The effect of progressive muscle relaxation on daily cortisol secretion

Abbreviated progressive muscle relaxation (APMR) is a much used stress-management technique. Its efficacy relevant to placebo control is already established in the literature and the primary aim of the present study was to ascertain whether its proven impact on psychological stress measures is matched by a decrease in prevailing levels of the stress-associated hormone cortisol, using accurate and robust measurement based on multiple sampling of full diurnal cortisol secretion profiles. First-year university students can face significant stress in adjustment to academic demands and immersion in a novel social network and provided a convenient study population. One hundred and one first-year students completed APMR with prevailing stress levels assessed a week before and after intervention. Both cortisol and self-report measures were significantly reduced post-intervention by 8% and 10%, respectively. The efficacy of the intervention was independent of, and not modulated by neuroticism, gender, age and smoking status. We also demonstrated that cortisol reduction was unlikely to have been a consequence of adaptation to any initial cortisol elevation prompted by the challenge of the demanding saliva collection protocol. We conclude that the efficacy of APMR in this population extends to reduction in biologically expressed stress levels as well as levels based solely on self-report

Abstract verification and debugging of constraint logic programs

The technique of Abstract Interpretation [13] has allowed the development of sophisticated program analyses which are provably correct and practical. The semantic approximations produced by such analyses have been traditionally applied to optimization during program compilation. However, recently, novel and promising applications of semantic approximations have been proposed in the more general context of program verification and debugging [3],[10],[7]

The Integrated National Electrification Programme and political democracy

Since the coming of democracy in South Africa, the last decade has been marked by extraordinary, yet positive changes in policy development. Democratic organisation, both as a system of government and as a value system commanding the support of ordinary people, is of key importance in these developments and the implications for South Africa are still being analysed. Noticeable are the fundamental changes in the energy sector where there has been a shift from energy self-reliance and energy security to a more sustainable policy approach driven by economic efficiency, social equity and environment protection. Institutes of Democracy like IDEA (2004) concur with this trend that a strong democratic system must support poverty reduction for meaningful democratic change and, in practice; this is clearly the trend being defined. It is now a sustainable development issue, and voter’s confidence that is fast becoming the defining principle and drives for rapid policy change and service delivery in the form of an Integrated National Electrification Programme (INEP) in the energy sector. Policy makers in energy policy acknowledge this phenomenon as defining what is now seen as a ‘post-apartheid energy paradigm shift’. In this paper, it is suggested that the National Electrification Programme (NEP) has performed beyond expectation in increasing access to electricity for the poor in the country. It is also argued that, there is now an electrification and political democracy nexus exhibited in social and political development of this country. In this line of thought, the argument given is that one of the reasons why people voted for the ruling party in 1999 and 2000 was the NEP. Furthermore this identified linkage provides policy recommendations that suggest that the government should deliver other basic services in a similar manner in order to gain people’s confidence. In South Africa, because of the country’s unique social, economic and political history, a trade-off between basic social service delivery and linkage with democracy then becomes very crucial. Keyword

The Integrated National Electrification Programme and political democracy

Since the coming of democracy in South Africa, the last decade has been marked by extraordinary, yet positive changes in policy development. Democratic organisation, both as a system of government and as a value system commanding the support of ordinary people, is of key importance in these developments and the implications for South Africa are still being analysed. Noticeable are the fundamental changes in the energy sector where there has been a shift from energy self-reliance and energy security to a more sustainable policy approach driven by economic efficiency, social equity and environment protection. Institutes of Democracy like IDEA (2004) concur with this trend that a strong democratic system must support poverty reduction for meaningful democratic change and, in practice; this is clearly the trend being defined. It is now a sustainable development issue, and voter’s confidence that is fast becoming the defining principle and drives for rapid policy change and service delivery in the form of an Integrated National Electrification Programme (INEP) in the energy sector. Policy makers in energy policy acknowledge this phenomenon as defining what is now seen as a ‘post-apartheid energy paradigm shift’. In this paper, it is suggested that the National Electrification Programme (NEP) has performed beyond expectation in increasing access to electricity for the poor in the country. It is also argued that, there is now an electrification and political democracy nexus exhibited in social and political development of this country. In this line of thought, the argument given is that one of the reasons why people voted for the ruling party in 1999 and 2000 was the NEP. Furthermore this identified linkage provides policy recommendations that suggest that the government should deliver other basic services in a similar manner in order to gain people’s confidence. In South Africa, because of the country’s unique social, economic and political history, a trade-off between basic social service delivery and linkage with democracy then becomes very crucial. Keyword

Pancreatic cancer: patterns in a low- to middle income population, Zambia

Demographic features (age, gender) of pancreatic cancer.In 2007, the Cancer Disease Hospital (CDH) was opened as the national referral center for patients diagnosed with cancer in Zambia. Since inception of the CDH, there has been no systematic analysis of the disease burden and implication on healthcare delivery with regards to pancreatic cancer. There are limited studies describing patterns of pancreatic cancer in a native African population. Data suggest African-Americans have a higher incidence and poorer prognosis of pancreatic cancer than non-African Americans. Objective: Our aim is to describe the demographic features (age, gender) of pancreatic cancer using the Cancer Disease Hospital (CDH) data base in a native African population and compare with the African-American cohort using the Surveillance, Epidemiology End Results (SEER) Program database. Methods: This was a retrospective study of patients diagnosed with pancreatic cancer at the CDH in Zambia, Southern Africa between 2007 and 2014. We entered the term “pancreatic cancer” into the CDH database, extracted patient medical records numbers, and manually located the records for review. From each chart we extracted: age, gender, geographic origin, ethnicity, clinical features at presentations, location of tumor, stage at diagnosis and treatment. Data collection tool and master code sheet created a priori were used. Data was analyzed using statistical analysis software (SAS). Descriptive statistics including means, medians as well as frequency distributions and crosstabulations were used. SEER database was used to compare subjects between Zambia and USA. Groups were compared using Chi-square tests and Wilcoxon Signed Rank test. A p-value less than 0.05 was used as the level of significance. Results: Thirty-eight charts were identified in the CDH dataset, of which 27 were included in final analysis and 11 excluded (5 non-pancreatic cancer diagnosis, 6 not manually located). The mean age of diagnosis was 55.7 years in the native African population, compared to 66.7 years for the AfricanAmericans in the SEER database, p < 0.0001. There were 63.0% males (CDH) compared to 48.1% (SEER), p=0.121. Further review of the CDH database revealed that the most common presenting symptom was abdominal pain (52.6%), mode of diagnosis surgical (83%, missing 3), histopathology adenocarcinoma (86%, missing 6), location head of pancreas (83%, missing 9) and stage 4 at diagnosis (100%, missing 3). Conclusion: Pancreatic cancer occurs at a younger age in Zambians when compared to the African American, USA population. There is no statistically significant difference in sex presentation between Zambian and USA black population.Office of Global AIDS/US Department of State

An assertion language for constraint logic programs

In an advanced program development environment, such as that discussed in the introduction of this book, several tools may coexist which handle both the program and information on the program in different ways. Also, these tools may interact among themselves and with the user. Thus, the different tools and the user need some way to communicate. It is our design principie that such communication be performed in terms of assertions. Assertions are syntactic objects which allow expressing properties of programs. Several assertion languages have been used in the past in different contexts, mainly related to program debugging. In this chapter we propose a general language of assertions which is used in different tools for validation and debugging of constraint logic programs in the context of the DiSCiPl project. The assertion language proposed is parametric w.r.t. the particular constraint domain and properties of interest being used in each different tool. The language proposed is quite general in that it poses few restrictions on the kind of properties which may be expressed. We believe the assertion language we propose is of practical relevance and appropriate for the different uses required in the tools considered

An overview of the ciao multiparadigm language and program development environment and its design philosophy

We describe some of the novel aspects and motivations behind the design and implementation of the Ciao multiparadigm programming system. An important aspect of Ciao is that it provides the programmer with a large number of useful features from different programming paradigms and styles, and that the use of each of these features can be turned on and off at will for each program module. Thus, a given module may be using e.g. higher order functions and constraints, while another module may be using objects, predicates, and concurrency. Furthermore, the language is designed to be extensible in a simple and modular way. Another important aspect of Ciao is its programming environment, which provides a powerful preprocessor (with an associated assertion language) capable of statically finding non-trivial bugs, verifying that programs comply with specifications, and performing many types of program optimizations. Such optimizations produce code that is highly competitive with other dynamic languages or, when the highest levéis of optimization are used, even that of static languages, all while retaining the interactive development environment of a dynamic language. The environment also includes a powerful auto-documenter. The paper provides an informal overview of the language and program development environment. It aims at illustrating the design philosophy rather than at being exhaustive, which would be impossible in the format of a paper, pointing instead to the existing literature on the system

The BIOMASS level 2 prototype processor : design and experimental results of above-ground biomass estimation

BIOMASS is ESA’s seventh Earth Explorer mission, scheduled for launch in 2022. The satellite will be the first P-band SAR sensor in space and will be operated in fully polarimetric interferometric and tomographic modes. The mission aim is to map forest above-ground biomass (AGB), forest height (FH) and severe forest disturbance (FD) globally with a particular focus on tropical forests. This paper presents the algorithms developed to estimate these biophysical parameters from the BIOMASS level 1 SAR measurements and their implementation in the BIOMASS level 2 prototype processor with a focus on the AGB product. The AGB product retrieval uses a physically-based inversion model, using ground-canceled level 1 data as input. The FH product retrieval applies a classical PolInSAR inversion, based on the Random Volume over Ground Model (RVOG). The FD product will provide an indication of where significant changes occurred within the forest, based on the statistical properties of SAR data. We test the AGB retrieval using modified airborne P-Band data from the AfriSAR and TropiSAR campaigns together with reference data from LiDAR-based AGB maps and plot-based ground measurements. For AGB estimation based on data from a single heading, comparison with reference data yields relative Root Mean Square Difference (RMSD) values mostly between 20% and 30%. Combining different headings in the estimation process significantly improves the AGB retrieval to slightly less than 20%. The experimental results indicate that the implemented retrieval scheme provides robust results that are within mission requirements

Independence in CLP Languages

Studying independence of goals has proven very useful in the context of logic programming. In particular, it has provided a formal basis for powerful automatic parallelization tools, since independence ensures that two goals may be evaluated in parallel while preserving correctness and eciency. We extend the concept of independence to constraint logic programs (CLP) and prove that it also ensures the correctness and eciency of the parallel evaluation of independent goals. Independence for CLP languages is more complex than for logic programming as search space preservation is necessary but no longer sucient for ensuring correctness and eciency. Two additional issues arise. The rst is that the cost of constraint solving may depend upon the order constraints are encountered. The second is the need to handle dynamic scheduling. We clarify these issues by proposing various types of search independence and constraint solver independence, and show how they can be combined to allow dierent optimizations, from parallelism to intelligent backtracking. Sucient conditions for independence which can be evaluated \a priori" at run-time are also proposed. Our study also yields new insights into independence in logic programming languages. In particular, we show that search space preservation is not only a sucient but also a necessary condition for ensuring correctness and eciency of parallel execution

A nurse‐led intervention improves detection and management of AKI in Malawi

BACKGROUND: Acute kidney injury is common and has significant impact on mortality and morbidity. There is a global drive to improve the lack of knowledge and understanding surrounding the recognition, diagnosis and management of patients with AKI in resource poor healthcare systems. OBJECTIVES: We propose a nurse‐led education programme to medical and nursing staff of the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, will improve the overall care and understanding of patients with AKI that will still be effective 3 months later. METHODS: This was a three phase, prospective interventional pilot study which evaluated base line knowledge and clinical practice amongst healthcare workers, provided a comprehensive combination nurse‐led class room and ward based teaching programme and evaluated the change in knowledge and clinical management of patients in the high dependency areas of the hospital immediately, and 3 months, after the teaching intervention. RESULTS: The nurse‐led intervention significantly improved the healthcare workers attitudes towards detecting or managing patients with suspected AKI (p < 0.0001). There were also significant improvements in the completion of fluid charts and recording of urine output (p < 0.0001), corner stones of AKI management. Knowledge and clinical intervention was still present three months later. There was however little change in the understanding that AKI could be a significant clinical problem in QECH and that it may have a major impact on mortality and working practice and this needs to be addressed in future teaching programmes. CONCLUSIONS: A low cost, nurse‐led AKI educational intervention improved the knowledge and management of AKI at QECH, which was still evident 3 months later