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1.
Proc Natl Acad Sci U S A ; 116(35): 17225-17230, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31405967

RESUMO

Of the $69.1 trillion global financial assets under management across mutual funds, hedge funds, real estate, and private equity, fewer than 1.3% are managed by women and people of color. Why is this powerful, elite industry so racially homogenous? We conducted an online experiment with actual asset allocators to determine whether there are biases in their evaluations of funds led by people of color, and, if so, how these biases manifest. We asked asset allocators to rate venture capital funds based on their evaluation of a 1-page summary of the fund's performance history, in which we manipulated the race of the managing partner (White or Black) and the strength of the fund's credentials (stronger or weaker). Asset allocators favored the White-led, racially homogenous team when credentials were stronger, but the Black-led, racially diverse team when credentials were weaker. Moreover, asset allocators' judgments of the team's competence were more strongly correlated with predictions about future performance (e.g., money raised) for racially homogenous teams than for racially diverse teams. Despite the apparent preference for racially diverse teams at weaker performance levels, asset allocators did not express a high likelihood of investing in these teams. These results suggest first that underrepresentation of people of color in the realm of investing is not only a pipeline problem, and second, that funds led by people of color might paradoxically face the most barriers to advancement after they have established themselves as strong performers.


Assuntos
Tomada de Decisões , Investimentos em Saúde , Julgamento , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
J Cancer Educ ; 32(1): 35-42, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-26637473

RESUMO

Cervical cancer is a common and deadly disease, especially in developing countries. We developed and implemented an interactive, tablet-based educational intervention to improve cervical cancer knowledge among women in rural Malawi. Chichewa-speaking adult women in six rural villages participated. Each woman took a pretest, participated in the lesson, and then took a posttest. The lesson included information on cervical cancer symptoms, causes, risk factors, prevention, and treatment. Over the 6-month study period, 243 women participated. Women ranged in age from 18 to 77 years. Only 15 % had education beyond primary school. Nearly half of participants (48 %) had heard of cervical cancer prior to viewing the lesson. For these women, the median number of correct responses on the pretest was 11 out of 20; after the lesson, they had a median of 18 correct responses (p < 0.001). After the intervention, 93 % of women indicated a desire for cervical cancer screening. Despite lack of familiarity with computers (96 %), most women (94 %) found the tablet easy to use. A tablet-based educational program was an effective, feasible, and acceptable strategy to disseminate cervical cancer information to women with low education in rural Malawi. This method may be appropriate to distribute health information about other health topics in low-resource settings.


Assuntos
Computadores de Mão/estatística & dados numéricos , Detecção Precoce de Câncer/métodos , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Estudos de Viabilidade , Feminino , Saúde Global , Humanos , Malaui , População Rural
3.
Heredity (Edinb) ; 115(5): 405-14, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25990876

RESUMO

Pancreas disease (PD), caused by a salmonid alphavirus (SAV), has a large negative economic and animal welfare impact on Atlantic salmon aquaculture. Evidence for genetic variation in host resistance to this disease has been reported, suggesting that selective breeding may potentially form an important component of disease control. The aim of this study was to explore the genetic architecture of resistance to PD, using survival data collected from two unrelated populations of Atlantic salmon; one challenged with SAV as fry in freshwater (POP 1) and one challenged with SAV as post-smolts in sea water (POP 2). Analyses of the binary survival data revealed a moderate-to-high heritability for host resistance to PD in both populations (fry POP 1 h(2)~0.5; post-smolt POP 2 h(2)~0.4). Subsets of both populations were genotyped for single nucleotide polymorphism markers, and six putative resistance quantitative trait loci (QTL) were identified. One of these QTL was mapped to the same location on chromosome 3 in both populations, reaching chromosome-wide significance in both the sire- and dam-based analyses in POP 1, and genome-wide significance in a combined analysis in POP 2. This independently verified QTL explains a significant proportion of host genetic variation in resistance to PD in both populations, suggesting a common underlying mechanism for genetic resistance across lifecycle stages. Markers associated with this QTL are being incorporated into selective breeding programs to improve PD resistance.


Assuntos
Resistência à Doença/genética , Doenças dos Peixes/genética , Pancreatopatias/veterinária , Locos de Características Quantitativas , Salmo salar/genética , Alphavirus , Animais , Mapeamento Cromossômico , Feminino , Doenças dos Peixes/virologia , Genética Populacional , Genótipo , Padrões de Herança , Masculino , Modelos Genéticos , Pancreatopatias/genética , Pancreatopatias/virologia , Polimorfismo de Nucleotídeo Único , Salmo salar/virologia
4.
Anaesthesia ; 70(8): 922-32, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25758401

RESUMO

Applying human factors principles to the design of clinical emergency guidelines is important. The UK Civil Aviation Authority uses a Checklist Assessment Tool for evaluating the content and usability of emergency drills before introduction into service on aircraft. We hypothesised that this model could be used to develop a generic medical tool. A three-stage modified Delphi process was used to adapt the above tool for use in designing medical emergency guidelines. The resulting Cognitive aids in Medicine Assessment Tool was then used to score and rank seven published difficult airway guidelines; the scores were used to assess its validity and reliability. Pearson's rank coefficient between these scores and scores from independent assessors was 0.89 (p = 0.007). Internal consistency, as assessed by Cronbach's alpha, was 0.74, 0.96 and 0.72 for the tool's three constituent domains of physical characteristics, content and layout/format, respectively. Inter-rater reliability, as assessed by Cohen's kappa, ranged from 0.33 to 0.72. The adoption of our tool has the potential to improve the usability of medical emergency guidelines.


Assuntos
Manuseio das Vias Aéreas/normas , Cognição , Técnica Delphi , Serviços Médicos de Emergência/normas , Humanos , Guias de Prática Clínica como Assunto , Reprodutibilidade dos Testes
5.
Anaesthesia ; 70(4): 452-61, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25476726

RESUMO

Concern that laryngoscopy and intubation might create or exacerbate a spinal cord injury has generated extensive research into cervical spinal movement during laryngoscopy. We performed a randomised trial on six cadavers, using three different laryngoscopes, before and after creating a type-2 odontoid peg fracture. Our primary outcome measure was the change in the space available for the spinal cord at the C1/2 segment measured by cinefluoroscopy. Tracheal intubation was performed using a minimal view of the glottis, a bougie, and manual in-line stabilisation. In a cadaveric model of type-2 odontoid fracture, the space available for the cord was preserved in maximum flexion and extension, and changed little on laryngoscopy and intubation.


Assuntos
Articulação Atlantoaxial/fisiopatologia , Intubação Intratraqueal/instrumentação , Laringoscópios , Movimento/fisiologia , Fraturas da Coluna Vertebral/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Cadáver , Vértebras Cervicais/fisiopatologia , Feminino , Fluoroscopia/métodos , Movimentos da Cabeça/fisiologia , Humanos , Intubação Intratraqueal/métodos , Laringoscopia , Processo Odontoide/diagnóstico por imagem , Processo Odontoide/lesões , Medula Espinal/patologia , Medula Espinal/fisiopatologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/patologia
6.
Diabetes Obes Metab ; 15(2): 144-52, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22950668

RESUMO

AIMS: The ability of dietary enrichment with monounsaturated fatty acid (MUFA), n-3 or n-6 polyunsaturated fatty acids (PUFAs) to reverse glucose intolerance and vascular dysfunction resulting from excessive dietary saturated fatty acids is not resolved. We hypothesized that partial replacement of dietary saturated fats with n-3 PUFA-enriched menhaden oil (MO) would provide greater improvement in glucose tolerance and vascular function compared to n-6 enriched safflower oil (SO) or MUFA-enriched olive oil (OO). METHODS: We fed mice a high saturated fat diet (HF) (60% kcal from lard) for 12 weeks before substituting half the lard with MO, SO or OO for an additional 4 weeks. At the end of 4 weeks, we assessed glucose tolerance, insulin signalling and reactivity of isolated pressurized gracilis arteries. RESULTS: After 12 weeks of saturated fat diet, body weights were elevated and glucose tolerance was abnormal compared to mice on control diet (13% kcal lard). Diet substituted with MO restored basal glucose levels, glucose tolerance and indices of insulin signalling (phosphorylated Akt) to normal, whereas restoration was limited for SO and OO substitutions. Although dilation to acetylcholine was reduced in arteries from mice on HF, OO and SO diets compared to normal diet, dilation to acetylcholine was fully restored and constriction to phenylephrine was reduced in MO-fed mice compared to normal. CONCLUSION: We conclude that short-term enrichment of an ongoing high fat diet with n-3 PUFA rich MO, but not MUFA rich OO or n-6 PUFA rich SO, reverses glucose tolerance, insulin signalling and vascular dysfunction.


Assuntos
Endotélio Vascular/fisiopatologia , Ácidos Graxos Ômega-3/farmacologia , Ácidos Graxos/farmacologia , Intolerância à Glucose , Resistência à Insulina , Doenças Vasculares/metabolismo , Animais , Peso Corporal , Dieta Hiperlipídica , Gorduras na Dieta , Modelos Animais de Doenças , Endotélio Vascular/metabolismo , Ingestão de Energia , Ácidos Graxos Monoinsaturados/farmacologia , Ácidos Graxos Ômega-3/administração & dosagem , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Azeite de Oliva , Óleos de Plantas , Óleo de Cártamo , Transdução de Sinais , Triglicerídeos/metabolismo , Doenças Vasculares/dietoterapia
7.
Space Sci Rev ; 219(5): 37, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37448777

RESUMO

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or ΔL∼0.56) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L∼5-7 at dusk, while a smaller subset exists at L∼8-12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L-shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.

8.
9.
Br J Anaesth ; 117(2): 148-50, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27251753
10.
J Acoust Soc Am ; 130(4): 1820-8, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21973335

RESUMO

Analytical and numerical modeling of the nonlinear interaction of shear wave with a frictional interface is presented. The system studied is composed of two homogeneous and isotropic elastic solids, brought into frictional contact by remote normal compression. A shear wave, either time harmonic or a narrow band pulse, is incident normal to the interface and propagates through the contact. Two friction laws are considered and the influence on interface behavior is investigated: Coulomb's law with a constant friction coefficient and a slip-weakening friction law which involves static and dynamic friction coefficients. The relationship between the nonlinear harmonics and the dissipated energy, and the dependence on the contact dynamics (friction law, sliding, and tangential stress) and on the normal contact stress are examined in detail. The analytical and numerical results indicate universal type laws for the amplitude of the higher harmonics and for the dissipated energy, properly non-dimensionalized in terms of the pre-stress, the friction coefficient and the incident amplitude. The results suggest that measurements of higher harmonics can be used to quantify friction and dissipation effects of a sliding interface.


Assuntos
Dinâmica não Linear , Som , Ultrassom/métodos , Simulação por Computador , Elasticidade , Transferência de Energia , Fricção , Movimento (Física) , Análise Numérica Assistida por Computador , Estresse Mecânico , Propriedades de Superfície , Fatores de Tempo
11.
J Acoust Soc Am ; 130(6): 3553-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22225010

RESUMO

A scheme for evaluating the effective quasistatic speed of sound c in two- and three-dimensional periodic materials is reported. The approach uses a monodromy-matrix operator to enable direct integration in one of the coordinates and exponentially fast convergence in others. As a result, the solution for c has a more closed form than previous formulas. It significantly improves the efficiency and accuracy of evaluating c for high-contrast composites as demonstrated by a two-dimensional scalar-wave example with extreme behavior.

12.
Transl Anim Sci ; 5(3): txab103, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34337342

RESUMO

Exploring alternative supplementation sources capable of maximizing feed and water efficiency in nursing Holstein calves is often ignored. The goals herein involve investigating the effects of two isoenergetic supplements on a nonmedicated milk replacer diet on total water intake, milk water intake, fresh water intake, feed intake parameters, and performance of Holstein nursing bull calves. Twenty-three animals (body weight [BW] = 94.67 ± 12.07 kg, age = 67 days old) were randomly assigned to one of three treatments for 68 days: control (CON; ad libitum milk replacer, n = 7), carbohydrate supplement (CHO; corn starch on top of ad libitum milk replacer-based diet, n = 8), or lipid supplement (FAT; menhaden fish oil on top of ad libitum milk replacer-based diet, n = 8). The isoenergetic supplementation consisted of 3% menhaden fish oil addition on DM basis for FAT. This was matched energetically with corn starch for the CHO group resulting in a 7% composition in DM basis. All animals were provided free access to mineral mix and 120 g daily dried microbrewer's spent grains (BG). Data were analyzed with the GLMMIX procedure of SAS in a completely randomized design with the diets as a fixed effect. Dry matter intake (DMI) adjusted by average daily gain (ADG; DMI/ADG) resulted in significantly lower values for supplemented groups with CON = 2.48, CHO = 2.38, and FAT = 2.27 kg/kg (ADG) (P = 0.033). Energy intake values were lower for CON when analyzing metabolizable energy intake (P < 0.0001), net energy intake for maintenance (P < 0.0001), and net energy intake for gain (P < 0.0001), followed by CHO, and then FAT. Total water intake (P < 0.0001), milk water intake (P < 0.0001), and fresh water intake (P < 0.0001) all resulted in CHO consuming 0.5 L or less water than the other two treatments. Energy requirements as digestible energy (P < 0.0001), metabolizable energy (P < 0.0001), net energy for maintenance (P < 0.0001), and net energy for gain (P < 0.0001) were lower for CHO, followed by CON, and then FAT having the highest requirements. Similar results were observed for residual feed (RFI; P = 0.006) and residual water intakes (RTWI; P = 0.902). Ultimately, no performance differences were detected with regards to BW (CON = 146.71, CHO = 146.25, and FAT = 150.48 kg; P > 0.1). These results indicate that lipid-based and starch-based supplementation can potentially increase feed efficiency and decrease voluntary water intake without adversely affecting performance.

13.
J Exp Biol ; 213(Pt 24): 4205-12, 2010 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-21113001

RESUMO

The large body size and high rates of metabolic heat production associated with male mating success in polygynous systems creates potential thermoregulatory challenges for species breeding in warm climates. This is especially true for marine predators carrying large blubber reserves intended for thermoregulation in cold water and fuel provision during extended fasts. Thermographic images were used to measure changes in skin temperature (T(S)) in adult male northern elephant seals (Mirounga angustirostris) over the breeding season. Environmental variables, primarily ambient temperature and solar radiation, were the principal determinants of mean and maximum T(S). When controlled for environmental variables, dominance rank significantly impacted mean T(S), being highest in alpha males. Behavioral activity significantly influenced T(S) but in a counter-intuitive way, with inactive males exhibiting the highest T(S). This was likely due to strong impacts of environmental variables on the kinds of behavior exhibited, with males being less active on warm, humid days at peak solar radiation. We classified thermal windows as areas in which T(S) was one standard deviation greater than mean T(S) for the individual seal within a thermograph. Thermal features suggest active physiological thermoregulation during and after combat and significant circulatory adaptations for heat dumping, as evidenced by recurring locations of thermal windows representing widely varying T(S) values. Frequent observations of localized T(S) above 37°C, particularly after combat, suggest the production of thermoregulatory stress during breeding behavior. Our findings demonstrate the importance of environmental drivers in shaping activity patterns during breeding and provide evidence for thermoregulatory costs of successful breeding in large polygynous males.


Assuntos
Comportamento Animal , Meio Ambiente , Atividade Motora , Focas Verdadeiras/fisiologia , Temperatura Cutânea , Animais , Regulação da Temperatura Corporal , Cruzamento , Comportamento Competitivo , Masculino , Comportamento Sexual Animal , Predomínio Social
14.
J Environ Qual ; 49(5): 1225-1235, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33016458

RESUMO

Naturally occurring gaseous by-products of ruminant production-carbon dioxide (CO2 ), methane (CH4 ), and nitrous oxide (N2 O)-can negatively affect the environment. Along with enteric fermentation, manure on pasture is among the most significant contributors to non-CO2 emissions. Condensed tannins, a group of naturally occurring phenolic compounds, can alter the route of nutrient excretion and interact with microbes, suggesting they are a plausible feed additive for reducing excreta gas emissions. We evaluated how quebracho (Schinopsis balansae) tannin extract fed at 0, 15, 30, and 45 g kg-1 of dry matter (DM) within a roughage-based diet affected fecal gas emissions at multiple locations (College Station and Stephenville, TX) during two periods corresponding to winter and spring. During both periods, CO2 , CH4 , and N2 O fluxes were determined using the vented-static chamber methodology over 39 d, and cumulative emissions were calculated. A random coefficients model with animal nested within dietary treatment and period as the random factor was analyzed by location due to the presence of collinearity with soil parameters within periods. Daily CO2 flux was influenced by soil moisture and temperature (r = .34; P < .01), whereas CH4 and N2 O were associated with soil moisture. Cumulative gas production confirmed a dietary effect for CO2 and gross CO2 equivalent at the College Station site (P ≤ .001), demonstrating a linear reduction as quebracho inclusion increased. Variance partitioning indicated that dietary treatment and seasonal period likely influenced animal digestive and metabolic parameters. Within specific environments, quebracho supplementation may assist in reducing fecal gas emissions.


Assuntos
Proantocianidinas , Animais , Fezes , Gases , Metano , Extratos Vegetais
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2019: 1139-1143, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31946095

RESUMO

Monitoring of key physiological and pharmacological parameters is an important part of a closed loop control system in critical care. Optical fiber sensors provide a versatile platform technology that can be easily incorporated into existing in-dwelling catheters or face masks. With appropriate functional coatings they can be used to monitor a range of relevant parameters and two different examples are presented: (i) respiration monitoring; (ii) drug level monitoring. Respiration monitoring involves monitoring of temperature and humidity in inhaled and exhaled breath. The optical fiber sensor consists of a fiber Bragg grating to measure temperature and a tip coating whose refractive index changes with humidity. The sensor is demonstrated to be able to track breath to breath changes when incorporated into a mask. Drug level monitoring is demonstrated in vitro using a long period grating coated with molecularly imprinted polymer nanoparticles that are sensitive to fentanyl. The sensor has a limit of detection of 50ng/ml.


Assuntos
Cuidados Críticos , Fibras Ópticas , Refratometria , Tecnologia de Fibra Óptica , Humanos , Umidade
16.
Anaesthesia ; 63(9): 932-7, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18616523

RESUMO

Tension-free vaginal tape insertion is a recommended treatment for stress incontinence. There is evidence that intra-operative testing of continence by asking patients to cough may improve outcomes, but an optimal sedation regimen has not been determined. We prospectively evaluated the effectiveness of propofol and remifentanil infusions in 25 patients using pre- and post-sedation peak cough pressures and pain scores. Patient satisfaction was assessed using the Iowa Satisfaction with Anaesthesia Score (ISAS). Post-sedation cough pressures were improved compared to baseline, with a mean peak pressure increase of 24 mmHg (95% CI 15.5-32.5; p < 0.001). Pain scores (median, IQR [range]) were low for local anaesthetic infiltration (0, [0-1]) and first (0, [0-1]) and second (0, [0-3.5]) needle insertions. Of the 19 patients completing the ISAS, all felt safe and satisfied. Sedation using propofol and remifentanil provides acceptable analgesia, satisfaction and effective continence testing.


Assuntos
Sedação Consciente/métodos , Piperidinas , Propofol , Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Adulto , Tosse/complicações , Feminino , Humanos , Hipnóticos e Sedativos , Cuidados Intraoperatórios/métodos , Pessoa de Meia-Idade , Medição da Dor/métodos , Satisfação do Paciente , Estudos Prospectivos , Implantação de Prótese/métodos , Remifentanil , Resultado do Tratamento , Incontinência Urinária por Estresse/etiologia
17.
J Fish Dis ; 31(12): 913-20, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19017068

RESUMO

Pancreas disease (PD) is an economically important disease of European farmed Atlantic salmon. It can cause significant losses because of morbidity, mortality and reduced production. The disease is caused by an alphavirus, known as salmon PD virus (SPDV) or salmonid alphavirus subtype 1 in Ireland. To examine whether it is possible to improve the natural resistance of Atlantic salmon to SPDV by selective breeding, 6000 genotyped, tagged, pedigreed fish from 150 full-sib families were exposed to a natural challenge during 2005 in a sea cage on a commercial salmon farm in the West of Ireland. Histopathological and serological examination was performed weekly on a proportion of all moribund fish to determine the onset of the infection and the likely cause of death. Heritabilities and genetic correlations are presented for resistance to a natural PD challenge and smolt input weight. The results indicate that the susceptibility of salmon to SPDV could be reduced by selective breeding based on the survival in a natural challenge to the virus.


Assuntos
Doenças dos Peixes/genética , Doenças dos Peixes/mortalidade , Predisposição Genética para Doença , Pancreatopatias/veterinária , Salmo salar/genética , Animais , Feminino , Irlanda , Masculino , Oceanos e Mares , Pancreatopatias/genética , Pancreatopatias/mortalidade , Fenótipo
18.
Health Informatics J ; 13(3): 195-206, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17711881

RESUMO

This article describes a study of a major change management project involving the establishment of a shared services organization to align the information services functions for two district health boards in New Zealand. The research uncovered a capability crisis that many people experienced when they realized the magnitude of the task they were involved in. Not everyone experienced the crisis and it seems that learning, especially in a complex healthcare environment, plays an important role in reducing the negative impact of change.


Assuntos
Adaptação Psicológica , Sistemas de Informação Hospitalar/organização & administração , Serviços Hospitalares Compartilhados , Aprendizagem , Inovação Organizacional , Nova Zelândia , Estudos de Casos Organizacionais
19.
S. Afr. j. clin. nutr. (Online) ; 35(3): 88-93, 2022. tables
Artigo em Inglês | AIM | ID: biblio-1398063

RESUMO

Background: Studies in children and adults have reported variations in 25-hydroxyvitamin D (25(OH)D), body mass index (BMI) and blood pressure (BP) over time. Furthermore, there has been a reported association of 25(OH)D with BMI, BP and lipid levels in some cross-sectional and longitudinal studies. Methods: This is a longitudinal study of a group of adolescents with measurements of 25(OH)D, BP, anthropometry and lipids at the ages of 11, 12 13, 15 and 18­20 years. For age-related changes, year 12 participants (n = 261) were matched with year 18­20 participants (n = 368), resulting in 200 paired participants. Longitudinal analyses using the Generalized Estimating Equations (GEE) comprised the following groups of participants, Year 11 (n = 288), Year 12 (n = 253), Year 13 (n = 292), Year 15 (n =238) and Year 18­20 (n = 368). The relationship of 25(OH)D with BMI, BP and lipid levels over a period of 10 years was assessed. Results: There were significant increases in mean BMI and BP, and decreases in 25(OH)D levels with age (all p-values < 0.0001).In females, systolic BP was significantly higher in older participants (18­20) years than younger participants (12 years), but 25(OH)D was significantly higher in younger than older participants. In males, there was significant increase in BP in participants between age 12 years and 18­20 years. 25(OH)D, total cholesterol (TC) and low-density lipoprotein (LDL-C) were significantly lower in 18­20-year-old participants compared with 12-year-old participants. Longitudinally, 25(OH)D was inversely associated with LDL-C. Conclusion: There is evidence of changes in 25(OH)D, BMI and BP in adolescents over a period of 10 years. After adjusting for covariates, BMI and LDL-C were significantly negatively associated with 25(OH)D, which suggests that vitamin D status might be associated positively with favourable lipid profiles in children and adolescents.


Assuntos
Humanos , Lactente , Vitamina D , Pressão Sanguínea , Adolescente , Estilo de Vida , Lipídeos
20.
Proc Math Phys Eng Sci ; 473(2202): 20170188, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28690416

RESUMO

Time-reversal symmetry for elastic wave propagation breaks down in a resonant mass-in-mass lattice whose inner-stiffness is weakly modulated in space and in time in a wave-like fashion. Specifically, one-way wave transmission, conversion and amplification as well as unidirectional wave blocking are demonstrated analytically through an asymptotic analysis based on coupled mode theory and numerically thanks to a series of simulations in harmonic and transient regimes. High-amplitude modulations are then explored in the homogenization limit where a non-standard effective mass operator is recovered and shown to take negative values over unusually large frequency bands. These modulated metamaterials, which exhibit either non-reciprocal behaviours or non-standard effective mass operators, offer promise for applications in the field of elastic wave control in general and in one-way conversion/amplification in particular.

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