854 resultados para fitting and managing keratoconus


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To assess the effects of any interventions which aim to prevent or manage radiation-induced skin reactions in people with cancer.

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Purpose: To investigate the influence of keratoconus on peripheral ocular aberrations. Methods: Aberrations of 7 mild and 5 moderate keratoconics were determined over a 42°horizontal x 32° vertical visual field with a modified COAS-HD aberrometer. Control data were obtained from an emmetropic group. Results: Most aberrations in keratoconics showed field dependence predominately along the vertical meridian. Mean spherical equivalent M, oblique astigmatism J45 and regular astigmatism J180 refraction components and total root mean square aberrations (excluding defocus) had high magnitudes in the inferior visual field. The rates of change of aberrations were higher in moderate than in mild keratoconics. Coma was the dominant peripheral higher-order aberration in both emmetropes and keratoconics; for the latter it had high magnitudes in the centre and periphery of the visual field. Conclusion: Greater rates of change of aberrations across the visual field occurred for the keratoconic groups than for the emmetropic control group. Moderate keratoconics had more rapid changes in, and higher magnitudes of aberrations across the visual field than mild keratoconics. The dominant higher-order aberration for the keratoconics across the visual field was vertical coma.

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Background: Violence in health care has been widely reported and health care workers, particularly nurses in acute care settings, are ill-equipped to manage patients who exhibit aggressive traits. Aim: The aim of this systematic review was to establish best practice in the prevention and management of aggressive behaviours in patients admitted to acute hospital settings. Data Sources: An extensive search of the major databases was conducted from 1990 to 2007. The search included published and unpublished studies and papers in English. Review Methods: This review considered any quantitative research study design that evaluated the effectiveness of interventions in the prevention and management of patients who exhibit aggressive behaviours in an acute hospital setting. Each included study was quality assessed by two independent reviewers and data were extracted using the relevant tools developed by the Joanna Briggs Institute. Results: Ten studies met the inclusion criteria and were included in the review. The evidence identified from the studies includes: the benefit of education and training of acute care nurses in aggression management techniques; use of “as required” medications is effective in minimising harm to patients and staff; and that specific interventions such as physical restraint may play a role in managing aggressive behaviours from patients in the acute care setting. Conclusions: This review makes several recommendations for the prevention and management of aggressive behaviours in acute hospital patients. However, due to the lack of high-quality studies conducted in the acute care setting there is huge scope for future research in this area.

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The Western Downs region, located in Southern Queensland, about 200 kilometres west of Brisbane, has been experiencing rapid and significant changes over the past years, due to a massive boom in the energy sector. The rapid growth triggered by the development of mining and energy sectors has generated environmental, socio-economic and land use issues, and has revealed strong weaknesses within the region’s current governance arrangements. The present paper develops a four-stage approach to managing current and expected changes in a resource-based region under tremendous stress and uncertainty.

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Background: General practitioners (GPs) and nurses are ideally placed to address the significant unmet demand for the treatment of cannabis-related problems given the numbers of people who regularly seek their care. The aim of this study was to evaluate differences between GPs and nurses’ perceived knowledge, beliefs, and behaviors toward cannabis use and its screening and management. Methods: This study involved 161 nurses and 503 GPs who completed a survey distributed via conference satchels to delegates of Healthed seminars focused on topics relevant to women and children’s health. Differences between GPs and nurses were analyzed using χ2- tests and two-sample t-tests, while logistic regression examined predictors of service provision. Results: GPs were more likely than nurses to have engaged in cannabis-related service provision, but also more frequently reported barriers related to time, interest, and having more important issues to address. Nurses reported less knowledge, skills, and role legitimacy. Perceived screening skills predicted screening and referral to alcohol and other drug (AOD) services, while knowing a regular user increased the likelihood of referrals only. Conclusions: Approaches to increase cannabis-related screening and intervention may be improved by involving nurses, and by leveraging the relationship between nurses and doctors, in primary care.

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The generation of a correlation matrix for set of genomic sequences is a common requirement in many bioinformatics problems such as phylogenetic analysis. Each sequence may be millions of bases long and there may be thousands of such sequences which we wish to compare, so not all sequences may fit into main memory at the same time. Each sequence needs to be compared with every other sequence, so we will generally need to page some sequences in and out more than once. In order to minimize execution time we need to minimize this I/O. This paper develops an approach for faster and scalable computing of large-size correlation matrices through the maximal exploitation of available memory and reducing the number of I/O operations. The approach is scalable in the sense that the same algorithms can be executed on different computing platforms with different amounts of memory and can be applied to different bioinformatics problems with different correlation matrix sizes. The significant performance improvement of the approach over previous work is demonstrated through benchmark examples.

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This study seeks to fill the gap in the existing literature by examining at how and whether disclosure of social value creation becomes a part of legitimation strategies of social enterprises. By using Suchman’s (1995) moral dimension of legitimacy theory this study sets out that three global social organizations, Grameen Bank, Charity Water, and the Bill and Melinda Gates Foundation, disclose social value creation as if they conform to expectations of the broader community. The study finds that there is an apparent disconnection between disclosure and actions by social enterprises. With references to few incidents highlighted in this study, social enterprises, use disclosures as their managerial efforts, rather than creating moral legitimacy. The notion of apparent disconnection between disclosure and real action by the case social enterprises is common with the notion of the motivation behind disclosure practices by corporations as captured in extant disclosure literature. The finding suggest that when an organisation (whether it is a corporation or a social enterprise) face legitimacy crisis, it appears to disclose good news than bad news questioning organizational moral legitimacy.

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