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Continuum
Kinds of Continuum Terms modified by Continuum Selected AbstractsCONTINUUM OF CARE AND THE ANTENATAL RECORD IN RURAL NEW SOUTH WALESAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2003Karen Patterson ABSTRACT Objective: The aim of the study was to determine the effect of the woman held antenatal record card (PNC2) on the continuity of maternity care received when presenting to the acute rural setting for clinical assessment. Design: Qualitative, open-ended questionnaires. Setting: Rural New South Wales public hospital. Subjects: Maternity consumers, 50 women who were inpatients receiving antenatal or postnatal care between August and October 1998. A stratified sample of healthcare professionals employed by the service, 12 midwives and 13 general practitioners. Main outcome measure: The self reported use of the antenatal card and the viewed effects of the card on the continuity of healthcare received. Results: The study identified a significant difference between the responding professionals (93%) positive perception of the effect of the PNC2 on the women's pregnancy continuum of care and the maternity consumer (36%), who felt it bore little impact on their care. The study findings suggested a lack of compliance and standardisation in usage of the antenatal card negated any flow on effects for the women. Conclusions: The intended purposes of the PNC2 were compromised in this rural setting. The study recommends that stakeholders in rural maternity care be accountable for examining the benefits and barriers of their antenatal practices, that the rural community's expectations of ,continuity of maternity care' are sought and that there should be a review of the available models of rural antenatal care. [source] Prophylaxis of Hemicrania Continua: Two New Cases Effectively Treated With TopiramateHEADACHE, Issue 3 2007Filippo Brighina MD Hemicrania continua (HC) is an uncommon and under-recognized primary headache disorder characterized by a strictly unilateral continuous headache of moderate intensity with possible exacerbations and associated with ipsilateral autonomic features. HC has generally a prompt and enduring response to indomethacin although 25% to 50% of treated patients develop gastrointestinal side effects. These cases pose a difficult management challenge as no other drug is consistently effective in HC. Recently 2 HC patients responsive to topiramate treatment have been reported. Here we describe 2 more patients effectively treated with topiramate. Neither reported any side effects and one had persisting response for 6 months after drug withdrawal. [source] From Hemicrania Lunaris to Hemicrania Continua: An Overview of the Revised International Classification of Headache DisordersHEADACHE, Issue 7 2004Jonathan P. Gladstone MD The International Headache Society's (IHS) Classification of Headache Disorders, published in 1988, is largely responsible for stimulating the rapid scientific and therapeutic advances that have revolutionized the field of headache. By establishing consistent operational diagnostic criteria for primary and secondary headache disorders, the IHS Classification has facilitated epidemiological and genetic studies as well as the multinational clinical trials that provide the basis for our present treatment guidelines. Fifteen years after its original release, a revised 2nd edition has been unveiled. Modifications are small but significant. We hope to introduce clinicians to the salient changes in the 2nd edition by highlighting the newly included headache types, acknowledging the renamed headache types, and reviewing the modifications in diagnostic criteria for existing headache types. Physicians involved in the care of headache patients need to be aware of these changes and should continue to consult the IHS criteria to ensure accurate diagnosis, to continue to refine the diagnostic criteria, and to contribute to the body of knowledge necessary to make further advances in the classification as well as in the field of headache. [source] Cultural theory in use: the intersection of structure, process and communication in business practiceJOURNAL OF PUBLIC AFFAIRS, Issue 4 2008Camille P. Schuster Examining and understanding the culture of 200+ countries to determine how business is conducted in those countries is a daunting and overwhelming prospect. By combining theories of culture, it is possible to create a Classification Of Cultures Model using Time, Task and Relationship concepts. However, this model does not suggest how to adapt when conducting business in a particular political/economic environment. Continua of cultural elements related to conducting business are created based upon structural elements, process elements and communication elements. Combining the continua with the Classification of Cultures Model creates the Global Business Process Model. This framework is a way to capture the array of cultures, identify similarities and differences in business practices, and provide a starting point for creating adaptive strategies and behaviours. Copyright © 2008 John Wiley & Sons, Ltd. [source] Continua and Umwelt: novel perspectives on viewing landscapesOIKOS, Issue 3 2004A. D. Manning First page of article [source] Applying a continua landscape approach to evaluate plant response to fragmentation: Primula vulgaris in the Cantabrian mountainsAPPLIED VEGETATION SCIENCE, Issue 4 2009Alicia Valdés Abstract Question: Continua landscape approaches conceptualize the effects of habitat fragmentation on the biota by considering fragmented landscapes as continuous gradients, departing from the view of habitat as either suitable (fragment) or unsuitable (matrix). They also consider the ecological gradients or the ,Umwelt' (species-specific perception of the landscape) to represent the processes that ultimately limit organisms' ability to colonize and persist within habitat remnants. Are these approaches suitable for evaluating the response of plant species to fragmentation? Location: Fragmented mid-elevation temperate forests, Cantabrian range, Spain. Methods: The presence, abundance and demographic structure of populations of the perennial herb Primula vulgaris were sampled across a continuous extent of 100 ha, subdivided into 400 50 m × 50 m sampling units. These variables were related to forest availability, forest subdivision and edge density, topography and the spatial clumpiness of populations (a measure of plant dispersal constraints and, hence, a major surrogate of plant Umwelt). Results: Fragmentation processes, especially habitat loss, negatively affect P. vulgaris, with a stronger effect on presence than on abundance and demography. Despite the importance of habitat availability, P. vulgaris does not occupy all potentially suitable forest habitat, mostly owing to dispersal constraints. A positive effect of slope on plant presence also suggests some effect of habitat quality in determining establishment and occupancy of forest landscape. Conclusions: Within-habitat dispersal constraints are as important as forest fragmentation in determining the landscape-scale distribution of P. vulgaris. By assessing the relative role of the diverse fragmentation processes, and of the species' landscape perception, a continua landscape approach proves to be a valuable tool for predicting plant response to landscape change. [source] The Utility of Heart Sounds and Systolic Intervals Across the Care ContinuumCONGESTIVE HEART FAILURE, Issue 2006W. Frank Peacock MD Acoustic cardiography is an exciting, new, easy-to-use, modernized technology that incorporates already proven techniques of phonocardiography. Application of acoustic cardiography to clinical practice can improve diagnosis and management of heart failure patients. Its clinical use should help address some of the need for robust, inexpensive, and widely accessible technology for proactive heart failure diagnosis and management. Acoustic cardiographically recorded measurements have been correlated with both cardiac catheterization and echocardiographically determined hemodynamic parameters. Heart sounds captured by acoustic cardiograms have proven to assist clinicians in assessing dyspneic patients in the emergency department by utilizing the strong specificity of an S3 for detecting acute decompensated heart failure. Acoustic cardiography offers a cost-efficient, easy-to-use method to optimize the devices used in cardiac resyncronization therapy. The rapidly and easily obtainable information gathered by acoustic cardiography should foster its more widespread use in diagnosis and treatment of heart failure, including cardiac resyncronization therapy device optimization. [source] The Utility of Heart Sounds and Systolic Intervals Across the Care ContinuumCONGESTIVE HEART FAILURE, Issue 2006W. Frank Peacock MD Acoustic cardiography is an exciting, new, easy-to-use, modernized technology that incorporates already proven techniques of phonocardiography. Application of acoustic cardiography to clinical practice can improve diagnosis and management of heart failure patients. Its clinical use should help address some of the need for robust, inexpensive, and widely accessible technology for proactive heart failure diagnosis and management. Acoustic cardiographically recorded measurements have been correlated with both cardiac catheterization and echocardiographically determined hemodynamic parameters. Heart sounds captured by acoustic cardiograms have proven to assist clinicians in assessing dyspneic patients in the emergency department by utilizing the strong specificity of an S3 for detecting acute decompensated heart failure. Acoustic cardiography offers a cost-efficient, easy-to-use method to optimize the devices used in cardiac resyncronization therapy. The rapidly and easily obtainable information gathered by acoustic cardiography should foster its more widespread use in diagnosis and treatment of heart failure, including cardiac resyncronization therapy device optimization. [source] The interpretation, assessment and conservation of ecological communitiesECOLOGICAL MANAGEMENT & RESTORATION, Issue 2009David A. Keith Summary Ecological communities are assemblages of species that occur together in space and time. Their properties include composition, structure, habitat, distribution, biological interactions and ecosystem functions. The community concept has a central role in conservation planning, and is a key approach for biodiversity conservation above the species level. The relatively recent application of risk assessment and regulatory systems to conservation of ecological communities has highlighted a number of challenges related to intrinsic uncertainties in the definition, diagnosis and assessment of ecological communities. In this review, I aim to elucidate some key conceptual issues essential to the interpretation of communities. Effective description, diagnosis and assessment of communities rests on an understanding of community theory in relation to environmental gradients and ecosystem dynamics. Continuum and discrete models can both contribute to interpretation of communities for conservation. Different sources of uncertainty are inherent in the key properties that characterize communities. Although some of these are reducible, remaining uncertainty must be incorporated into assessments and decision-making processes for conservation. Protocols for assessing extinction risks of communities address rates of decline in distribution, size of distribution and rates of decline in ecological functions. Some protocols assess these factors in a manner that may be inconsistent with equivalent methods for assessing species. Communities may be viewed in a framework that distinguishes thematic, spatial and temporal scales. These scales influence the outcomes of risk assessment, the benefits and limitations of maps and how well communities perform their function in conservation planning. When applied effectively, ecological communities can be powerful tools for delivering cost-effective outcomes for land-use planning and biodiversity conservation. [source] Strain-Gradient Elasticity for Bridging Continuum and Atomistic Estimates of Stiffness of Binary Lennard-Jones CrystalsADVANCED ENGINEERING MATERIALS, Issue 6 2010Andrei A. Gusev Lagrangian variational approach is employed to derive the equations of equilibrium of strain-gradient elasticity. For a periodic lamellar-morphology strain-gradient medium, we present an exact formula for the overall, system stiffness. We compare the formula with direct atomistic estimates of stiffness of binary Lennard-Jones crystals. The comparison reveals that the strain-gradient formula remains fairly accurate for all the crystals studied, including those with order of unity atoms in the crystal unit cell. Thus, one can surmise that the strain-gradient correction alone can already be sufficient to extend the scope of validity of continuum-level elasticity to near atomistic length scales. [source] Pressure Ulcers in Elderly Patients with Hip Fracture Across the Continuum of CareJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2009Mona Baumgarten PhD OBJECTIVES: To identify care settings associated with greater pressure ulcer risk in elderly patients with hip fracture in the postfracture period. DESIGN: Prospective cohort study. SETTING: Nine hospitals that participate in the Baltimore Hip Studies network and 105 postacute facilities to which patients from these hospitals were discharged. PARTICIPANTS: Hip fracture patients aged 65 and older who underwent surgery for hip fracture. MEASUREMENTS: A full-body skin examination was conducted at baseline (as soon as possible after hospital admission) and repeated on alternating days for 21 days. Patients were deemed to have an acquired pressure ulcer (APU) if they developed one or more new stage 2 or higher pressure ulcers after hospital admission. RESULTS: In 658 study participants, the APU cumulative incidence at 32 days after initial hospital admission was 36.1% (standard error 2.5%). The adjusted APU incidence rate was highest during the initial acute hospital stay (relative risk (RR)=2.2, 95% confidence interval (CI)=1.3,3.7) and during re-admission to the acute hospital (RR=2.2, 95% CI=1.1,4.2). The relative risks in rehabilitation and nursing home settings were 1.4 (95% CI=0.8,2.3) and 1.3 (95% CI=0.8,2.1), respectively. CONCLUSION: Approximately one-third of hip fracture patients developed an APU during the study period. The rate was highest in the acute setting, a finding that is significant in light of Medicare's policy of not reimbursing hospitals for the treatment of hospital-APUs. Hip fracture patients constitute an important group to target for pressure ulcer prevention in hospitals. [source] Estimating dispersal rate of the silky cane weevil (Coleoptera: Curculionidae),JOURNAL OF APPLIED ENTOMOLOGY, Issue 6 2005H. Puche Abstract:, The objective of this study was to estimate the silky cane weevil rate of dispersal under near-natural conditions inside a screened enclosure where an array of buckets was baited with cut sugarcane stalks. One hundred weevils were released and weevils inside the buckets were counted hourly for 8 h, and then 24 and 48 h after release. A passive diffusion model was used to estimate the weevil's dispersal and disappearance rates, within and between rows of buckets with sugarcane. The weevils concentrated around the release point and slowly moved towards the boundaries of the experimental plot over time with an overall average dispersal rate of 2.8 ± 3.58 cm2/h. Dispersal and disappearance rates within and between rows were not significantly different among the time intervals considered (1,8, 8,24 and 24,48 h after release) except for the 1,8 time interval on the array representing the release point when the dispersal rate, D, was significantly higher than those at other time intervals. Continuum of the substratum to disperse from one side of the array to another via a wooden bridge may explain the higher dispersal rate through this array. The number of buckets exposed to the sun during the morning hours was significantly higher on those rows exposed to the sun (south side of the screen enclosure) than on the shaded side. Longer times of bucket exposure to the sun may explain the predominant distribution of weevils in that area suggesting that the weevil population is constantly expanding and retracting according to micro environmental conditions. [source] Continuum and discrete calculation of fractional contributions to solvation free energyJOURNAL OF COMPUTATIONAL CHEMISTRY, Issue 13 2003Antonio Morreale Abstract Approaches to compute fractional contributions to the solvation free energy are developed in the context of continuum self consistent reaction field calculations (both classical and quantum mechanical), as well as in the framework of discrete molecular dynamics simulations. It is found that for a series of typical pharmacological drugs there is a good agreement between the different fractional descriptions. Algorithms reported here can be easily applied as molecular descriptors in the context of quantitative structure-activity relationships. © 2003 Wiley Periodicals, Inc. J Comput Chem 24: 1610,1623, 2003 [source] Criminal Offenders with Mental Retardation: Risk Assessment and the Continuum of Community Based Treatment ProgrammesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2001Edwin J. Mikkelsen Jr [source] The development of nurses as managers: the prevalence of the self-development routeJOURNAL OF NURSING MANAGEMENT, Issue 4 2000D. Foster PHD Aim This article identifies ways in which hospital sisters and charge nurses (ward managers) are developed as managers in one London teaching hospital.Context Ward managers are practising in the context of increasing management responsibility in which decision-making is being driven to occur as close to the patient as possible. Decision-making about the management development opportunities for ward managers rests with senior nurse managers who have espoused their own preferences about the styles of management development open to ward managers. Methods For this small-scale exploratory-descriptive study, qualitative research methods were used with a postal self-completed questionnaire followed by a focus group. The target population was a group of 22 senior nurse managers. There was a questionnaire response rate of 68% (n=15 respondents, four of whom participated in the focus group). Findings The research exposed and substantiated four styles of management development. The organizational prevalence of these styles and the ward managers' preference for each style were also ascertained. The most prevalent style was the one for which there was the least preference. Conclusions The findings indicated that there was a general mismatch between the style of management development prevalent in the organization and the style of management development preferred by the subjects. This left the ward managers generally to follow an unstructured self-development route. The use of a theoretical framework, expressed as a Reluctance-Readiness to Manage Continuum, is suggested to harness the propensity to self-develop and to link it with the organizational need to develop nurses as managers through the paradox of structuring self-development. [source] Physical Activity Research in NursingJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2001Lorraine B. Robbins Purpose: To present exemplars of physical activity research in nursing, illustrate the importance of physical activity research across the lifespan, and recommend directions for theory development and research. Methods: Studies of physical activity and exercise currently being conducted by nurse investigators were reported and critiqued by attendees of the Midwest Nursing Research Society 2000 Preconference session entitled "Promoting Physical Activity Among Diverse Groups Across the Health Continuum." Physical activity and exercise literature during the past decade was reviewed. Databases searched included Medline, CINAHL, Wilson, and ERIC. Findings: Investigators have emphasized the need to evaluate the effects of theory-based physical activity interventions designed to alter key correlates of physical activity identified through descriptive research. Conclusions: Regular physical activity is necessary for health promotion and disease prevention for all populations. Continued research in this important area of health behavior is critical to identify the most effective interventions to increase physical activity among diverse populations. [source] Sensory Processing and Adaptive Behavior Deficits of Children Across the Fetal Alcohol Spectrum Disorder ContinuumALCOHOLISM, Issue 6 2010Joshua L. Carr Background:, Prenatal alcohol exposure can have detrimental effects on a child's development of adaptive behaviors necessary for success in the areas of academic achievement, socialization, and self-care. Sensory processing abilities have been found to affect a child's ability to successfully perform adaptive behaviors. The current study explored whether significant differences in sensory processing abilities, adaptive behavior, and neurocognitive functioning are observed between children diagnosed with partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), or children who were prenatally exposed to alcohol (PEA), but did not meet criteria for an FASD diagnosis. The influence of IQ on adaptive behavior as well as further exploration of the relationship between sensory processing and adaptive behavior deficits among these children was also examined. Methods:, A secondary analysis was conducted on some of the Short Sensory Profile (SSP) scores, Adaptive Behavior Assessment System,Second Edition (ABAS-II) scores, and Wechsler Intelligence Scale,Fourth Edition/Wechsler Preschool and Primary Scale of Intelligence,Third Edition (WISC- IV/WPPSI,III) scores of 46 children between 3 and 14 years of age with pFAS, ARND, or who were PEA. Results:, Greater sensory processing deficits were found in children with a diagnosis of pFAS and ARND compared to those in the PEA group. Children with an ARND diagnosis scored significantly worse on measures of adaptive behavior than the PEA group. Children with pFAS scored significantly lower than children with ARND or PEA on perceptual/performance IQ. No correlation was found between IQ scores and adaptive behaviors across the FASD diagnostic categories. A significant positive correlation was found between SSP and ABAS-II scores. Conclusions:, Regardless of the diagnosis received under the FASD umbrella, functional difficulties that could not be observed using traditional measures of intelligence were found, supporting guidelines that a broad range of standardized assessments be included when screening children for FASD. [source] Joining the Evangelical Club: The Movement of the Wesleyan-Holiness Churches in Australia Along the Church-Sect ContinuumJOURNAL OF RELIGIOUS HISTORY, Issue 3 2008GLEN O'BRIENArticle first published online: 12 AUG 200 A number of North American Wesleyan-Holiness denominations emerged in Australia, beginning in the years following the Second World War. Some of these churches moved from being despised and marginalized sects to established denominations while others remained small and isolated, experiencing little growth. Their story demonstrates that movement along the church-sect continuum is by no means a smooth and inevitable one. Random processes may lower or raise religious tension within the group thus affecting its movement along the continuum. The strict behavioural standards in Wesleyan-Holiness churches have gradually been lowered and the distinctive beliefs of these groups have been eroded. Wesleyan-Holiness churches in Australia have grown primarily through "switchers" from other denominations more than from new convert growth, so that they have become more generically "Evangelical" and less distinctively "Holiness" in their beliefs and practices. [source] A Critical Time for Practice Change in the Pain Treatment Continuum: We Need to Reconsider the Role of Pumps in the Patient Care AlgorithmPAIN MEDICINE, Issue 7 2010Timothy R. Deer MD No abstract is available for this article. [source] Regime Types and Discrimination against Ethnoreligious Minorities: A Cross-Sectional Analysis of the Autocracy,Democracy ContinuumPOLITICAL STUDIES, Issue 3 2003Jonathan Fox Although many assume that the relationship between the autocracy,democracy continuum and discrimination is linear, with autocracies discriminating the most and democracies discriminating the least, the assumption is not universal. This study uses the Minorities at Risk dataset to test this relationship with regard to government treatment of religiously differentiated ethnic minorities (ethnoreligious minorities) as well as ethnic minorities that are not religiously differentiated. The results show that the pattern of treatment of ethnoreligious minorities differs from that of other ethnic minorities. The extent to which a state is democratic has no clear influence on the level of discrimination against non-religiously differentiated ethnic minorities, but it has a clear influence on the level of discrimination against ethnoreligious minorities. Autocracies discriminate more than democracies against ethnoreligious minorities, but semi-democracies, those governments that are situated between democracies and autocracies, discriminate even less. This result is consistent on all 11 measures used here and is statistically significant for seven of them, and it remains strong when controlling for other factors, including separatism. This phenomenon increases in strength from the beginning to the end of the 1990s. Also, democracies discriminate against ethnoreligious minorities more than they do against other minorities. The nature of liberal democracy may provide an explanation for this phenomenon. [source] Framing Disparities Along the Continuum of Care from Chronic Kidney Disease to Transplantation: Barriers and InterventionsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2009K. Ladin Research in renal transplantation continues to document scores of disparities affecting vulnerable populations at various stages along the transplantation process. Given that both biological and environmental determinants contribute significantly to variation, identifying factors underlying an unfairly biased distribution of the disease burden is crucial. Confounded definitions and gaps in understanding causal pathways impede effectiveness of interventions aimed at alleviating disparities. This article offers an operational definition of disparities in the context of a framework aimed at facilitating interventional research. Utilizing an original framework describing the entire continuum of the transplant process from diagnosis of chronic kidney disease through successful transplant, this article explores the case of racial disparities, illustrating key factors predicting and perpetuating disparities. Though gaps in current research leave us unable to identify which stages of the transplant pathway adversely affect most people, by identifying key risk factors across the continuum of care, this article highlights areas suited for targeted interventions and presents recommendations for improvement and future research. [source] Performance of Greater Sage-Grouse Models for Conservation Assessment in the Interior Columbia Basin, U.S.A.CONSERVATION BIOLOGY, Issue 5 2002Michael J. Wisdom Consequently, we evaluated the performance of two models designed to assess landscape conditions for Greater Sage-Grouse across 13.6 million ha of sagebrush steppe in the interior Columbia Basin and adjacent portions of the Great Basin of the western United States (referred to as the basin). The first model, the environmental index model, predicted conditions at the scale of the subwatershed (mean size of approximately 7800 ha) based on inputs of habitat density, habitat quality, and effects of human disturbance. Predictions ranged on a continuous scale from 0 for lowest environmental index to 2 for optimal environmental index. The second model, the population outcome model, predicted the composite, range-wide conditions for sage grouse based on the contribution of environmental index values from all subwatersheds and measures of range extent and connectivity. Population outcomes were expressed as five classes (A through E) that represented a gradient from continuous, well-distributed populations (outcome A) to sparse, highly isolated populations with a high likelihood of extirpation (outcome E). To evaluate performance, we predicted environmental index values and population outcome classes in areas currently occupied by sage grouse versus areas where extirpation has occurred. Our a priori expectations were that models should predict substantially worse environmental conditions ( lower environmental index) and a substantially higher probability of extirpation ( lower population outcome class) in extirpated areas. Results for both models met these expectations. For example, a population outcome of class E was predicted for extirpated areas, as opposed to class C for occupied areas. These results suggest that our models provided reliable landscape predictions for the conditions tested. This finding is important for conservation planning in the basin, where the models were used to evaluate management of federal lands for sage grouse. Resumen: Modelos válidos de hábitat y de poblaciones del urogallo (Centrocercus urophasianus) son una necesidad crítica para su manejo debido a la creciente preocupación por la viabilidad de la población. Por lo tanto, evaluamos el funcionamiento de dos modelos diseñados para evaluar las condiciones del paisaje para el urogallo en 13.6 millones de ha de la estepa de artemisa en la Cuenca Columbia Interior y las porciones adyacentes de la Gran Cuenca de los Estados Unidos occidentales (referidos como cuenca). El primer modelo (modelo de índice ambiental) predijo condiciones a escala de la subcuenca (tamaño promedio , 7800 ha) basado en información de la densidad del hábitat, calidad del hábitat y efectos de la perturbación humana. Las predicciones variaron en una escala continua a partir de 0 (el índice ambiental más bajo) a 2 (índice ambiental óptimo). El segundo modelo (modelo del resultado de la población) predijo las condiciones compuestas, de amplio rango, para el urogallo con base en la contribución de los valores de índice ambiental de todas las subcuencas y las medidas de extensión y de conectividad de la pradera. Los resultados de la población fueron expresados en cinco clases (A - E) que representan un gradiente de poblaciones continuas, bien-distribuidas (resultado A) a poblaciones escasas, altamente aisladas con una alta probabilidad de extirpación (resultado E). Para evaluar el funcionamiento, predijimos valores de índice ambiental y resultados de la población en las áreas actualmente ocupadas por urogallos versus áreas donde ha ocurrido la extirpación. Nuestras expectativas a priori eran que los modelos deben predecir condiciones ambientales substancialmente peores (índice ambiental más bajo) y una probabilidad de extirpación sustancialmente mayor (menor resultado de la población) en áreas extirpadas. Los resultados para ambos modelos cumplieron estas expectativas. Por ejemplo, se predijo un resultado de la población de la clase E para áreas extirpadas, en comparación con la clase C para áreas ocupadas. Estos resultados sugieren que nuestros modelos proporcionaron predicciones de paisaje confiables para las condiciones probadas. Este hallazgo es importante para planeación de la conservación de la cuenca, donde los modelos fueron utilizados para evaluar el manejo de terrenos federales para urogallos. [source] Strain field measurements of rubber by image analysis and design criteria for laminated rubber bearings (LRB)EARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 4 2004Chamindalal Sujeewa Lewangamage Abstract Although seismic isolation rubber bearings in bridges and buildings have proven to be a very effective passive method for reducing earthquake-induced forces, a detailed mechanical modeling of the rubber that is used in bearings under large strains has not been established. Therefore, a 3D model of failure behavior and the design criteria for the safety evaluation of seismic isolation bearings have not yet been developed. This paper presents: (1) correlation-based template-matching algorithms to measure large strain fields of continua; (2) a failure criterion for rubber; and (3) the design criteria for the safety evaluation of laminated algorithms, data-validation algorithms were developed and implemented to eliminate possible unrealistic displacement vectors present in the measured displacement field. The algorithms were successfully employed in the strain field measurement of LRB and rubber materials that are subjected to failure. The measured local strains for rubber material at failure were used to develop a failure criterion for rubber. The validity of the proposed criterion was evaluated by applying it to the LRB; the criterion was introduced into a 3D finite element model of LRB, compared with the experimental results of bearings failure, and verified. Finally, design criteria are proposed for LRB for the safety evaluation. Copyright © 2003 John Wiley & Sons, Ltd. [source] Health care resource utilization in patients with active epilepsyEPILEPSIA, Issue 5 2010Tobias Kurth Summary Purpose:, To evaluate health care resource utilization (HRU) in active epilepsy. Methods:, Thomson-Reuters insurance databases included 14 million persons in 2005,2007. We extracted information for individuals with insurance claims suggestive of epilepsy. Using iterative expert classification, we sorted patients by type of epilepsy. For each type we calculated prevalence and HRU. A distance analysis identified closely similar types, and a principal components analysis revealed dimensions of variation in HRU. Results:, The prevalence of active epilepsy was 3.4 per 1,000. Most common diagnoses among 46,847 patients were generalized convulsive epilepsy (33.3%) and complex partial seizures (24.8%). Patients averaged 10 physician visits per year, 24 diagnostic tests/procedures per year, >30 drug dispensings per year, and <1 emergency room (ER) visit per year, the minority of each of these being related to epilepsy. Female patients generally had more HRU, and HRU increased with age. Patients were hospitalized most frequently for disorders other than epilepsy. HRU was similar for most epilepsy types, excepting grand mal status, epilepsia partialis continua, and infantile spasms. The first principal components of HRU variation was nonepilepsy HRU, followed by components of epilepsy-related medications, other epilepsy/emergency care, and epilepsy visits/diagnostic procedures. Discussion:, The prevalence of active epilepsy in the United States is substantially less than the prevalence of any history of recurrent seizure. Nonepilepsy-related HRU dominated HRU in epilepsy patients and was the principal source of variation. There is a core set of epilepsy diagnoses, the HRU patterns of which are indistinguishable, whereas patients with grand mal status, epilepsia partialis continua, and infantile spasms all have distinct patterns. To provide more specific insights into the economic impact of the condition, studies of HRU in epilepsy should make a distinction about epilepsy-related and unrelated care. [source] Characterization of the Tetanus Toxin Model of Refractory Focal Neocortical Epilepsy in the RatEPILEPSIA, Issue 2 2005Karen E. Nilsen Summary:,Purpose: To characterize in detail a model of focal neocortical epilepsy. Methods: Chronic focal epilepsy was induced by injecting 25,50 ng of tetanus toxin or vehicle alone (controls) into the motor neocortex of rats. EEG activity was recorded from electrodes implanted at the injection site, along with facial muscle electromyographic (EMG) activity and behavioral monitoring intermittently for up to 5 months in some animals. Drug responsiveness was assessed by using the antiepileptic drugs (AEDs) diazepam (DZP) and phenytoin (PHT) delivered systemically, while 1,2,3,4-tetrahydro-6-nitro-2,3-dioxo-benzo[f]quinoxaline-7-sulfonamide (NBQX), a competitive antagonist at AMPA receptors, was administered directly to the brain to investigate the potential benefits of focal drug delivery. Results: Tetanus toxin induced mild behavioral seizures that persisted indefinitely in all animals. EEG spiking activity, occurring up to 80% of the time, correlated with clinical seizures consisting of interrupted behavioral activity, rhythmic bilateral facial twitching, and periods of abrupt motor arrest. Seizures were refractory to systemic administration of DZP and PHT. However, focal delivery of NBQX to the seizure site reversibly reduced EEG and behavioral seizure activity without detectable side effects. Conclusions: This study provides a long-term detailed characterisation of the tetanus toxin model. Spontaneous, almost continuous, well-tolerated seizures occur and persist, resembling those seen in neocortical epilepsy, including cortical myoclonus and epilepsia partialis continua. The seizures appear to be similarly resistant to conventional AEDs. The consistency, frequency, and clinical similarity of the seizures to refractory epilepsy in humans make this an ideal model for investigation of both mechanisms of seizure activity and new therapeutic approaches. [source] Centralization and Decentralization in Administration and Politics: Assessing Territorial Dimensions of Authority and PowerGOVERNANCE, Issue 1 2001Paul D. Hutchcroft Throughout the world, diverse countries are implementing programs of decentralization as a means of promoting both democratic and developmental objectives. Unfortunately, however, scholarship has yet to offer a comprehensive framework within which to assess and reform central-local relations. This article seeks to overcome the "division of labor" that has long separated analyses of administrative and political structures, and to provide stronger conceptual vocabulary for describing and analyzing the complexities of centralization and decentralization in both administration and politics. After developing two distinct continua of administrative and political centralization/decentralization, the paper then combines them in a single matrix able to highlight the wide range of strategies and outcomes that emerge from the complex interplay of the two spheres. Depending on where a country lies within the matrix, it is argued, strategies of decentralization may do more harm than good. Strategies of devolution are especially problematic in settings with strong local bosses, and should never be attempted without careful analysis of the preexisting character of central-local ties. [source] Hemicrania Continua Responsive to Intravenous Methyl PrednisoloneHEADACHE, Issue 4 2009Sanjay Prakash DM Hemicrania continua (HC) is a strictly unilateral, continuous primary headache disorder with periodic exacerbations, usually accompanied by cranial autonomic disturbances. Exquisite and persistent effect of indomethacin is a fundamental property of HC. We report 2 patients of HC in which attacks were successfully eliminated by repeated infusion of methyl prednisolone. [source] Hemicrania Continua Secondary to an Ipsilateral Brainstem LesionHEADACHE, Issue 3 2007Marcelo M. Valença MD We describe a 47-year-old woman with a 3-year history of a continuum mild-moderate right-side headache, with exacerbations, associated with stabbing volleys of pain on right orbit-temporal region (10/10) and right eye ptosis and lacrimation with conjunctival injection. The pain was completely abolished with indomethacin (100 mg per day). The diagnosis of hemicrania continua was made according to the International Headache Society (IHS) criteria. The headache presentation was precipitated by a stroke and a right-side brainstem lesion was present at magnetic resonance imaging. This case report shows anatomoclinical evidence of the involvement of brainstem structures on the pathophysiology of hemicrania continua. [source] Prophylaxis of Hemicrania Continua: Two New Cases Effectively Treated With TopiramateHEADACHE, Issue 3 2007Filippo Brighina MD Hemicrania continua (HC) is an uncommon and under-recognized primary headache disorder characterized by a strictly unilateral continuous headache of moderate intensity with possible exacerbations and associated with ipsilateral autonomic features. HC has generally a prompt and enduring response to indomethacin although 25% to 50% of treated patients develop gastrointestinal side effects. These cases pose a difficult management challenge as no other drug is consistently effective in HC. Recently 2 HC patients responsive to topiramate treatment have been reported. Here we describe 2 more patients effectively treated with topiramate. Neither reported any side effects and one had persisting response for 6 months after drug withdrawal. [source] Hemicrania Continua-Like Headache Associated With Internal Carotid Artery Dissection May Respond to IndomethacinHEADACHE, Issue 1 2007Avi Ashkenazi MD Hemicrania continua (HC) is an idiopathic, chronic disorder characterized by a continuous, strictly unilateral headache associated with ipsilateral cranial autonomic symptoms. The symptoms of HC typically respond dramatically to indomethacin therapy. We describe a patient with traumatic internal carotid artery dissection, who presented with a clinical picture mimicking HC that initially responded to indomethacin. Patients with a clinical picture similar to HC should be managed with a high index of suspicion for a possible cervical arterial dissection. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||