et al, 1998), with an average length of in-patient stay of nine days. Studies have reported that up to half of these patients suffer further episodes (Cox et al, 1998; Dupuy et al, 1999). Reducing the recurrence of cellulitis could therefore have a significant impact on both patient morbidity and NHS costs. Aims: To assess whether prophylactic antibiotics prescribed after an episode of cellulitis of the leg results in fewer subsequent attacks and reduced health service costs (PATCH prophylactic antibiotics for the treatment of cellulitis at home). Methods: This article describes two related studies in which participants are randomised to receive either 12 months of prophylaxis (PATCH I) or six months of prophylaxis (PATCH II). The PATCH I study recruits only patients with recurrent disease defined as two or more episodes of cellulitis in the last three years. PATCH II has more open criteria and includes patients with a first episode of cellulitis and also participants with recurrent disease. It is expected that 260 patients will be recruited into PATCH I and 400 patients into PATCH II.
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Objective To determine whether a three day burst of a potent corticosteroid is more effective than a mild preparation used for seven days in children with mild or moderate atopic eczema. Design Randomised, double blind, parallel group study of 18 weeks' duration. Setting 13 general practices and a teaching hospital in the Nottingham area. Participants 174 children with mild or moderate atopic eczema recruited from general practices and 33 from a hospital outpatient clinic. Interventions 0.1% betamethasone valerate applied for three days followed by the base ointment for four days versus 1% hydrocortisone applied for seven days. Main outcome measures Primary outcomes were total number of scratchfree days and number of relapses. Secondary outcomes were median duration of relapses, number of undisturbed nights, disease severity (six area, six sign atopic dermatitis severity scale), scores on two quality of life measures (children's life quality index and dermatitis family impact questionnaire), and number of patients in whom treatment failed in each arm. Results No differences were found between the two groups. This was consistent for all outcomes. The median number of scratchfree days was 118.0 for the mild group and 117.5 for the potent group (difference 0.5, 95% confidence interval - 2.0 to 4.0, P = 0.53). The median number of relapses for both groups was 1.0. Both groups showed clinically important improvements in disease severity and quality of life compared with baseline. Conclusion A short burst of a potent topical corticosteroid is just as effective as prolonged use of a milder preparation for controlling mild or moderate atopic eczema in children.
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Recombinant tau protein is widely used to study the biochemical, cellular and pathological aspects of tauopathies, including Alzheimer's disease and frontotemporal dementia with Parkinsonism linked to chromosome 17 (FTPD-17). Pure tau in high yield is a requirement for in vitro evaluation of the protein's physiological and toxic functions. However, the preparation of recombinant tau is complicated by the protein's propensity to aggregate and form truncation products, necessitating the use of multiple, time-consuming purification methods. In this study, we investigated parameters that influence the expression of wild type and FTPD-17 pathogenic tau, in an attempt to identify ways to maximise expression yield. Here, we report on the influence of the choice of host strain, induction temperature, duration of induction, and media supplementation with glucose on tau expression in Escherichia coli. We also describe a straightforward process to purify the expressed tau proteins using immobilised metal affinity chromatography, with favourable yields over previous reports. An advantage of the described method is that it enables high yield production of functional oligomeric and monomeric tau, both of which can be used to study the biochemical, physiological and toxic properties of the protein.
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Background : Developmental coordination disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents’ awareness and building capacity but few interventions incorporating these best practices are documented. Objective : To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioural changes when managing their child’s health condition. Methods : A mixed-methods, before-after-follow-up design guided by the theory of planned behaviour was employed. Data about the knowledge, skills and behaviours of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. One-way repeated measures ANOVAs and thematic analyses were performed on data as appropriate. Results : Fifty-eight participants completed all questionnaires. There was a significant effect of time on self-reported knowledge [F(2.00,114.00)=16.37, p=0.00] and skills [F(1.81,103.03)=51.37, p=0.00] with higher post- and follow-up scores than pre-intervention scores. Thirty-seven (65%) participants reported an intention to change behaviour postintervention; 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents’ behavioural change: sharing information, trialing strategies and changing attitudes. Factors influencing parents’ ability to implement these behavioural changes included clear recommendations, time, and ‘right’ attitude. Perceived outcomes associated with the parental behavioural changes involved improvement in well-being for the children at school, at home, and for the family as a whole. Conclusions : The online module increased parents’ self-reported knowledge and skills in DCD management. Future research should explore its impacts on children’s outcomes long-term.
Resumo:
Background : Developmental coordination disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents’ awareness and building capacity but few interventions incorporating these best practices are documented. Objective : To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioral changes when managing their child’s health condition. Methods : A mixed-methods, before-after design guided by the theory of planned behavior was employed. Data about the knowledge, skills and behaviors of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. Paired T-tests, sensitivity analyses and thematic analyses were performed on data as appropriate. Results: One hundred-sixteen, 81 and 58 participants respectively completed the three questionnaires. For knowledge and skills, post- and follow-up scores were significantly higher than baseline scores (p<0.01). Fifty-two (64%) participants reported an intention to change behavior post-intervention and 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents’ behavioral change: sharing information, trialing strategies and changing attitudes. Factors influencing parents’ ability to implement these behavioral changes included clear recommendations, time, and ‘right’ attitude. Perceived outcomes associated with the parental behavioral changes involved improvement in well-being for the children at school, at home, and for the family as a whole. Conclusions : The online module increased parents’ self-reported knowledge and skills in DCD management. Future research should explore its impacts on children’s long-term outcomes.
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•Objetivos: Se tradujo, adaptó y evaluaron las propiedades clinimétricas de la escala POSAS en pacientes con cicatrices hipertróficas (CHT) y queloides (CQ) cómo secuelas de quemadura, que fueron manejados con Z plastias en la Fundación del Quemado en Bogotá (Colombia), entre Junio de 2015 a Abril de 2016. •Métodos: Estudio de evaluación de las propiedades clinimétricas de una escala. Se hizo una traducción y adaptación transcultural siguiendo el método de traducción-retrotraducción. Se aplicó el instrumento adaptado a cincuenta y dos pacientes (n=52) antes y después de la intervención quirúrgica. Se evaluó la validez, confiabilidad, sensibilidad al cambio y la utilidad de la escala. •Resultados: Se hallaron diferencias significativas en los puntajes obtenidos del Observador y del Paciente, antes y después de la intervención quirúrgica (p<0.000); a excepción de prurito. La escala POSAS demostró ser altamente confiable para la Escala del Observador y del Paciente (α = 0.912 y 0.765). Hubo alta correlación en las evaluaciones de dos observadores para las variables ordinales de la Escala del Observador (r>0.6). La concordancia entre las evaluaciones de dos observadores para las variables categóricas de la Escala del Paciente fue buena para la evaluación antes de la intervención para pigmentación y relieve (κ>0.61). Se demostró que el instrumento es capaz de detectar cambios clínicos en el tiempo (p<0.0000), a excepción de prurito (p= 0.271). •Conclusiones: La escala POSAS demostró ser un instrumento válido, confiable y útil para evaluar la calidad de la cicatriz en pacientes con CHT y CQ cómo secuelas de quemadura.
Resumo:
Como futuros administrados es importante recordar que nuestra función no será únicamente crear una empresa y generar constantemente ingresos. Esto es una de tantas tareas que tiene una persona que se encamina por crear o ser parte de una empresa, sea grande o pequeña siempre existirán variables que con los años se han convertido más y más indispensables en los procesos de este recorrido. El tema principal de nuestro estudio de caso es entender el concepto del endomarketing o como muchos lo conocen marketing interno; en pocas palabras es algo que por años se ha visto su efectividad en la productividad y satisfacción de los empleados. Google es una de las multinacionales más grandes del mundo, que el ultimo reconocimiento fue por parte de uno de los ranking más influyentes “The World’s Billionaries” ocupando como el CEO de la compañía Larry Page el puesto #12 , que por años ha sabido invertir en su recurso más importante que son sus empleados. En una entrevista con la revista Fortune, Larry exclama que “es importante que la empresa sea una familia, que las personas sientan que son parte de la empresa, y que la empresa es como una familia para ellos. Cuando se trata a las personas de esa manera, se obtiene una mejor productividad”. Con este pequeño ejemplo e idea de cómo una de las marcas más influyentes en el mundo ha fortalecido su mejor recurso por años el cual le ha remunerado con el éxito que tiene hoy en día. Entonces es como el mercadeo interno o endomarketing siendo uno de los conceptos tratados en el mercadeo en general hoy en día, logrando meterse como un modelo de negocio en la mayoría de empresas que existen hoy. Este es uno de los motivos que nos motivó para desarrollar este estudio de caso que verán a continuación, el cual se basa en la investigación y análisis de variables que comprenden a la empresa Petrofac, y si bien ha sabido implementar el concepto en sus procesos diarios. El estudio de caso describe como a través de los años ha sabido implementar con éxito la herramienta de evaluación y análisis del mercado interno a los empleados que constituyen hoy en día Petrofac International Limited. Abarcaremos primero con los objetivos del estudio, seguido del inicio y crecimiento de la empresa en los últimos años, en que países tiene presencia y cuáles son sus proyectos más importantes hoy en día. El estudio de caso será implementado por un tipo de investigación descriptiva, que con la recopilación de suficiente información tanto cuantitativa como cualitativa nos ira fortaleciendo la hipótesis principal, usaremos datos estadísticos que serán recopilados de encuestas, entrevistas y focus group. Al final con el análisis y a las conclusiones que lleguemos se busca demostrar el impacto positivo que ha tenido los empleados de diferentes países y de diferentes culturas que poco a poco han influenciado a la empresa para alcanzar el éxito que ha logrado hasta ahora, y de la misma forma como la empresa ha influenciado en cada una de las vidas de estas personas sin importar el lugar en el que estén laborando, siempre la empresa busca que se sientan parte de ella. Como resultados generales, se obtienen argumentos que sustentan que la implementación del mercadeo interno le permite a la empresa generar ventajas competitivas y dinámicas, que son desarrolladas internamente para un futuro reflejarlas ante los clientes externos. El estudio permitió concluir que el mercadeo interno debe ser una estrategia de comunicación dentro de una empresa convirtiéndose de primera necesidad para la compañía, pues los beneficios que genera son cada vez más necesarios para cada área que abarca el negocio.