3,859 research outputs found

    Law Enforcement and Adult Protective Services Working Together: A Team Approach to Elder Abuse Cases

    Get PDF
    Educational Objectives 1. Familiarize readers with the different roles and responsibilities of Adult Protective Services and law enforcement in elder abuse cases. 2. Demonstrate the benefits of working collaboratively to resolve complex elder abuse and domestic violence cases

    Can CT scan protocols used for radiotherapy treatment planning be adjusted to optimise image quality and patient dose? A systematic review

    Get PDF
    This article reviews publications related to the use of CT scans for radiotherapy treatment planning, specifically the impact of scan protocol changes on CT number and treatment planning dosimetry and on CT image quality. A search on PubMed and EMBASE and a subsequent review of references yielded 53 relevant articles. CT scan parameters significantly affect image quality. Some will also affect Hounsfield unit (HU) values, though this is not comprehensively reported on. Changes in tube kilovoltage and, on some scanners, field of view and reconstruction algorithms have been found to produce notable HU changes. The degree of HU change which can be tolerated without changing planning dose by >1% depends on the body region and size, planning algorithms, treatment beam energy and type of plan. A change in soft-tissue HU value has a greater impact than changes in HU for bone and air. The use of anthropomorphic phantoms is recommended when assessing HU changes. There is limited published work on CT scan protocol optimization in radiotherapy. Publications suggest that HU tolerances of ±20 HU for soft tissue and of ±50 HU for the lung and bone would restrict dose changes in the treatment plan to <1%. Literature related to the use of CT images in radiotherapy planning has been reviewed to establish the acceptable level of HU change and the impact on image quality of scan protocol adjustment. Conclusions have been presented and further work identified

    Agile Methodology In Offshore Outsourcing

    Get PDF
    Firms have to be cognizant of appropriate methods to deploy when managing offshore outsourcing.  As industry continues to deploy agile methodology, such methodology may not be the best approach in offshore outsourcing.  Managers may benefit from more disciplined application development methodologies.  The case study examines risk factors of offshore outsourcing of software projects and the appropriateness of agile methodologies in these projects. The findings contribute important insight into the benefits and limitations of agile methods in offshore outsourcing

    Association of plasma uric acid with ischaemic heart disease and blood pressure: mendelian randomisation analysis of two large cohorts

    Get PDF
    Objectives: To assess the associations between both uric acid levels and hyperuricaemia, with ischaemic heart disease and blood pressure, and to explore the potentially confounding role of body mass index. Design: Mendelian randomisation analysis, using variation at specific genes (SLC2A9 (rs7442295) as an instrument for uric acid; and FTO (rs9939609), MC4R (rs17782313), and TMEM18 (rs6548238) for body mass index). Setting: Two large, prospective cohort studies in Denmark. Participants: We measured levels of uric acid and related covariables in 58 072 participants from the Copenhagen General Population Study and 10 602 from the Copenhagen City Heart Study, comprising 4890 and 2282 cases of ischaemic heart disease, respectively. Main outcome: Blood pressure and prospectively assessed ischaemic heart disease. Results: Estimates confirmed known observational associations between plasma uric acid and hyperuricaemia with risk of ischaemic heart disease and diastolic and systolic blood pressure. However, when using genotypic instruments for uric acid and hyperuricaemia, we saw no evidence for causal associations between uric acid, ischaemic heart disease, and blood pressure. We used genetic instruments to investigate body mass index as a potentially confounding factor in observational associations, and saw a causal effect on uric acid levels. Every four unit increase of body mass index saw a rise in uric acid of 0.03 mmol/L (95% confidence interval 0.02 to 0.04), and an increase in risk of hyperuricaemia of 7.5% (3.9% to 11.1%). Conclusion: By contrast with observational findings, there is no strong evidence for causal associations between uric acid and ischaemic heart disease or blood pressure. However, evidence supports a causal effect between body mass index and uric acid level and hyperuricaemia. This finding strongly suggests body mass index as a confounder in observational associations, and suggests a role for elevated body mass index or obesity in the development of uric acid related conditions

    Studies on the inactivation of indoleacetic acid by roots

    Get PDF
    The enzymatic breakdown of indoleacetic acid in the presence of aqueous pea root extracts containing an "indoleacetic acid-oxidase" system was studied. A method based on the "Salkowski" colour reaction was used for the estimation of residual indoleacetic acid. A comparison was made between the "indoleacetic acid-oxidase" activity of extracts made from the roots of plants grown in water and the activity of extracts made from the roots of plants grown in a solution of indoleacetic acid. It was found that the activity of the extracts from the "indoleacetic acid-grown" roots was higher than that of the extracts from the "water-grown" roots. Thus the "maximum rate attained in the reaction" was greater, and the "length of the lag period" shorter, when extracts of the "indoleacetic acid-grown" roots were used. Further, the relationship between the length of the lag period and the maximum rate attained appeared to be slightly different for reaction mixtures containing the two types of extract. The inhibitory activity of solutions prepared from the "water-grown" root extracts and the "indoleacetic acid-grown" root extracts by i. boiling, ii. seitz filtration, or iii. ultrafiltration, wasdetermined. The inhibitor solutions prepared from the "indoleaceticacid-grown" root extracts were always found to be less active thanthe corresponding inhibitor solutions prepared from the "water-grown" root extracts. It was thought that this difference in inhibitorlevel may have accounted for the different level of "enzyme activity"demonstrated for the extracts of the "water-grown" and "indoleacetic acid-grown" roots. The significance of the enhanced "indoleacetic acid-oxidase" activity of "indoleacetic acid-grown" root extracts was discussedin relation to the hypothesis of adaptive enzyme formation. It was concluded that the enzyme was not formed adaptively in the pea root tissues in response to the applied indoleacetic acid.<p

    Prehabilitation in alcohol dependence as a treatment model for sustainable outcomes. A narrative review of literature on the risks associated with detoxification, from animal models to human translational research

    Get PDF
    In this review paper we discuss how the overarching concept of pre-habilitation is applicable to alcohol dependence. Central to pre-habilitation are the concepts of expected harm, risks and proactive planning to eliminate the harm or cope with the risks. We review the evidence from animal models, psychological experimental studies, as well as pharmacological studies, on the potential risks and harms associated with medically assisted alcohol detoxification and the current treatment paradigm for alcohol dependence. Animal models provide an approximation mostly of the physical aspect of alcohol withdrawal and detoxification process and make predictions about the development of the phenomena in humans. Despite their limitations, these models provide good evidence that withdrawal from chronic ethanol use induces cognitive impairment, which is worsened by repeated bouts of withdrawal and that these impairments are dependent on the duration of alcohol withdrawal. Initial clinical observations with alcohol dependent patients confirmed increased incidence of seizures. In recent years, accumulating evidence suggest that patients who have had repeated episodes of withdrawal also show changes in their affect, increased craving as well as significant deterioration of cognitive abilities, when compared to patients with fewer withdrawals. Alcohol dependence is associated with tolerance and withdrawal, with neuroadaptations in GABA-A and glutamatergic N-methyl-D-aspartate (NMDA) receptors playing key roles. It is suggested that dysregulation of the NMDA receptor system underpins alcohol related memory impairments. Finally we discuss the Structured Preparation for Alcohol Detoxification (SPADe) as an example of how pre-habilitation has been applied in clinical practice. We discuss the importance of partial control over drinking as an interim step towards abstinence and early introduction of lifestyle changes for both the patient and the immediate environment prior detoxification and while the patient is still drinking

    Finding Our Way to Food Democracy: Lessons from US Food Policy Council Governance

    Get PDF
    Food policy councils (FPCs) are an embodiment of food democracy, providing a space for community members, professionals, and government to learn together, deliberate, and collectively devise place-based strategies to address complex food systems issues. These collaborative governance networks can be considered a transitional stage in the democratic process, an intermediary institution that coordinates interests not typically present in food policymaking. In practice, FPCs are complex and varied. Due to this variety, it is not entirely clear how the structure, membership, and relationship to government of an FPC influence its policy priorities. This article will examine the relationship between an FPC’s organizational structure, relationship to government, and membership and its policy priorities. Using data from a 2018 survey of FPCs in the United States by the Johns Hopkins Center for a Livable Future paired with illustrative cases, we find that an FPC’s relationship to government and membership have more bearing on its policy priorities than the organizational structure. Further, the cases illustrate how membership is determined and deliberation occurs, highlighting the difficulty of including underrepresented voices in the process

    Students' valuing of art in a humanities art appreciation course at a Midwestern junior college

    Get PDF
    Art Appreciation is often a course that undergraduate students take to meet their general education requirements. However, many students have little interest or value of art due to a lack of previous art experiences and often choose the course because they feel it will be relatively easy. This qualitative, naturalistic inquiry focused on students' meaning making and valuing of art as well as their perceived changes in how they value art, art's practical use, and art's benefits to individuals and society from their experiences in taking an Art Appreciation course. Altering the traditional art history, aesthetics, and art criticism approach to teaching Art Appreciation, the researcher added art production as part of the curriculum in order to facilitate a broader range of art experiences, increased artistic understanding, and valuing of art. Art is valued for intrinsic and extrinsic reasons. The review of literature concerned artistic and aesthetic valuing; art experiences in relation to one's learning, living, and psychological influences; as well as examining curriculum and teaching methods in undergraduate Art Appreciation courses. Naturalistic inquirers lean toward humans' value making and ground the theory from the data collected in a natural setting (Lincoln and Guba, 1985). Data were gathered from course assignments that included students' responses from class discussions, art history questions, art criticism activities as well as art productions. From these data, an art appreciation education theory emerged based on students' experiences that included six components: 1) a comfortable and safe learning environment; 2) foundational knowledge and application of the formal qualities of art; 3) foundational knowledge of art history and art criticism; 4) collaborative class participation opportunities through group discussions and projects; 5) hands-on, low-stakes art creation experiences; and 6) valuing reflections. The findings revealed that students expressed viewing artworks, determining how art was valued in the past and today, learning art techniques, creating art, engaging with the class, working collaboratively on art projects, and learning and critiquing artwork from history provided many benefits that could transfer to others and society and contributed to students developing their own unique standard in which to make meaning and value art
    • …
    corecore