6,188 research outputs found
Evaluation of ERTS-1 data for certain hydrological uses
The author has identified the following significant results. ERTS-1 MSS data have been used in a variety of hydrologic research including snow-extent mapping; studies of snowmelt, snowmelt runoff, spectral reflectance of snow for assessing snowpack conditions, and snow albedo; lake ice formation, breakup, and migration; lake current measurements; multispectral studies of lake ice; and flood studies. MSS sensing of soil moisture over a well-vegetated test site was unsuccessfully attempted. Although a powerful research tool, ERTS-1 has very limited use as an operational system for hydrologic communities because of its 18-day revisit cycle and its lack of a quick look capability
Commercial hospitality : a vehicle for the sustainable empowerment of Nepali women
To illustrate how commercial hospitality has catalysed sustainable social change in Nepal through empowering women. Utilising a new framework, developed by combining existing theories, empowerment of women Tea House owners/ managers is assessed. Within a critical feminist paradigm, primary research consisting of interviews and participant observation was undertaken in Nepal over a three month period in the central region of Nepal. Involvement in the hospitality industry improved the livelihoods of the women Tea House owners/ managers, it also has the potential to facilitate sustainable empowerment for future generations, providing them with education, choice, control and opportunities. Although steps were taken to limit rhetorical issues, language barriers could have influenced the findings of the interviews. To fully investigate the potential for hospitality to act as a vehicle for the sustainable empowerment of women, it is suggested that this study be replicated again in another region or that a detailed ethnographic study be carried out. Demonstrates how the commercial hospitality industry can be a force for good; women working in the industry are agents of change, actively improving their levels of empowerment in their immediate environment. The commercial hospitality industry has pioneered the empowerment of women and this could lay the foundation for the further emancipation of women. To date, there has been limited research into the relationship between involvement in the commercial hospitality sector and the empowerment of women; this paper begins to fill this gap by investigating a tourist region of Nepal
Evaluation of LANDSAT-2 data for selected hydrologic applications
There are no author-identified significant results in this report
The role of dietary polyphenols in the moderation of the inflammatory response in early stage colorectal cancer
Current focus in colorectal cancer management is on reducing overall mortality by increasing the number of early stage cancers diagnosed and treated with curative intent. Despite the success of screening programmes in down-staging colorectal cancer, interval cancer rates are substantial and other strategies are desirable. Sporadic colorectal cancer is largely associated with lifestyle factors including diet. Polyphenols are phytochemicals ingested as part of a normal diet which are abundant in plant foods including fruits/berries and vegetables. These may exert their anti-carcinogenic effects via the modulation of inflammatory pathways. Key signal transduction pathways are fundamental to the association of inflammation and disease progression including those mediated by NF-κB and STAT, PI3K and COX. Our aim was to examine the evidence for the effect of dietary polyphenols intake on tumour and host inflammatory responses to determine if polyphenols may be effective as part of a dietary intervention. There is good epidemiological evidence of a reduction in colorectal cancer risk from case-control and cohort studies assessing polyphenol intake. It would be premature to suggest a major public health intervention to promote their consumption however, dietary change is safe and feasible, emphasising the need for further investigation of polyphenols and colorectal cancer risk
Cancer and systemic inflammation: treat the tumour and treat the host
Determinants of cancer progression and survival are multifactorial and host responses are increasingly appreciated to have a major role. Indeed, the development and maintenance of a systemic inflammatory response has been consistently observed to confer poorer outcome, in both early and advanced stage disease. For patients, cancer-associated symptoms are of particular importance resulting in a marked impact on day-to-day quality of life and are also associated with poorer outcome. These symptoms are now recognised to cluster with one another with anorexia, weight loss and physical function forming a recognised cluster whereas fatigue, pain and depression forming another. Importantly, it has become apparent that these symptom clusters are associated with presence of a systemic inflammatory response in the patient with cancer. Given the understanding of the above, there is now a need to intervene to moderate systemic inflammatory responses, where present. In this context the rationale for therapeutic intervention using nonselective anti-inflammatory agents is clear and compelling and likely to become a part of routine clinical practice in the near future. The published literature on therapeutic intervention using anti-inflammatory agents for cancer-associated symptoms was reviewed. There are important parallels with the development of useful treatments for the systemic inflammatory response in patients with rheumatological disease and cardiovascular disease
Expert consensus for respiratory physiotherapy management of mechanically ventilated adults with community-acquired pneumonia: A Delphi study
Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.
Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with CAP. Quantitative data using Likert scales determined level of agreement, with qualitative data collected through open‐ended responses. Consensus threshold was set a priori at 70%. Items not achieving consensus were modified and new items added based on themes from qualitative data. Quantitative data were analysed descriptively, with thematic analysis used on qualitative data.
Results: The panel comprised 29 international clinical and academic experts in critical care physiotherapy. Response rate was more than 95% for each round. Outcome achieved was 38 consensus statements covering assessment and treatment, with 28 statements (74%) providing consensus on recommended clinical practice, two consensus disagreement statements (7%) for what practice is not recommended, and eight statements (21%) indicating which treatments may be beneficial.
Conclusion: Expert consensus regarding physiotherapy for intubated adults with CAP patients provides an evidence‐based approach to guide clinical practice. The consensus statements can also be used to guide research evaluating physiotherapy interventions for patients with CAP
Attitudes of surgeons to the use of postoperative markers of the systemic inflammatory response following elective surgery
Background:
Cancer is responsible for 7.6 million deaths worldwide and surgery is the primary modality of a curative outcome. Postoperative care is of considerable importance and it is against this backdrop that a questionnaire based study assessing the attitudes of surgeons to monitoring postoperative systemic inflammation was carried out.
Method:
A Web based survey including 10 questions on the “attitudes of surgeons to the use of postoperative markers of the systemic inflammatory response following elective surgery” was distributed via email. Two cohorts were approached to participate in the survey. Cohort 1 consisted of 1092 surgeons on the “Association of Coloproctology of Great Britain and Ireland (ACPGBI)” membership list. Cohort 2 consisted of 270 surgeons who had published in this field in the past as identified by two recent reviews. A reminder email was sent out 21 days after the initial email in both cases and the survey was closed after 42 days in both cases.
Result:
In total 29 surgeons (2.7%) from cohort 1 and 40 surgeons (14.8%) from cohort 2 responded to the survey. The majority of responders were from Europe (77%), were colorectal specialists (64%) and were consultants (84%) and worked in teaching hospitals (54%) and used minimally invasive techniques (87%). The majority of responders measured CRP routinely in the post-operative period (85%) and used CRP to guide their decision making (91%) and believed that CRP monitoring should be incorporated into postoperative guidelines (81%).
Conclusion:
Although there was a limited response the majority of surgeons surveyed measure the systemic inflammatory response following elective surgery and use CRP measurements together with clinical findings to guide postoperative care. The present results provide a baseline against which future surveys can be compared
Evaluation of LANDSAT-2 data for selected hydrologic applications
There are no author-identified significant results in this report
Comparison of the prognostic value of measures of the tumor inflammatory cell infiltrate and tumor-associated stroma in patients with primary operable colorectal cancer
The aim of the present study was to compare the clinical utility of two measures of the
inflammatory cell infiltrate - a H&E-based assessment of the generalised inflammatory cell
infiltrate (the Klintrup-Mäkinen (KM) grade), and an immunohistochemistry-based
assessment of combined CD3+ and CD8+ T-cell density (the “Immunoscore”), in conjunction
with assessment of the tumor stroma percentage (TSP) in patients undergoing resection of
stage I-III colorectal cancer (CRC). 246 patients were identified from a prospectively
maintained database of CRC resections in a single surgical unit. Assessment of KM grade
and TSP was performed using full H&E sections. CD3+ and CD8+ T-cell density was
assessed on full sections and the Immunoscore calculated. KM grade and Immunoscore were
strongly associated (P<0.001). KM grade stratified cancer-specific survival (CSS) from 88%
to 66% (P=0.002) and Immunoscore from 93% to 61% (P<0.001). Immunoscore further
stratified survival of patients independent of KM grade from 94% (high KM, Im4) to 60%
(low KM, Im0/1). Furthermore, TSP stratified survival of patients with a weak inflammatory
cell infiltrate (low KM: from 75% to 47%; Im0/1: from 71% to 38%, both P<0.001) but not
those with a strong inflammatory infiltrate. On multivariate analysis, only Immunoscore (HR
0.44, P<0.001) and TSP (HR 2.04, P<0.001) were independently associated with CSS. These
results suggest that the prognostic value of an immunohistochemistry-based assessment of the
inflammatory cell infiltrate is superior to H&E-based assessment in patients undergoing
resection of stage I-III CRC. Furthermore, assessment of the tumor-associated stroma, using
TSP, further improves prediction of outcome
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