887 resultados para nutritional guidance


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The grain legume Australian sweet lupin (Lupinus angustifolius; ASL) is gaining international interest as a functional food ingredient; however its addition to refined wheat bread has been shown to decrease bread volume and textural quality, the extent of which is influenced by ASL variety. The present study evaluated the effects of ASL incorporation (20% of total flour) of the six commercial varieties; Belara, Coromup, Gungurru, Jenabillup, Mandelup and Tanjil, on the level of nutritional, phytochemical and bioactive composition and protein quality of refined wheat flour bread. Protein, dietary fiber, phenolic and carotenoid content, antioxidant capacity and protein digestibility corrected amino acid score (PDCAAS) were higher (p < 0.05), whereas available carbohydrate level was lower (p < 0.05) in ASL–wheat breads than the wheat-only bread, regardless of the ASL variety used. In addition, the blood-glucose lowering bioactive peptide γ-conglutin was detected in all ASL–wheat breads but not in wheat-only bread. The ASL variety used significantly (p < 0.05) affected the dietary fiber, fat, available carbohydrates and polyphenolic level, the antioxidant capacity and the PDCAAS of the ASL–wheat breads. These findings demonstrate the potential nutritional and health benefits of adding ASL to refined wheat bread and highlight the importance of selecting specific ASL varieties to maximise its nutritional attributes.

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The grain legume Australian sweet lupin (Lupinus angustifolius; ASL) is gaining international interest as a functional food ingredient; however its addition to refined wheat bread has been shown to decrease bread volume and textural quality, the extent of which is influenced by ASL variety. The present study evaluated the effects of ASL incorporation (20% of total flour) of the six commercial varieties; Belara, Coromup, Gungurru, Jenabillup, Mandelup and Tanjil, on the level of nutritional, phytochemical and bioactive composition and protein quality of refined wheat flour bread. Protein, dietary fiber, phenolic and carotenoid content, antioxidant capacity and protein digestibility corrected amino acid score (PDCAAS) were higher (p < 0.05), whereas available carbohydrate level was lower (p < 0.05) in ASL–wheat breads than the wheat-only bread, regardless of the ASL variety used. In addition, the blood-glucose lowering bioactive peptide γ-conglutin was detected in all ASL–wheat breads but not in wheat-only bread. The ASL variety used significantly (p < 0.05) affected the dietary fiber, fat, available carbohydrates and polyphenolic level, the antioxidant capacity and the PDCAAS of the ASL–wheat breads. These findings demonstrate the potential nutritional and health benefits of adding ASL to refined wheat bread and highlight the importance of selecting specific ASL varieties to maximise its nutritional attributes.

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In this 'Summary Guidance for Daily Practice', we describe the basic principles of prevention and management of foot problems in persons with diabetes. This summary is based on the International Working Group on the Diabetic Foot (IWGDF) Guidance 2015. There are five key elements that underpin prevention of foot problems: (1) identification of the at-risk foot; (2) regular inspection and examination of the at-risk foot; (3) education of patient, family and healthcare providers; (4) routine wearing of appropriate footwear, and; (5) treatment of pre-ulcerative signs. Healthcare providers should follow a standardized and consistent strategy for evaluating a foot wound, as this will guide further evaluation and therapy. The following items must be addressed: type, cause, site and depth, and signs of infection. There are seven key elements that underpin ulcer treatment: (1) relief of pressure and protection of the ulcer; (2) restoration of skin perfusion; (3) treatment of infection; (4) metabolic control and treatment of co-morbidity; (5) local wound care; (6) education for patient and relatives, and; (7) prevention of recurrence. Finally, successful efforts to prevent and manage foot problems in diabetes depend upon a well-organized team, using a holistic approach in which the ulcer is seen as a sign of multi-organ disease, and integrating the various disciplines involved.

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Recommendations - 1 To identify a person with diabetes at risk for foot ulceration, examine the feet annually to seek evidence for signs or symptoms of peripheral neuropathy and peripheral artery disease. (GRADE strength of recommendation: strong; Quality of evidence: low) - 2 In a person with diabetes who has peripheral neuropathy, screen for a history of foot ulceration or lower-extremity amputation, peripheral artery disease, foot deformity, pre-ulcerative signs on the foot, poor foot hygiene and ill-fitting or inadequate footwear. (Strong; Low) - 3 Treat any pre-ulcerative sign on the foot of a patient with diabetes. This includes removing callus, protecting blisters and draining when necessary, treating ingrown or thickened toe nails, treating haemorrhage when necessary and prescribing antifungal treatment for fungal infections. (Strong; Low) - 4 To protect their feet, instruct an at-risk patient with diabetes not to walk barefoot, in socks only, or in thin-soled standard slippers, whether at home or when outside. (Strong; Low) - 5 Instruct an at-risk patient with diabetes to daily inspect their feet and the inside of their shoes, daily wash their feet (with careful drying particularly between the toes), avoid using chemical agents or plasters to remove callus or corns, use emollients to lubricate dry skin and cut toe nails straight across. (Weak; Low) - 6 Instruct an at-risk patient with diabetes to wear properly fitting footwear to prevent a first foot ulcer, either plantar or non-plantar, or a recurrent non-plantar foot ulcer. When a foot deformity or a pre-ulcerative sign is present, consider prescribing therapeutic shoes, custom-made insoles or toe orthosis. (Strong; Low) - 7 To prevent a recurrent plantar foot ulcer in an at-risk patient with diabetes, prescribe therapeutic footwear that has a demonstrated plantar pressure-relieving effect during walking (i.e. 30% relief compared with plantar pressure in standard of care therapeutic footwear) and encourage the patient to wear this footwear. (Strong; Moderate) - 8 To prevent a first foot ulcer in an at-risk patient with diabetes, provide education aimed at improving foot care knowledge and behaviour, as well as encouraging the patient to adhere to this foot care advice. (Weak; Low) - 9 To prevent a recurrent foot ulcer in an at-risk patient with diabetes, provide integrated foot care, which includes professional foot treatment, adequate footwear and education. This should be repeated or re-evaluated once every 1 to 3 months as necessary. (Strong; Low) - 10 Instruct a high-risk patient with diabetes to monitor foot skin temperature at home to prevent a first or recurrent plantar foot ulcer. This aims at identifying the early signs of inflammation, followed by action taken by the patient and care provider to resolve the cause of inflammation. (Weak; Moderate) - 11 Consider digital flexor tenotomy to prevent a toe ulcer when conservative treatment fails in a high-risk patient with diabetes, hammertoes and either a pre-ulcerative sign or an ulcer on the distal toe. (Weak; Low) - 12 Consider Achilles tendon lengthening, joint arthroplasty, single or pan metatarsal head resection, or osteotomy to prevent a recurrent foot ulcer when conservative treatment fails in a high-risk patient with diabetes and a plantar forefoot ulcer. (Weak; Low) - 13 Do not use a nerve decompression procedure in an effort to prevent a foot ulcer in an at-risk patient with diabetes, in preference to accepted standards of good quality care. (Weak; Low)

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Foot problems complicating diabetes are a source of major patient suffering and societal costs. Investing in evidence-based, internationally appropriate diabetic foot care guidance is likely among the most cost-effective forms of healthcare expenditure, provided it is goal-focused and properly implemented. The International Working Group on the Diabetic Foot (IWGDF) has been publishing and updating international Practical Guidelines since 1999. The 2015 updates are based on systematic reviews of the literature, and recommendations are formulated using the Grading of Recommendations Assessment Development and Evaluation system. As such, we changed the name from 'Practical Guidelines' to 'Guidance'. In this article we describe the development of the 2015 IWGDF Guidance documents on prevention and management of foot problems in diabetes. This Guidance consists of five documents, prepared by five working groups of international experts. These documents provide guidance related to foot complications in persons with diabetes on: prevention; footwear and offloading; peripheral artery disease; infections; and, wound healing interventions. Based on these five documents, the IWGDF Editorial Board produced a summary guidance for daily practice. The resultant of this process, after reviewed by the Editorial Board and by international IWGDF members of all documents, is an evidence-based global consensus on prevention and management of foot problems in diabetes. Plans are already under way to implement this Guidance. We believe that following the recommendations of the 2015 IWGDF Guidance will almost certainly result in improved management of foot problems in persons with diabetes and a subsequent worldwide reduction in the tragedies caused by these foot problems.

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The use of UAVs for remote sensing tasks; e.g. agriculture, search and rescue is increasing. The ability for UAVs to autonomously find a target and perform on-board decision making, such as descending to a new altitude or landing next to a target is a desired capability. Computer-vision functionality allows the Unmanned Aerial Vehicle (UAV) to follow a designated flight plan, detect an object of interest, and change its planned path. In this paper we describe a low cost and an open source system where all image processing is achieved on-board the UAV using a Raspberry Pi 2 microprocessor interfaced with a camera. The Raspberry Pi and the autopilot are physically connected through serial and communicate via MAVProxy. The Raspberry Pi continuously monitors the flight path in real time through USB camera module. The algorithm checks whether the target is captured or not. If the target is detected, the position of the object in frame is represented in Cartesian coordinates and converted into estimate GPS coordinates. In parallel, the autopilot receives the target location approximate GPS and makes a decision to guide the UAV to a new location. This system also has potential uses in the field of Precision Agriculture, plant pest detection and disease outbreaks which cause detrimental financial damage to crop yields if not detected early on. Results show the algorithm is accurate to detect 99% of object of interest and the UAV is capable of navigation and doing on-board decision making.

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An important limitation of the existing IGC algorithms, is that they do not explicitly exploit the inherent time scale separation that exist in aerospace vehicles between rotational and translational motions and hence can be ineffective. To address this issue, a two-loop partial integrated guidance and control (PIGC) scheme has been proposed in this paper. In this design, the outer loop uses a recently developed, computationally efficient, optimal control formulation named as model predictive static programming. It gives the commanded pitch and yaw rates whereas necessary roll-rate command is generated from a roll-stabilization loop. The inner loop tracks the outer loop commands using the Dynamic inversion philosophy. Uncommonly, Six-Degree of freedom (Six-DOF) model is used directly in both the loops. This intelligent manipulation preserves the inherent time scale separation property between the translational and rotational dynamics, and hence overcomes the deficiency of current IGC designs, while preserving its benefits. Comparative studies of PIGC with one loop IGC and conventional three loop design were carried out for engaging incoming high speed target. Simulation studies demonstrate the usefulness of this method.

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This paper presents an optimization of the performance of a recently proposed virtual sliding target (VST) guidance scheme in terms of maximization of its launch envelope for three- dimensional (3-D) engagements. The objective is to obtain the launch envelope of the missile using the VST guidance scheme for different lateral launch angles with respect to the line of sight (LOS) and demonstrate its superiority over kinematics-based guidance laws like proportional navigation (PN). The VST scheme uses PN as its basic guidance scheme and exploits the relation between the atmospheric properties, missile aerodynamic characteristics, and the optimal trajectory of the missile. The missile trajectory is shaped by controlling the instantaneous position and the speed of a virtual target which the missile pursues during the midcourse phase. In the proposed method it is shown that an appropriate value of initial position for the virtual target in 3-D, combined with optimized virtual target parameters, can significantly improve the launch envelope performance. The paper presents the formulation of the optimization problem, obtains the approximate models used to make the optimization problem more tractable, and finally presents the optimized performance of the missile in terms of launch envelope and shows significant improvement over kinematic-based guidance laws. The paper also proposes modification to the basic VST scheme. Some simulations using the full-fledged six degrees-of-freedom (6-DOF) models are also presented to validate the models and technique used.

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This paper compares closed-loop performance of seeker-based and radar-based estimators for surface-to-air interception through 6-degree-of-freedom simulation using proportional navigation guidance.Ground radar measurements are evader range, azimuth and elevation angles contaminated by Gaussian noise. Onboard seeker measurements are pursuer-evader relative range, range rate also contaminated by Gaussian noise. The gimbal angles and line-of-sight rates in the gimbal frame,contaminated by time-correlated non-Gaussian noise with realistic numerical values are also available as measurements. In both the applications, extended Kalman filter with Gaussian noise assumption are used for state estimation. For a typical engagement, it is found that,based on Monte Carlo studies, seeker estimator outperforms radar estimator in terms of autopilot demand and reduces the miss distance.Thus, a seeker estimator with white Gaussian assumption is found to be adequate to handle the measurements even in the presence of non-Gaussian correlated noise. This paper uses realistic numerical values of all noise parameters.

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A nonlinear suboptimal guidance scheme is developed for the reentry phase of the reusable launch vehicles. A recently developed methodology, named as model predictive static programming (MPSP), is implemented which combines the philosophies of nonlinear model predictive control theory and approximate dynamic programming. This technique provides a finite time nonlinear suboptimal guidance law which leads to a rapid solution of the guidance history update. It does not have to suffer from computational difficulties and can be implemented online. The system dynamics is propagated through the flight corridor to the end of the reentry phase considering energy as independent variable and angle of attack as the active control variable. All the terminal constraints are satisfied. Among the path constraints, the normal load is found to be very constrictive. Hence, an extra effort has been made to keep the normal load within a specified limit and monitoring its sensitivity to the perturbation.

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In this paper, a relative velocity approach is used to analyze the capturability of a geometric guidance law. Point mass models are assumed for both the missile and the target. The speeds of the missile and target are assumed to remain constant throughout the engagement. Lateral acceleration, obtained from the guidance law, is applied to change the path of the missile. The kinematic equations for engagements in the horizontal plane are derived in the relative velocity space. Some analytical results for the capture region are obtained for non-maneuvering and maneuvering targets. For non-maneuvering targets it is enough for the navigation gain to be a constant to intercept the target, while for maneuvering targets a time varying navigation gain is needed for interception. These results are then verified through numerical simulations.

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This paper discusses how expert guidance can be best provided in work intensive clinical settings. The adequacy for supporting learning in the clinical practicum for health care disciplines is often complicated by the intensive work practices in healthcare settings. Often, clinicians' work is so intense that the scope for providing close guidance for students is quite restricted. The case advanced here draws on a range of empirical work to propose how clinician-student interactions might be optimized through the provision of a clinical ccn guided learning such as demonstrating and role-modeling. These roles can contribute in essential ways to the development of learning environments where clinicians have the opportunity to facilitate the learning of others as part of their workload, and without being burdened by the requirements of teaching and assessment processes. It differs from other approaches because although clinicians partner students and provide feedback to them, clinicians are not expected to formally assess or award a grade for student performance. Assessment and remedial action, when required, is undertaken by the role of a designated clinical supervisor qualified to perform such activities. © 2010 Springer Science+Business Media B.V.

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The doctoral dissertation, entitled Siperiaa sanoiksi - uralilaisuutta teoiksi. Kai Donner poliittisena organisaattorina sekä tiedemiehenä antropologian näkökulmasta clarifies the early history of anthropological fieldwork and research in Siberia. The object of research is Kai Donner (1888-1935), fieldworker, explorer and researcher of Finno-Ugric languages, who made two expeditions to Siberia during 1911-1913 and 1914. Donner studied in Cambridge in 1909 under the guidance of James Frazer, A. C. Haddon and W. H. R. Rivers - and with Bronislaw Malinowski. After finishing his expeditions, Donner organized the enlistment of Finnish university students to receive military training in Germany. He was exiled and participated in the struggle for Finnish independence. After that, he organized military offensives in Russia and participated in domestic politics and policy in cooperation with C. G. E. Mannerheim. He also wrote four ethnographic descriptions on Siberia and worked with the Scandinavian Arctic areas researchers and Polar explorers. The results of this analysis can be sum up as follows: In the history of ethnographic research in Finland, it is possible to find two types of fieldwork tradition. The first tradition started from M. A. Castrén's explorations and research and the second one from August Ahlqvist's. Donner can be included in the first group with Castrén and Sakari Pälsi, unlike other contemporary philologists, or cultural researcher colleagues, which used the method of August Ahlqvist. Donner's holistic, lively and participant-observation based way of work is articulated in his writings two years before Malinowski published his thesis about modern fieldwork. Unfortunately, Donner didn't get the change to continue his researche because of the civil war in Finland, and due to the dogmatic position of E. N. Setälä. Donner's main work - the ethnohistorical Siberia - encloses his political and anthropological visions about a common and threatened Uralic nation under the pressure of Russian. The important items of his expeditions can be found in the area of cultural ecology, nutritional anthropology and fieldwork methods. It is also possible to prove that in his short stories from Siberia, there can be found some psychological factors that correlate his early life history.