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Search Results: 1 - 10 of 461331 matches for " A Westwood "
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Paediatric admissions to hospitals in the Cape Town Metro district: A survey
A Westwood, M Levin, J Hageman
South African Journal of Child Health , 2012,
Abstract: A point prevalence survey of 381 paediatric medical inpatients in the 11 public hospitals in Cape Town in November 2008 showed that 70% of them were in central hospitals, with 39.4% requiring level 3 (sub-specialist) care. Numbers of children in hospital and their levels of health care requirement did not vary by sub-district of residence. Seventy-seven per cent of patients were under 5 years of age; 5% were teenagers. Few patients changed level of care during admission, but 10% did not need to be in hospital at the time of review. Median length of stay was 4 days, with children with level 3 needs having the longest lengths of stay. An under-provision of level 1 beds was demonstrated. HIV infection had been identified in 12% of admissions. While children with level 3 problems were well catered for in terms of bed provision, level 1 and step-down/home care provision were deficient or inefficiently utilised.
An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation
H Buys, R Muloiwa, C Westwood, D Richardson, B Cheema, A Westwood
South African Medical Journal , 2013,
Abstract: Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resourceconstrained countries and could be evaluated further in community emergency settings.
Adenosine Stress Perfusion Cardiac MRI: Improving Image Quality Using a 32-Channel Surface Coil  [PDF]
Thomas R. Burchell, Redha Boubertakh, Saidi Mohiddin, Marc E. Miquel, Mark A. Westwood, Anthony Mathur, L. Ceri Davies
Open Journal of Medical Imaging (OJMI) , 2011, DOI: 10.4236/ojmi.2011.12004
Abstract: Purpose: Adenosine stress CMR is commonly used to assess myocardial ischaemia. Obtaining high quality images requires maximising signal to noise ratio (SNR) over a large double-oblique field of view (FOV) whilst minimising artefacts. A 32-channel surface coil may provide a higher SNR over a larger FOV compared to standard coils, possibly leading to improved image quality. Materials and Methods: 50 adenosine perfusion CMR scans were performed on a Philips Achieva CV 1.5T, with either a 5 or 32-channel coil (25 patients each) using standardised acquisition protocols. 3 short axis slices were acquired per cardiac cycle and the resulting cine images were scored by two blinded CMR specialists on a quality scale of 1 to 5. Phantom studies were performed using similar acquisition parameters and the SNR was calculated and compared across a range of acceleration factors. Results: The mean patient age was 62 ± 11 years and 50% of patients were male. The image quality scores were higher using the 32-channel coil (mean 3.8 ± 0.7 vs 3.2 ± 0.9 p = 0.002). The average phantom SNR was greater for the 32-element coil across the range of acceleration factors measured (103 vs 86 p = <0.001). Conclusions: The 32-channel coil produces significantly higher quality images and a higher SNR than the 5-channel coil in routine perfusion CMR.
Investigating the Information Needs of University Students in Foundational Foreign Language Courses
Glenna Westwood
Studies in Self-Access Learning Journal , 2012,
Abstract: This investigation seeks to address two issues: first, to discover if there is evidence that university students in foundational language courses need information resources to support their language learning and second, if such evidence exists, what the specific information resource needs might be and how important those resources are to students’ language learning. After engaging in a year of foreign language study, the author used the evidence gathered to develop and conduct a survey of the user needs of language students at the Self Access Centre (CAADI) of the University of Guanajuato, Mexico. Results of the survey supported the personal learning experiences of the author. Over 80% of students surveyed reported using the information resources in the CAADI at least once a week with general grammar books, course text books and films being reported as the most important resources. This investigation provides a starting point for research in to the collection development practices of academic libraries supporting the learning of foreign languages. By examining the information needs of one population, evidence has been provided that these students do indeed need information resources to support their language learning. The study suggests specific resource types that could be important for these users.
Spatial Interactions between Successive Eye and Arm Movements: Signal Type Matters
Christopher D. Cowper-Smith, Jonathan Harris, Gail A. Eskes, David A. Westwood
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0058850
Abstract: Spatial interactions between consecutive movements are often attributed to inhibition of return (IOR), a phenomenon in which responses to previously signalled locations are slower than responses to unsignalled locations. In two experiments using peripheral target signals offset by 0°, 90°, or 180°, we show that consecutive saccadic (Experiment 1) and reaching (Experiment 3) responses exhibit a monotonic pattern of reaction times consistent with the currently established spatial distribution of IOR. In contrast, in two experiments with central target signals (i.e., arrowheads pointing at target locations), we find a non-monotonic pattern of reaction times for saccades (Experiment 2) and reaching movements (Experiment 4). The difference in the patterns of results observed demonstrates different behavioral effects that depend on signal type. The pattern of results observed for central stimuli are consistent with a model in which neural adaptation is occurring within motor networks encoding movement direction in a distributed manner.
Improved survival of thalassaemia major in the UK and relation to T2* cardiovascular magnetic resonance
Bernadette Modell, Maren Khan, Matthew Darlison, Mark A Westwood, David Ingram, Dudley J Pennell
Journal of Cardiovascular Magnetic Resonance , 2008, DOI: 10.1186/1532-429x-10-42
Abstract: The Register was updated to the end of 2003, copies of death certificates were obtained, and causes of death in beta thalassaemia major were extracted. In addition, patients who had T2* CMR assessment of cardiac iron load and/or received the oral iron chelator deferiprone were identified from clinical records.The main causes of death were anaemia (before 1980), infections, complications of bone marrow transplantation and cardiac disease due to iron overload. From 1980 to 1999 there were 12.7 deaths from all causes per 1,000 patient years. Forty per cent of patients born before 1980 had T2* cardiovascular magnetic resonance between 2000 and 2003, and 36% of these patients were prescribed deferiprone before end of 2003. In 2000–2003, the death rate from all causes fell significantly to 4.3 per 1,000 patient years (-62%, p < 0.05). This was mainly driven by the reduction in the rate of deaths from iron overload which fell from 7.9 to 2.3 deaths per 1,000 patient years (-71%, p < 0.05).Since 1999, there has been a marked improvement in survival in thalassaemia major in the UK, which has been mainly driven by a reduction in deaths due to cardiac iron overload. The most likely causes for this include the introduction of T2* CMR to identify myocardial siderosis and appropriate intensification of iron chelation treatment, alongside other improvements in clinical care.Over the past 50 years the prevalence of thalassaemia major has increased throughout North-West Europe, reflecting immigration from endemic areas [1]. In the United Kingdom (UK) a database of affected children was created in the 1960s to assess the prevalence of the disorder among Cypriots in London [2], and to describe its natural history [3]. This was subsequently developed into the UK Thalassaemia Register, a clinical and research tool designed to promote equitable high quality care by simultaneously collecting audit data, and disseminating specialist knowledge to clinics with small numbers of patients. The
Response of Phytoplankton Photophysiology to Varying Environmental Conditions in the Sub-Antarctic and Polar Frontal Zone
Wee Cheah, Andrew McMinn, F. Brian Griffiths, Karen J. Westwood, Simon W. Wright, Lesley A. Clementson
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0072165
Abstract: Climate-driven changes are expected to alter the hydrography of the Sub-Antarctic Zone (SAZ) and Polar Frontal Zone (PFZ) south of Australia, in which distinct regional environments are believed to be responsible for the differences in phytoplankton biomass in these regions. Here, we report how the dynamic influences of light, iron and temperature, which are responsible for the photophysiological differences between phytoplankton in the SAZ and PFZ, contribute to the biomass differences in these regions. High effective photochemical efficiency of photosystem II (/0.4), maximum photosynthesis rate (), light-saturation intensity (), maximum rate of photosynthetic electron transport (1/), and low photoprotective pigment concentrations observed in the SAZ correspond to high chlorophyll and iron concentrations. In contrast, phytoplankton in the PFZ exhibits low / ( 0.2) and high concentrations of photoprotective pigments under low light environment. Strong negative relationships between iron, temperature, and photoprotective pigments demonstrate that cells were producing more photoprotective pigments under low temperature and iron conditions, and are responsible for the low biomass and low productivity measured in the PFZ. As warming and enhanced iron input is expected in this region, this could probably increase phytoplankton photosynthesis in this region. However, complex interactions between the biogeochemical processes (e.g. stratification caused by warming could prevent mixing of nutrients), which control phytoplankton biomass and productivity, remain uncertain.
Neural Coding of Movement Direction in the Healthy Human Brain
Christopher D. Cowper-Smith,Esther Y. Y. Lau,Carl A. Helmick,Gail A. Eskes,David A. Westwood
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0013330
Abstract: Neurophysiological studies in monkeys show that activity of neurons in primary cortex (M1), pre-motor cortex (PMC), and cerebellum varies systematically with the direction of reaching movements. These neurons exhibit preferred direction tuning, where the level of neural activity is highest when movements are made in the preferred direction (PD), and gets progressively lower as movements are made at increasing degrees of offset from the PD. Using a functional magnetic resonance imaging adaptation (fMRI-A) paradigm, we show that PD coding does exist in regions of the human motor system that are homologous to those observed in non-human primates. Consistent with predictions of the PD model, we show adaptation (i.e., a lower level) of the blood oxygen level dependent (BOLD) time-course signal in M1, PMC, SMA, and cerebellum when consecutive wrist movements were made in the same direction (0° offset) relative to movements offset by 90° or 180°. The BOLD signal in dorsolateral prefrontal cortex adapted equally in all movement offset conditions, mitigating against the possibility that the present results are the consequence of differential task complexity or attention to action in each movement offset condition.
A Qualitative Study of Friendship in Patients with Anorexia Nervosa and Possible Autism Spectrum Disorder  [PDF]
Eli Doris, Heather Westwood, William Mandy, Kate Tchanturia
Psychology (PSYCH) , 2014, DOI: 10.4236/psych.2014.511144
Abstract:

Difficulties in friendships have been reported both in people with Autism Spectrum Disorder (ASD) and in individuals with Anorexia Nervosa (AN). This small-scale qualitative study aimed to evaluate the friendship experiences of seven patients with AN who presented with possible ASD traits; to determine whether their experiences were reflective of those found in people with ASD, and whether any difficulties were present before the onset of their eating disorder. Participants were interviewed using the ADOS-G and the interviews were transcribed and analysed. Four principle themes emerged from the thematic analysis: limited social network, lack of contact or communication, difficulty understanding the concept of friendship, and focus of attention away from the self; which could not be explained by the state of starvation alone. The evidence presented here not only reflects the friendship experiences of individuals with AN as documented in the literature, but also the friendship difficulties which have been observed in people with ASD without a comorbid eating disorder. The findings provide evidence that friendship difficulties experienced by people with AN precede the onset of the eating disorder and therefore offer support for the idea of a shared phenotype between AN and ASD. This study also highlights the need to address friendship difficulties in treatment interventions for AN in order to promote recovery. Further research is warranted to better explore the friendship similarities between people with AN and ASD, and to develop friendship focused interventions for patients with AN.

F-18-fluoro-2-deoxyglucose positron emission tomography (PET) and PET/computed tomography imaging in primary staging of patients with malignant melanoma: a systematic review
Schr?er-Günther Milly A,Wolff Robert F,Westwood Marie E,Scheibler Fül?p J
Systematic Reviews , 2012, DOI: 10.1186/2046-4053-1-62
Abstract: Purpose The aim of this systematic review was to systematically assess the potential patient-relevant benefit (primary aim) and diagnostic and prognostic accuracy (secondary aim) of positron emission tomography (PET) and PET/computed tomography (CT) in primary staging of malignant melanoma. This systematic review updates the previous evidence for PET(/CT) in malignant melanoma. Materials and methods For the first aim, randomized controlled trials (RCTs) investigating patient-relevant outcomes and comparing PET and PET(/CT) with each other or with conventional imaging were considered. For the secondary aim, a review of reviews was conducted, which was amended by an update search for primary studies. MEDLINE, EMBASE and four databases of the Cochrane Library were searched. The risk of bias was assessed using a modified QUADAS tool. Results No RCTs investigating the patient-relevant benefit of PET(/CT) and no prognostic accuracy studies were found. Seventeen diagnostic accuracy studies of varying quality were identified. For patients with American Joint Committee on Cancer (AJCC) stages I and II, sensitivity mostly ranged from 0 to 67%. Specificity ranged from 77 to 100%. For AJCC stages III and IV, sensitivity ranged from 68 to 87% and specificity from 92 to 98%. Conclusion There is currently no evidence of a patient-relevant benefit of PET(/CT) in the primary staging of malignant melanoma. RCTs investigating patient-relevant outcomes are therefore required. The diagnostic accuracy of PET(/CT) appears to increase with higher AJCC stages.
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