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Integrated
Kinds of Integrated Terms modified by Integrated Selected AbstractsINTEGRATED LANDSCAPE ANALYSES OF CHANGE OF MIOMBO WOODLAND IN TANZANIA AND ITS IMPLICATION FOR ENVIRONMENT AND HUMAN LIVELIHOODGEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 1 2009LENNART STRÖMQUIST ABSTRACT. Landscapes bear witness to past and present natural and societal processes influencing the environment and human livelihoods. By analysing landscape change at different spatial scales over time the effects on the environment and human livelihoods of various external and internal driving forces of change can be studied. This paper presents such an analysis of miombo woodland surrounding the Mkata plains in central Tanzania. The rich natural landscape diversity of the study area in combination with its historical and political development makes it an ideal observation ground for this kind of study. The paper focuses on long-term physical and biological changes, mainly based on satellite information but also on field studies and a review of documents and literature. The miombo woodlands are highly dynamic semi-arid ecosystems found on a number of nutrient-poor soil groups. Most of the woodlands are related to an old, low-relief geomorphology of erosion surfaces with relatively deep and leached soils, or to a lesser extent also on escarpments and steep Inselberg slopes with poor soils. Each period in the past has cast its footprints on the landscape development and its potential for a sustainable future use. On a regional level there has been a continual decrease in forest area over time. Expansion of agriculture around planned villages, implemented during the 1970s, in some cases equals the loss of forest area (Mikumi-Ulaya), whilst in other areas (Kitulangalo), the pre-independence loss of woodland was small; the agricultural area was almost the same during the period 1975,1999, despite the fact that forests have been lost at an almost constant rate over the same period. Illegal logging and charcoal production are likely causes because of the proximity to the main highway running through the area. Contrasting to the general regional pattern are the conditions in a traditional village (Ihombwe), with low immigration of people and a maintained knowledge of the resource potential of the forest with regards to edible plants and animals. In this area the local community has control of the forest resources in a Forest Reserve, within which the woody vegetation has increased in spite of an expansion of agriculture on other types of village land. The mapping procedure has shown that factors such as access to transport and lack of local control have caused greater deforestation of certain areas than during the colonial period. Planned villages have furthermore continued to expand over forest areas well after their implementation, rapidly increasing the landscape fragmentation. One possible way to maintain landscape and biodiversity values is by the sustainable use of traditional resources, based on local knowledge of their management as illustrated by the little change observed in the traditionally used area. [source] INTEGRATED MODELING FOR WATERSHED MANAGEMENT: MULTIPLE OBJECTIVES AND SPATIAL EFFECTS,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 2 2002Stephen C. Newbold ABSTRACT: This paper presents an optimization framework for prioritizing sites for wetlands restoration on a watershed or landscape scale. The framework is designed for analyzing the potential environmental impacts of alternative management strategies while accounting for economic constraints, thereby aiding decision makers in explicitly considering multiple management objectives. The modeling strategy consists of two phases. First, relationships between the configuration of land use types in a watershed and valued ecosystem services are specified mathematically. Second, those functions are incorporated into a spatial optimization model that allows comparisons of the expected environmental impacts and economic costs of management strategies that change the configuration of land use in the watershed. By way of a stylized example, this paper develops the general structure of the framework, presents simulation results based on two production functions for ecosystem services, and discusses the potential utility of the methodology for watershed management. [source] To Integrate of Not to Integrate?ARCHITECTURAL DESIGN, Issue 1 2010Ugur Tanyeli Abstract Turkish architecture over the last 150 years has been plagued by its preoccupation with its integration with the West. Should it be embracing or reflecting Western cultural, technical and professional standards? U,ur Tanyeli provides the background to this pessimistic context and describes how a new generation of architects over the last 10 years have transcended this predicament by producing work that turns away from this obsession with identity. Copyright © 2010 John Wiley & Sons, Ltd. [source] Randomized controlled trial of cognitive,behavioural therapy for coexisting depression and alcohol problems: short-term outcomeADDICTION, Issue 1 2010Amanda L. Baker ABSTRACT Aims Alcohol use disorders and depression co-occur frequently and are associated with poorer outcomes than when either condition occurs alone. The present study (Depression and Alcohol Integrated and Single-focused Interventions; DAISI) aimed to compare the effectiveness of brief intervention, single-focused and integrated psychological interventions for treatment of coexisting depression and alcohol use problems. Methods Participants (n = 284) with current depressive symptoms and hazardous alcohol use were assessed and randomly allocated to one of four individually delivered interventions: (i) a brief intervention only (single 90-minute session) with an integrated focus on depression and alcohol, or followed by a further nine 1-hour sessions with (ii) an alcohol focus; (iii) a depression focus; or (iv) an integrated focus. Follow-up assessments occurred 18 weeks after baseline. Results Compared with the brief intervention, 10 sessions were associated with greater reductions in average drinks per week, average drinking days per week and maximum consumption on 1 day. No difference in duration of treatment was found for depression outcomes. Compared with single-focused interventions, integrated treatment was associated with a greater reduction in drinking days and level of depression. For men, the alcohol-focused rather than depression-focused intervention was associated with a greater reduction in average drinks per day and drinks per week and an increased level of general functioning. Women showed greater improvements on each of these variables when they received depression-focused rather than alcohol-focused treatment. Conclusions Integrated treatment may be superior to single-focused treatment for coexisting depression and alcohol problems, at least in the short term. Gender differences between single-focused depression and alcohol treatments warrant further study. [source] Carbon sequestration under Miscanthus: a study of 13C distribution in soil aggregatesGCB BIOENERGY, Issue 5 2009MARTA DONDINI Abstract The growing of bioenergy crops has been widely suggested as a key strategy in mitigating anthropogenic CO2 emissions. However, the full mitigation potential of these crops cannot be assessed without taking into account their effect on soil carbon (C) dynamics. Therefore, we analyzed the C dynamics through four soil depths under a 14-year-old Miscanthus plantation, established on former arable land. An adjacent arable field was used as a reference site. Combining soil organic matter (SOM) fractionation with 13C natural abundance analyses, we were able to trace the fate of Miscanthus -derived C in various physically protected soil fractions. Integrated through the whole soil profile, the total amount of soil organic carbon (SOC) was higher under Miscanthus than under arable crop, this difference was largely due to the input of new C. The C stock of the macroaggregates (M) under Miscanthus was significantly higher than those in the arable land. Additionally, the C content of the micro-within macroaggregates (mM) were higher in the Miscanthus soil as compared with the arable soil. Analysis of the intramicroaggregates particulate organic matter (POM) suggested that the increase C storage in mM under Miscanthus was caused by a decrease in disturbance of M. Thus, the difference in C content between the two land use systems is largely caused by soil C storage in physically protected SOM fractions. We conclude that when Miscanthus is planted on former arable land, the resulting increase in soil C storage contributes considerably to its CO2 mitigation potential. [source] Adhesive, Flexible, and Robust Polysaccharide Nanosheets Integrated for Tissue-Defect RepairADVANCED FUNCTIONAL MATERIALS, Issue 16 2009Toshinori Fujie Abstract Recent developments in nanotechnology have led to a method for producing free-standing polymer nanosheets as a macromolecular organization. Compared with bulk films, the large aspect ratio of such nanosheets leads to unique physical properties, such as transparency, noncovalent adhesion, and high flexibility. Here, a biomedical application of polymer nanosheets consisting of biocompatible and biodegradable polysaccharides is reported. Micro-scratch and bulge tests indicate that the nanosheets with a thickness of tens of nanometers have sufficient physical adhesiveness and mechanical strength for clinical use. A nanosheet of 75,nm thickness, a critical load of 9.1,×,104,N m,1, and an elastic modulus of 9.6,GPa is used for the minimally invasive repair of a visceral pleural defect in beagle dogs without any pleural adhesion caused by wound repair. For the first time, clinical benefits of sheet-type nano-biomaterials based on molecular organization are demonstrated, suggesting that novel therapeutic tools for overlapping tissue wounds will be possible without the need for conventional surgical interventions. [source] Diurnal and seasonal variation in methane emissions in a northern Canadian peatland measured by eddy covarianceGLOBAL CHANGE BIOLOGY, Issue 9 2010KEVIN D. LONG Abstract Eddy covariance measurements of methane (CH4) net flux were made in a boreal fen, typical of the most abundant peatlands in western Canada during May,September 2007. The objectives of this study were to determine: (i) the magnitude of diurnal and seasonal variation in CH4 net flux, (ii) the relationship between the temporally varying flux rates and associated changes in controlling biotic and abiotic factors, and (iii) the contribution of CH4 emission to the ecosystem growing season carbon budget. There was significant diurnal variation in CH4 emission during the peak of the growing season that was strongly correlated with associated changes in solar radiation, latent heat flux, air temperature and ecosystem conductance to water vapor. During days 181,215, nighttime average CH4 efflux was only 47% of the average midday values. The peak value for daily average CH4 emission rate was approximately 80 nmol m,2 s,1 (4.6 mg CH4 m,2 h,1), and seasonal variation in CH4 flux was strongly correlated with changes in soil temperature. Integrated over the entire measurement period [days 144,269 (late May,late September)], the total CH4 emission was 3.2 g CH4 m,2, which was quite low relative to other wetland ecosystems and to the simultaneous high rate of ecosystem net CO2 sequestration that was measured (18.1 mol CO2 m,2 or 217 g C m,2). We estimate that the negative radiative forcing (cooling) associated with net carbon storage over the life of the peatland (approximately 2200 years) was at least twice the value of positive radiative forcing (warming) caused by net CH4 emission over the last 50 years. [source] Whole-system approaches to health and social care partnerships for the frail elderly: an exploration of North American models and lessonsHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2006Dennis L. Kodner PhD Abstract Irrespective of cross-national differences in long-term care, countries confront broadly similar challenges, including fragmented services, disjointed care, less-than-optimal quality, system inefficiencies and difficult-to-control costs. Integrated or whole-system strategies are becoming increasingly important to address these shortcomings through the seamless provision of health and social care. North America is an especially fertile proving ground for structurally oriented whole-system models. This article summarises the structure, features and outcomes of the Program of All-Inclusive Care for Elderly People (PACE) programme in the United States, and the Système de soins Intégrés pour Personnes Âgées (SIPA) and the Programme of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) in Canada. The review finds a somewhat positive pattern of results in terms of service access, utilisation, costs, care provision, quality, health status and client/carer satisfaction. It concludes with the identification of common characteristics which are thought to be associated with the successful impact of these partnership initiatives, as well as a call for further research to understand the relationships, if any, between whole-system models, services and outcomes in integrated care for elderly people. [source] On parameter estimation of a simple real-time flow aggregation modelINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 7 2006Huirong Fu Abstract There exists a clear need for a comprehensive framework for accurately analysing and realistically modelling the key traffic statistics that determine network performance. Recently, a novel traffic model, sinusoid with uniform noise (SUN), has been proposed, which outperforms other models in that it can simultaneously achieve tractability, parsimony, accuracy (in predicting network performance), and efficiency (in real-time capability). In this paper, we design, evaluate and compare several estimation approaches, including variance-based estimation (Var), minimum mean-square-error-based estimation (MMSE), MMSE with the constraint of variance (Var+MMSE), MMSE of autocorrelation function with the constraint of variance (Var+AutoCor+MMSE), and variance of secondary demand-based estimation (Secondary Variance), to determining the key parameters in the SUN model. Integrated with the SUN model, all the proposed methods are able to capture the basic behaviour of the aggregation reservation system and closely approximate the system performance. In addition, we find that: (1) the Var is very simple to operate and provides both upper and lower performance bounds. It can be integrated into other methods to provide very accurate approximation to the aggregation's performance and thus obtain an accurate solution; (2) Var+AutoCor+MMSE is superior to other proposed methods in the accuracy to determine system performance; and (3) Var+MMSE and Var+AutoCor+MMSE differ from the other three methods in that both adopt an experimental analysis method, which helps to improve the prediction accuracy while reducing computation complexity. Copyright © 2005 John Wiley & Sons, Ltd. [source] Systematic review of the effectiveness of integrated care pathways: what works, for whom, in which circumstances?INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2009Davina Allen RGN BA(Hons) PhD Abstract Aim, Integrated care pathways (ICP) are management technologies which formalise multidisciplinary team-working and enable professionals to examine their roles and responsibilities. ICPs are now being implemented across international healthcare arena, but evidence to support their use is equivocal. The aim of this study was to identify the circumstances in which ICPs are effective, for whom and in what contexts. Methods, A systematic review of high-quality randomised controlled trials published between 1980 and 2008 (March) evaluating ICP use in child and adult populations in the full range of healthcare settings. Results 1For relatively predictable trajectories of care ICPs can be effective in supporting proactive care management and ensuring that patients receive relevant clinical interventions and/or assessments in a timely manner. This can lead to improvements in service quality and service efficiency without adverse consequences for patients. 2ICPs are an effective mechanism for promoting adherence to guidelines or treatment protocols thereby reducing variation in practice. 3ICPs can be effective in improving documentation of treatment goals, documentation of communication with patients, carers and health professionals. 4ICPs can be effective in improving physician agreement about treatment options. 5ICPs can be effective in supporting decision-making when they incorporate a decision-aide. 6The evidence considered in this review indicates that ICPs may be particularly effective in changing professional behaviours in the desired direction, where there is scope for improvement or where roles are new. 7Even in contexts in which health professionals are already experienced with a particular pathway, ICP use brings additional beneficial effects in directing professional practice in the desired direction. 8ICPs may be less effective in bringing about service quality and efficiency gains in variable patient trajectories. 9ICPs may be less effective in bringing about quality improvements in circumstances in which services are already based on best evidence and multidisciplinary working is well established. 10Depending on their purpose, the benefits of ICPs may be greater for certain patient subgroups than others. 11We do not know whether the costs of ICP development and implementation are justified by any of their reported benefits. 12ICPs may need supporting mechanisms to underpin their implementation and ensure their adoption in practice, particularly in circumstances in which ICP use is a significant change in organisational culture. 13ICP documentation can introduce scope for new kinds of error. Conclusions, ICPs are most effective in contexts where patient care trajectories are predictable. Their value in settings in which recovery pathways are more variable is less clear. ICPs are most effective in bringing about behavioural changes where there are identified deficiencies in services; their value in contexts where inter-professional working is well established is less certain. None of the studies reviewed included an economic evaluation and thus it is not known whether their benefits justify the costs of their implementation. [source] Updating Geographic Distribution of Artemia urmiana Günther, 1890 (Branchiopoda: Anostraca) in Europe: An Integrated and Interdisciplinary ApproachINTERNATIONAL REVIEW OF HYDROBIOLOGY, Issue 5 2009Theodore J. Abatzopoulos Abstract Artemia urmiana (a species previously considered endemic of Lake Urmia, NW Iran) has been found in Lake Koyashskoe, a hypersaline lake on the Black Sea coast of the Crimean peninsula (Ukraine). Therefore, this is the first record of A. urmiana in Europe which updates its distribution. The species identification was based on an integrated and interdisciplinary approach using discriminant analysis of the morphometric characters, scanning electron microscopy, and molecular profile analysis. The data derived from the above mentioned approaches converge to significant similarity of the population under investigation with A. urmiana. The updated geographic distribution of the species, deriving from the present report, asks for additional contribution of other disciplines (e.g., avian dispersal of cysts, history of salt trade) to be finally clarified. At present we suggest that the punctuated geographic distribution of A. urmiana is probably linked to its low dispersal capability, and we suppose that its presence in two distant sites could be explained by historical human salt trade between Lake Urmia and the ancient port of Kimmerik, whose remains have been found in the present Lake Koyashskoe. (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Effects of nursing interventions within an integrated care pathway for patients with hip fractureJOURNAL OF ADVANCED NURSING, Issue 2 2007Lars-Eric Olsson Abstract Title. Effects of nursing interventions within an integrated care pathway for patients with hip fracture Aim., This paper reports a study to evaluate the contribution of nursing care within an integrated care pathway for patients with hip fracture. Background., There is growing interest in quality assurance in health care. Integrated care pathways are a method to achieve this goal, and are a multi-professional team approach where the requirement for nurses to work effectively within the team is important. However, the nurses' role and contribution within the team have not been well described. Method., A quasi-experimental, prospective study comparing an intervention group with a comparison group was carried out. One hundred and twelve independently living patients, aged 65 years or older and admitted to a Swedish hospital with a hip fracture, were consecutively selected. Pathological fracture and severe intellectual impairment (Pfeiffer's test <3 points) served as exclusion criteria. The intervention was designed to focus on patients' motivation and their prerequisites for rehabilitation and was based on the concept of transition. The main outcome measure was the number of patients restored to preoperative activities of daily living levels in 2003,2004. Findings., In the intervention group 21% were restored to activities of daily living to level A (independent) at discharge, whereas only 5% in the comparison group were restored to this level. No patients in the intervention group, admitted as independent, remained at activities of daily living level F (dependent), whereas 16% remained at level F in the comparison group (P = 0·003). Conclusion., When admitting older patients with a hip fracture, it is important to acquire good knowledge about each patient and their prerequisites and to offer them accelerated rehabilitation in accordance with their individual ability. By monitoring process indicators during the transition, serious deviations from the care plan can be avoided. [source] Response surface methodology study of the combined effects of temperature, pH, and aw on the growth rate of Trichoderma asperellumJOURNAL OF APPLIED MICROBIOLOGY, Issue 4 2007B.A.D. Begoude Abstract Aims:, To evaluate the influence of environmental parameters (water activity aw, temperature, and pH) on the radial growth rate of Trichoderma asperellum (strains PR10, PR11, PR12, and 659-7), an antagonist of Phytophthora megakarya, the causal agent of cocoa black pod disease. Methods and Results:, The radial growth of four strains of T. asperellum was monitored for 30 days on modified PDA medium. Six levels of aw (0·995, 0·980, 0·960, 0·930, 0·910, and 0·880) were combined with three values of pH (4·5, 6·5, and 8·5) and three incubation temperatures (20, 25, and 30°C). Whatever the strain, mycelial growth rate was optimal at aw between 0·995 and 0·980, independently of the temperature and pH. Each strain appeared to be very sensitive to aw reduction. In addition, all four strains were able to grow at all temperatures and pH values (4·5,8·5) tested, highest growth rate being observed at 30°C and at pH 4·5,6·5. The use of response surface methodology to model the combined effects of aw, temperature, and pH on the radial growth rate of the T. asperellum strains confirmed the observed results. In our model, growth of the T. asperellum strains showed a greater dependence on aw than on temperature or pH under in vitro conditions. Conclusion:,aw is a crucial environmental factor. Low aw can prevent growth of T. asperellum strains under some conditions. The observed and predicted radial growth rate of strain PR11 showed its greater capacity to support low aw (0·93) as compared with other tested strains at 20°C. This is in agreement with its better protective level when applied in medium-scale trials on cocoa plantations. Significance and Impact of the Study:, This study should contribute towards improving the biocontrol efficacy of T. asperellum strains used against P. megakarya. Integrated into a broader study of the impact of environmental factors on the biocontrol agent,pathogen system, this work should help to build a more rational control strategy, possibly involving the use of a compatible adjuvant protecting T. asperellum against desiccation. [source] Laboratory Models Available to Study Alcohol-Induced Organ Damage and Immune Variations: Choosing the Appropriate ModelALCOHOLISM, Issue 9 2010Nympha B. D'Souza El-Guindy The morbidity and mortality resulting from alcohol-related diseases globally impose a substantive cost to society. To minimize the financial burden on society and improve the quality of life for individuals suffering from the ill effects of alcohol abuse, substantial research in the alcohol field is focused on understanding the mechanisms by which alcohol-related diseases develop and progress. Since ethical concerns and inherent difficulties limit the amount of alcohol abuse research that can be performed in humans, most studies are performed in laboratory animals. This article summarizes the various laboratory models of alcohol abuse that are currently available and are used to study the mechanisms by which alcohol abuse induces organ damage and immune defects. The strengths and weaknesses of each of the models are discussed. Integrated into the review are the presentations that were made in the symposium "Methods of Ethanol Application in Alcohol Model,How Long is Long Enough" at the joint 2008 Research Society on Alcoholism (RSA) and International Society for Biomedical Research on Alcoholism (ISBRA) meeting, Washington, DC, emphasizing the importance not only of selecting the most appropriate laboratory alcohol model to address the specific goals of a project but also of ensuring that the findings can be extrapolated to alcohol-induced diseases in humans. [source] A Human Oral-throat Cast Integrated with a Twin-stage Impinger for Evaluation of Dry Powder InhalersJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 7 2000T. SRICHANA The aim of this study was to investigate the applicability of replacing the glass throat from a twin-stage impinger (TSI) with a human oral-throat cast. Monodisperse aerosols were used to calibrate the human oral cast-TSI at 60 L min,1 and cut-off in particle size was compared with that of the TSI described in the British Pharmacopoeia which employs a glass throat. The amount of salbutamol sulphate (and lactose) delivered by the Cyclohaler depositing on various elements of the in-vitro model were determined. The calibration of the model containing a human oral-throat cast at 60 L min,1 gave a particle size cut-off of 5.2 ,m which was less than that of the TSI (6.3 ,m). The oral-throat cast trapped more drug than the glass throat model with a formulation that employed the larger carrier (63,90 ,m; P<0.05) while it trapped a lesser amount of drug with those filled with the lower size carrier (Lactochem, micronised lactose). The greater amount of lactose in the formulation that employed the larger-sized carrier (63,90 ,m) was deposited closer to the inlet of the oral-throat cast than to the inlet of the glass throat model. Replacement of the glass throat in the TSI by the human oral-throat cast, leads to a change in deposition efficiency, with the cast having a higher filter efficiency and hence more aerosol particles being captured before their entry into the TSI. This should be investigated further to determine whether such a model might provide a more realistic assessment of the in-vivo characteristics of an aerosol in comparison with the TSI currently being employed, which utilises the glass throat as the portal of entry. [source] Teaching nature of science within a controversial topic: Integrated versus nonintegratedJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 4 2006Rola Khishfe This study investigated the influence of two different explicit instructional approaches in promoting more informed understandings of nature of science (NOS) among students. Participants, a total of 42 students, comprised two groups in two intact sections of ninth grade. Participants in the two groups were taught environmental science by their regular classroom teacher, with the difference being the context in which NOS was explicitly taught. For the "integrated" group, NOS instruction was related to the science content about global warming. For the "nonintegrated" group, NOS was taught through a set of activities that specifically addressed NOS issues and were dispersed across the content about global warming. The treatment for both groups spanned 6 weeks and addressed a unit about global warming and NOS. An open-ended questionnaire, in conjunction with semistructured interviews, was used to assess students' views before and after instruction. Results showed improvements in participants' views of NOS regardless of whether NOS was integrated within the regular content about global warming. Comparison of differences between the two groups showed "slightly" greater improvement in the informed views of the integrated group participants. On the other hand, there was greater improvement in the transitional views of the nonintegrated group participants. Therefore, the overall results did not provide any conclusive evidence in favor of one approach over the other. Implications on the teaching and learning of NOS are discussed. © 2006 Wiley Periodicals, Inc. J Res Sci Teach 43: 395,418, 2006 [source] Properties of the Sieve Bootstrap for Fractionally Integrated and Non-Invertible ProcessesJOURNAL OF TIME SERIES ANALYSIS, Issue 2 2008D. S. Poskitt Abstract., In this article, we investigate the consequences of applying the sieve bootstrap under regularity conditions that are sufficiently general to encompass both fractionally integrated and non-invertible processes. The sieve bootstrap is obtained by approximating the data-generating process by an autoregression, whose order h increases with the sample size T. The sieve bootstrap may be particularly useful in the analysis of fractionally integrated processes since the statistics of interest can often be non-pivotal with distributions that depend on the fractional index d. The validity of the sieve bootstrap is established for |d|<1/2 and it is shown that when the sieve bootstrap is used to approximate the distribution of a general class of statistics then the error rate will be of an order smaller than , ,>0. Practical implementation of the sieve bootstrap is considered and the results are illustrated using a canonical example. [source] Goal attainment for spasticity management using botulinum toxinPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2006Stephen Ashford Abstract Background and Purpose. To determine whether goal attainment scaling (GAS) can demonstrate functional gains following injection of botulinum toxin (BTX) for spasticity in severely disabled patients. Method. Subjects were categorized as ,responder' (positive clinical outcome) and ,non-responder' (non-significant clinical outcome) on the basis of their overall clinical response. GAS scores for functional goals were calculated retrospectively and compared with standard outcome assessments undertaken at the time of intervention. Integrated care pathway (ICP) proformas were interrogated for 18 patients with acquired brain injuries. Mean age was 44.4 (SD 13.4) years. Results. Baseline GAS and Barthel scores were similar for the responder and non-responder groups. The outcome GAS score was significantly greater in the responder than in the non-responder group (Mann,Whitney U = 11.0; p = 0.011) as was the change in GAS score (Mann,Whitney U = 8.0; p = 0.004). GAS scores reflected change recorded in focal outcome measures. However, the Barthel Index measured change in only one case. Conclusions. This exploratory retrospective study provides preliminary support for the hypothesis that GAS provides a useful measure of functional gains in response to treatment with BTX, and is more sensitive than global measures such as the Barthel Index. Copyright © 2006 John Wiley & Sons, Ltd. [source] Integrated, sequential, and contingent screening for Down syndrome,local needs should drive methodologyPRENATAL DIAGNOSIS, Issue 2 2007Philip Wyatt No abstract is available for this article. [source] Sequential and contingent prenatal screening for Down syndromePRENATAL DIAGNOSIS, Issue 9 2006Nicholas J Wald Abstract Objective To compare the Integrated test in three policies for prenatal Down syndrome screening: Integrated screening for all women, sequential screening (first-trimester tests allowing early completion of screening for high-risk pregnancies), and Contingent screening (early completion of screening for high- and low-risk pregnancies). Design and Methods Estimation of detection rates (DRs) and false-positive rates (FPRs) using Monte Carlo simulation and cost effectiveness for each method. Setting and Population Down syndrome affected and unaffected pregnancies studied in the Serum Urine and Ultrasound Screening Study (SURUSS). Results and Main Outcomes Integrated screening has the best screening performance. The performance of the other two policies approached that of Integrated screening as the first-trimester test FPR decreased. If the first-trimester FPR is set to 0.5% (risk , 1 in 30) with an overall DR of 90%, sequential and contingent screening yield overall FPRs of 2.25% and 2.42%, respectively, and 66% of the affected pregnancies are detected by the first-trimester test. The Integrated test on all women yields an FPR of 2.15%. With sequential screening, 99.5% of women would proceed to an Integrated test, or 30% with contingent screening if those with first-trimester test risks of ,1 in 2000 are classified screen-negative and receive no further testing. About 20% of affected pregnancies identified in the first trimester using sequential or contingent screening would have unnecessary terminations (they would miscarry before the early second trimester). Contingent screening is the most cost-effective if there is no alphafetoprotein screening for neural tube defects, otherwise Integrated screening is more cost-effective. Conclusions Integrated screening for all women is the simplest, most effective, and the safest policy. Contingent screening is the most complex with the lowest screening performance. Making an earlier diagnosis with sequential and contingent screening has adverse consequences that are sufficient to discourage their use. Copyright © 2006 John Wiley & Sons, Ltd. [source] Art, dreams and active imagination: A post-Jungian approach to transference and the imageTHE JOURNAL OF ANALYTICAL PSYCHOLOGY, Issue 2 2005Joy Schaverien Abstract:, The term active imagination is sometimes applied rather uncritically to describe all forms of creative activity that take place in depth psychology. Whilst there are many forms of expression that evoke or are evoked by active imagination, they cannot automatically be classed as active imagination. In this article investigation of visualized mental imagery, dreams and art reveals three distinct forms of image-based psychological activity. Integrated and mediated within the transference and countertransference dynamic, it is proposed that the engagement in active imagination reflects and is influenced by the transference. Distinctions between sign and symbol, simple and big dreams as well as diagrammatic and embodied imagery clarify the differences. Examples from clinical practice demonstrate each mode in action within the analytic frame. [source] Is the Corporate Loan Market Globally Integrated?THE JOURNAL OF FINANCE, Issue 6 2007A Pricing Puzzle ABSTRACT We offer evidence that interest rate spreads on syndicated loans to corporate borrowers are economically significantly smaller in Europe than in the United States, other things equal. Differences in borrower, loan, and lender characteristics do not appear to explain this phenomenon. Borrowers overwhelmingly issue in their natural home market and bank portfolios display home bias. This may explain why pricing discrepancies are not competed away, though their causes remain a puzzle. Thus, important determinants of loan origination market outcomes remain to be identified, home bias appears to be material for pricing, and corporate financing costs differ across Europe and the United States. [source] Impact of reducing intrinsic cognitive load on learning in a mathematical domainAPPLIED COGNITIVE PSYCHOLOGY, Issue 3 2006Paul Ayres This paper examines the effectiveness of instructional strategies that lower cognitive load by reducing task complexity (intrinsic cognitive load). Three groups of 13-year-old students were required to learn a mathematical task under different conditions. One group (Isolated) followed a strategy that used part-tasks where the constituent elements were isolated from each other (element isolation). A second group (Integrated) received whole tasks where all elements were fully integrated, and a third group (Mixed) followed a mixed strategy progressing from part-tasks to whole-tasks. Results indicated that the part-task strategy was effective in lowering cognitive load for all students, but only benefitted learning for students with low prior knowledge. In contrast, students with a higher prior knowledge learned significantly more having studied whole tasks during instruction compared with part-tasks. The mixed-mode method proved to be ineffective for both levels of prior knowledge. These results are discussed in terms of cognitive load theory. Copyright © 2006 John Wiley & Sons, Ltd. [source] Magnetic ghosts: mineral magnetic measurements on Roman and Anglo-Saxon graves,,ARCHAEOLOGICAL PROSPECTION, Issue 3 2004N. T. Linford Abstract The location of inhumations, in the absence of ferrous grave goods, often presents a considerable challenge to archaeological geophysics, given the small size of the features and the slight physical contrast between the fill of the grave and the surrounding subsoil. Even during excavation, the identification of graves may be complicated where site conditions do not favour the preservation of human skeletal remains and only a subtle soil stain is likely to survive. A recent initiative in the UK has seen the formation of the Buried Organic-matter,Decomposition Integrated with Elemental Status (BODIES) research group, to examine the decomposition of organic artefacts in ancient graves with respect to localized changes in pH, redox potential and nutrient status. This paper presents initial results from a limited mineral magnetic study of two grave sites in an attempt to ascertain whether the decomposition of organic remains may lead to a detectable magnetic signature within the soil. Results from a series of isothermal, hysteresis and magneto-thermal experiments will be presented together with surface magnetometer and topsoil susceptibility surveys. Copyright © Crown Copyright 2004. Recorded with the permission of Her Majesty's Stationery Office. Published by John Wiley & Sons, Ltd. [source] Intensified Process for the Purification of an Enzyme from Inclusion Bodies Using Integrated Expanded Bed Adsorption and RefoldingBIOTECHNOLOGY PROGRESS, Issue 4 2006Matthew H. Hutchinson This work describes the integration of expanded bed adsorption (EBA) and adsorptive protein refolding operations in an intensified process used to recover purified and biologically active proteins from inclusion bodies expressed in E. coli. ,5 -3-Ketosteroid isomerase with a C-terminal hexahistidine tag was expressed as inclusion bodies in the cytoplasm of E. coli. Chemical extraction was used to disrupt the host cells and simultaneously solubilize the inclusion bodies, after which EBA utilizing immobilized metal affinity interactions was used to purify the polyhistidine-tagged protein. Adsorptive refolding was then initiated in the column by changing the denaturant concentration in the feed stream from 8 to 0 M urea. Three strategies were tested for performing the refolding step in the EBA column: (i) the denaturant was removed using a step change in feed-buffer composition, (ii) the denaturant was gradually removed using a gradient change in feed-buffer composition, and (iii) the liquid flow direction through the column was reversed and adsorptive refolding performed in the packed bed. Buoyancy-induced mixing disrupted the operation of the expanded bed when adsorptive refolding was performed using either a step change or a rapid gradient change in feed-buffer composition. A shallow gradient reduction in denaturant concentration of the feed stream over 30 min maintained the stability of the expanded bed during adsorptive refolding. In a separate experiment, buoyancy-induced mixing was completely avoided by performing refolding in a settled bed, which achieved comparable yields to refolding in an expanded bed but required a slightly more complex process. A total of 10% of the available KSI,(His6) was recovered as biologically active and purified protein using the described purification and refolding process, and the yield was further increased to 19% by performing a second iteration of the on-column refolding operation. This process should be applicable for other polyhistidine tagged proteins and is likely to have the greatest benefit for proteins that tend to aggregate when refolded by dilution. [source] Integrated care of childhood disease in Brazil: Mothers' response to the recommendations of health workersACTA PAEDIATRICA, Issue 8 2005Antonio JL Alves da Cunha Abstract Aim: To describe the process of follow-up in primary care facilities where the Integrated Management of Childhood Illness (IMCI) strategy was implemented. IMCI was developed by WHO and UNICEF as an integrated approach to manage sick children under 5 y of age and aims to reduce mortality and morbidity. Methods: From August 2001 to February 2002, 229 sick children who had a health condition included in the IMCI case management guidelines were seen in six family healthcare facilities in Brazil. We analysed the care provided to 153 children who were recommended for a 2- or 5-d follow-up visit. Children who did not return were visited and assessed at home. Results: Only 87 children (56.9%) timely returned for follow-up: 70 had improved, eight presented the same health conditions, five were worse and four had a new problem. The main reasons given for not returning for follow-up were: the child had improved (35.1%) and other family priorities (47.4%). Home visits showed that, although most children had improved (n=49), some had a new health problem and one child was sick enough to be referred. Prescription of antibiotics was associated with increased probability of returning for a follow-up visit (RR =1.64 [1.22,2.20], p=0.001). Conclusion: Adherence to follow-up was just over 50%, mostly because the condition had already resolved, but some children were still sick and needed intervention. Training on counselling on the recognition of danger signs and when to return for a follow-up visit must be reinforced. [source] Discovering Maximal Generalized Decision Rules Through Horizontal and Vertical Data ReductionCOMPUTATIONAL INTELLIGENCE, Issue 4 2001Xiaohua Hu We present a method to learn maximal generalized decision rules from databases by integrating discretization, generalization and rough set feature selection. Our method reduces the data horizontally and vertically. In the first phase, discretization and generalization are integrated and the numeric attributes are discretized into a few intervals. The primitive values of symbolic attributes are replaced by high level concepts and some obvious superfluous or irrelevant symbolic attributes are also eliminated. Horizontal reduction is accomplished by merging identical tuples after the substitution of an attribute value by its higher level value in a pre-defined concept hierarchy for symbolic attributes, or the discretization of continuous (or numeric) attributes. This phase greatly decreases the number of tuples in the database. In the second phase, a novel context-sensitive feature merit measure is used to rank the features, a subset of relevant attributes is chosen based on rough set theory and the merit values of the features. A reduced table is obtained by removing those attributes which are not in the relevant attributes subset and the data set is further reduced vertically without destroying the interdependence relationships between classes and the attributes. Then rough set-based value reduction is further performed on the reduced table and all redundant condition values are dropped. Finally, tuples in the reduced table are transformed into a set of maximal generalized decision rules. The experimental results on UCI data sets and a real market database demonstrate that our method can dramatically reduce the feature space and improve learning accuracy. [source] Abductive Diagnosis Using Time-Objects: Criteria for the Evaluation of SolutionsCOMPUTATIONAL INTELLIGENCE, Issue 1 2001Elpida T. Keravnou Diagnostic problem solving aims to account for, or explain, a malfunction of a system (human or other). Any plausible potential diagnostic solution must satisfy some minimum criteria relevant to the application. Often there will be several plausible solutions, and further criteria will be required to select the "best" explanation. Expert diagnosticians may employ different, complex criteria at different stages of their reasoning. These criteria may be combinations of some more primitive criteria, which therefore should be represented separately and explicitly to permit their flexible and transparent combined usage. In diagnostic reasoning there is a tight coupling between the formation of potential solutions and their evaluation. This is the essence of abductive reasoning. This article presents an abductive framework for diagnostic problem solving. Time-objects, an association of a property and an existence, are used as the representation formalism and a number of primitive, general evaluation criteria into which time has been integrated are defined. Each criterion provides an intuitive yardstick for evaluating the space of potential solutions. The criteria can be combined as appropriate for particular applications to define plausible and best explanations. The central principle is that when time is diagnostically significant, it should be modeled explicitly to enable a more accurate formulation and evaluation of diagnostic solutions. The integration of time and primitive evaluation criteria is illustrated through the Skeletal Dysplasias Diagnostician (SDD) system, a diagnostic expert system for a real-life medical domain. SDD's notions of plausible and best explanation are reviewed so as to show the difficulties in formalizing such notions. Although we illustrate our work by medical problems, it has been motivated by consideration of problems in a number of other domains (fermentation monitoring, air and ground traffic control, power distribution) and is intended to be of wide applicability. [source] Snap: A time critical decision-making framework for MOUT simulationsCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 3-4 2008Shang-Ping Ting Abstract Deliberative reasoning based on the rational analysis of various alternatives often requires too much information and may be too slow in time critical situations. In these situations, humans rely mainly on their intuitions rather than some structured decision-making processes. An important and challenging problem in Military Operations on Urban Terrain (MOUT) simulations is how to generate realistic tactical behaviors for the non-player characters (also known as bots), as these bots often need to make quick decisions in time-critical and uncertain situations. In this paper, we describe our work on Snap, a time critical decision-making framework for the bots in MOUT simulations. The novel features of Snap include case-based reasoning (CBR) and thin slicing. CBR is used to make quick decisions by comparing the current situation with past experience cases. Thin slicing is used to model human's ability to quickly form up situation awareness under uncertain and complex situations using key cues from partial information. To assess the effectiveness of Snap, we have integrated it into Twilight City, a virtual environment for MOUT simulations. Experimental results show that Snap is very effective in generating quick decisions during time critical situations for MOUT simulations. Copyright © 2008 John Wiley & Sons, Ltd. [source] Impulse-based dynamic simulation in linear timeCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 4-5 2007Jan Bender Abstract This paper describes an impulse-based dynamic simulation method for articulated bodies which has a linear time complexity. Existing linear-time methods are either based on a reduced-coordinate formulation or on Lagrange multipliers. The impulse-based simulation has advantages over these well-known methods. Unlike reduced-coordinate methods, it handles nonholonomic constraints like velocity-dependent ones and is very easy to implement. In contrast to Lagrange multiplier methods the impulse-based approach has no drift problem and an additional stabilisation is not necessary. The presented method computes a simulation step in O(n) time for acyclic multi-body systems containing equality constraints. Closed kinematic chains can be handled by dividing the model into different acyclic parts. Each of these parts is solved independently from each other. The dependencies between the single parts are solved by an iterative method. In the same way inequality constraints can be integrated in the simulation process in order to handle collisions and permanent contacts with dynamic and static friction. Copyright © 2007 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||||||||