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| 2. |
- Aartsen, Marja, et al.
(författare)
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Ageing in the light of crises : Economic crisis, demographic change, and the search for meaning
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Old age has many images, with the one of a crisis regaining momentum. While images of activity and opportunity gained ground during recent decades, this trend now seems to reverse. The current economic crisis drains the financial resources of older people, which increases old age poverty. Moreover, governments react to the double-pressure of economic crises and population ageing through budget cuts, which reduces support systems for older people. It, moreover, centers public discourses more strongly on social problems associated with old age. Both developments underline the needs associated with old age and draw our attention away from the potentials of old age. In other words, they bring discussions on old age back to the topic of crises. This working paper discusses how the economic crisis affects older people, how governments, labour markets, and families react to the double-pressure of population ageing and economic crisis, and how individuals perceive their old age. It concludes with reflections on the implications of growing crisis-centrism in discussions on old age. Such crisis-centrism can lead us to overlook social inequalities in old age and to neglect the subjective character of the perception of old age. The public image of old age might, thus, be stronger associated with the idea of crisis than what older people’s lived experience suggests.
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| 3. |
- Abate, Ebba, et al.
(författare)
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Effects of albendazole treatment on the clinical outcome and immunological responses in patients with helminth infection and pulmonary tuberculosis : a randomized clinical trial
- 2013
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The impact of helminth infection on the host immune response to tuberculosis (TB) has been characterized in experimental models but less so in the clinical setting. The objective of this study was to investigate the impact of deworming on the clinical outcome and cell mediated immune response in active TB.Methods: Newly diagnosed pulmonary TB patients in Gondar, Ethiopia were examined for helminth infection. Helminth-positive TB patients (W+/TB) were randomized to albendazole (400mg X III per os) or placebo. The primary outcome was change in TB-score after 2 months, and secondary outcomes were sputum smear conversion at the 2nd month, and changes in chest x-ray pattern, CD4+ T-cell count, eosinophil count, IgE-levels and immunological responses after 3 months. In a subset of W+/TB, W-/TB patients and healthy controls, flow cytometry and ELISPOT assays were used to characterize the regulatory T-cell population (Tregs) and the frequency of PPD- stimulated IFN-γ, IL-5 and IL-10 producing peripheral blood mononuclear cells (PBMCs).Results: A total of 140 helminth co-infected TB patients were included with an HIV coinfection rate of 22.8 %. Following albendazole treatment of the W+/TB patients, there was a significant decrease in helminth infection compared to placebo (8% (4/49) vs. 48 % (22/46), p<0.001). No significant effect was observed for albendazole compared to placebo on the primary outcome as evaluated by the TB-score (5.6 ±2.87 vs. 5.87 ±2.54, p=0.59). Eosinophil counts decreased significantly in the albendazole group. In a subgroup analysis of helminthnegative patients following albendazole treatment versus placebo, the albendazole group showed a trend for lower levels of IL-10 producing cells at month three (p=0.08). At baseline, W+/TB patients had a significantly higher mean level of Tregs (% Tregs/CD4+) compared to W-/TB patients and helminth-positive community controls. Additionally, the frequency of IFN-γ, IL-5 and spontaneous IL-10 levels was increased in helminth-positive compared to helminth-negative TB patients.Conclusions: No significant effects on the clinical outcome as measured with the TB-score was detected after albendazole treatment of helminth-positive TB patients compared to placebo. However, significant changes were observed in specific immunological responses such as reduced eosinophil counts and a trend towards lower levels of IL-10 producing cells. At baseline, helminth co-infected TB patients exhibited an increased Treg response as well as an increased IL-5 and spontaneous IL-10 production.
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| 4. |
- Abate, Ebba, et al.
(författare)
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Impact of helminth infection on the clinical presentation 1 of pulmonary tuberculosis
- 2013
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The effects of helminth infection on chronic infectious diseases such as HIV and tuberculosis (TB) merit further characterization. Thus, we assessed the baseline clinical characteristics of helminth infection in patients with active TB in a high endemic area.Methodology: Consecutive, newly diagnosed TB patients were recruited from three health institutions in the north Gondar administrative zone, Ethiopia. Structured questionnaires were used to collect socio-demographic and clinical characteristics. Additionally, the TB score, mid upper arm circumference, body mass index (BMI), BCG vaccination status, stool and sputum microscopy as well as HIV serology and CD4+T cells counts were evaluated.Results: A total of 377 pulmonary TB patients were included in the study. The helminth co infection rate was 33% (123/377) and the most prevalent parasite was Ascaris lumbricoides (53%, 65/123). The HIV co-infection rate was 29% (110/377). Seventy percent (77/110) of the HIV co-infected patients were on anti- retroviral therapy at the time of TB diagnosis. Helminth infection was more prevalent in HIV-negative TB patients compared to HIV-positive TB patients (p=0.025). Smoking and walking bare foot were independently associated to helminth infection in TB patients after adjusting for the influence of HIV. Other than increased eosinophilia, no other significant differences were observed between helminth positive and helminth negative TB patients in the clinical presentation including the TB score, CD4+T-cells, BMI or bacterial load.Conclusion: The clinical presentation of active pulmonary tuberculosis was not affected by helminth infection. Helminth infection was less frequent among HIV-positive TB patients and this finding merits further investigation.
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| 5. |
- Abate, Ebba
(författare)
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The impact of helminth infection in patients with active tuberculosis
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The geographic distribution of helminth infection and tuberculosis (TB) overlap substantially. Experimental animal models and limited data from humans have shown that intestinal helminths could subvert the host immune response towards a T-helper 2 (Th2)-type immune response and an increased regulatory T-cell activity (Tregs). This in turn affects the host's ability to mount an effective Th1 immune-mediated protection against Mycobacterium tuberculosis. However, evidence for this hypothesis in the human setting from helminth infected TB patients is limited. This thesis primarily focuses on the immunological and clinical impact of helminth infection on pulmonary TB. The kinetics of the Quantiferon-Gold (QFN) assay, which measures IFN-³ response to TB-specific antigens in whole blood was assessed and showed a modest decline during TB treatment to the level observed for healthy blood donors. We further assessed another clinical monitoring tool, the-TB-score, composed of clinical signs and symptoms of TB, and found an early decline two weeks after initiation of TB- treatment where a failure of decline correlated with increased mortality. Overall, the helminth co-infection rate was significantly higher in TB patients compared to healthy controls. Helminth co-infection was associated to a significantly higher rate of eosinophilia and IgE-levels in healthy controls and patients with tuberculosis. During the first weeks of anti-TB treatment, a marked decrease in the rate of helminth infection was observed in HIV co-infected compared to HIV-negative TB patients. However, helminth co-infection was more common in HIV negative than HIV positive TB patients. There was no detectable impact of helminth infection on the clinical presentation of pulmonary tuberculosis. At baseline, helminth co-infected TB patients showed an increased frequency of Tregs compared to helminth negative TB patients and healthy controls. This was accompanied by an increased rate of PPD stimulated IL-5 and spontaneous production of IL-10 by peripheral blood mononuclear cells among helminth co-infected TB patients. A placebo controlled randomized trial was conducted in order to test the hypothesis that albendazole treatment of helminth positive TB patients may improve the clinical response of TB by reducing the immunmodulatory effect of helminthes on TB immunity. A total of 140 helminth co-infected TB patients were randomized to albendazole (400 mg per os for three consecutive days) or placebo. No significant difference was observed between the albendazole and placebo group in terms of the primary outcome (TB score change between baseline and week 8). Among the secondary outcomes, a significant decline of peripheral eosinophil cells was observed in the albendazole treated group, but no effect on other outcome variables (changes in chest x-ray findings, IgE level and sputum smear conversion). Regarding the immunological assessment no significant difference was observed for changes in Tregs, and PPD-induced production of IFN- ³ or IL-5 although a non-significant trend of a decrease in IL-10 expressing PBMCs were observed in the albendazole group. Taken together, the burden of helminth infection was higher in TB patients than in a healthy control group. Helminth co-infection during pulmonary TB in the human setting induces an immune response characterized by increased IgE production, eosinophilia as well as increased levels of Tregs and spontaneous IL-10 production. Thus, the immunological impact of helminth infection on the outcome and risk for developing TB merits further investigation.
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| 6. |
- Abbas, Muhammad
(författare)
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On the Implementation of Integer and Non-Integer Sampling Rate Conversion
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main focus in this thesis is on the aspects related to the implementation of integer and non-integer sampling rate conversion (SRC). SRC is used in many communication and signal processing applications where two signals or systems having different sampling rates need to be interconnected. There are two basic approaches to deal with this problem. The first is to convert the signal to analog and then re-sample it at the desired rate. In the second approach, digital signal processing techniques are utilized to compute values of the new samples from the existing ones. The former approach is hardly used since the latter one introduces less noise and distortion. However, the implementation complexity for the second approach varies for different types of conversion factors. In this work, the second approach for SRC is considered and its implementation details are explored. The conversion factor in general can be an integer, a ratio of two integers, or an irrational number. The SRC by an irrational numbers is impractical and is generally stated for the completeness. They are usually approximated by some rational factor.The performance of decimators and interpolators is mainly determined by the filters, which are there to suppress aliasing effects or removing unwanted images. There are many approaches for the implementation of decimation and interpolation filters, and cascaded integrator comb (CIC) filters are one of them. CIC filters are most commonly used in the case of integer sampling rate conversions and often preferred due to their simplicity, hardware efficiency, and relatively good anti-aliasing (anti-imaging) characteristics for the first (last) stage of a decimation (interpolation). The multiplierless nature, which generally yields to low power consumption, makes CIC filters well suited for performing conversion at higher rate. Since these filters operate at the maximum sampling frequency, therefore, are critical with respect to power consumption. It is therefore necessary to have an accurate and efficient ways and approaches that could be utilized to estimate the power consumption and the important factors that are contributing to it. Switching activity is one such factor. To have a high-level estimate of dynamic power consumption, switching activity equations in CIC filters are derived, which may then be used to have an estimate of the dynamic power consumption. The modeling of leakage power is also included, which is an important parameter to consider since the input sampling rate may differ several orders of magnitude. These power estimates at higher level can then be used as a feed-back while exploring multiple alternatives.Sampling rate conversion is a typical example where it is required to determine the values between existing samples. The computation of a value between existing samples can alternatively be regarded as delaying the underlying signal by a fractional sampling period. The fractional-delay filters are used in this context to provide a fractional-delay adjustable to any desired value and are therefore suitable for both integer and non-integer factors. The structure that is used in the efficient implementation of a fractional-delay filter is know as Farrow structure or its modifications. The main advantage of the Farrow structure lies in the fact that it consists of fixed finite-impulse response (FIR) filters and there is only one adjustable fractional-delay parameter, used to evaluate a polynomial with the filter outputs as coefficients. This characteristic of the Farrow structure makes it a very attractive structure for the implementation. In the considered fixed-point implementation of the Farrow structure, closed-form expressions for suitable word lengths are derived based on scaling and round-off noise. Since multipliers share major portion of the total power consumption, a matrix-vector multiple constant multiplication approach is proposed to improve the multiplierless implementation of FIR sub-filters.The implementation of the polynomial part of the Farrow structure is investigated by considering the computational complexity of different polynomial evaluation schemes. By considering the number of operations of different types, critical path, pipelining complexity, and latency after pipelining, high-level comparisons are obtained and used to short list the suitable candidates. Most of these evaluation schemes require the explicit computation of higher order power terms. In the parallel evaluation of powers, redundancy in computations is removed by exploiting any possible sharing at word level and also at bit level. As a part of this, since exponents are additive under multiplication, an ILP formulation for the minimum addition sequence problem is proposed.
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| 7. |
- Abbas, Qaisar, et al.
(författare)
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Energy Stability of the MUSCL Scheme
- 2010
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Ingår i: Proc. 7th South African Conference on Computational and Applied Mechanics. - Berlin : South African Association for Theoretical and Applied Mechanics. ; , s. 65:1-8, s. 61-68
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Abbas, Qaisar, 1975-
(författare)
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Weak Boundary and Interface Procedures for Wave and Flow Problems
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis, we have analyzed the accuracy and stability aspects of weak boundary and interface conditions (WBCs) for high order finite difference methods on Summations-By-Parts (SBP) form. The numerical technique has been applied to wave propagation and flow problems.The advantage of WBCs over strong boundary conditions is that stability of the numerical scheme can be proven. The boundary procedures in the advection-diffusion equation for a boundary layer problem is analyzed. By performing Navier-Stokes calculations, it is shown that most of the conclusions from the model problem carries over to the fully nonlinear case.The work was complemented to include the new idea of using WBCs on multiple grid points in a region, where the data is known, instead of at a single point. It was shown that we can achieve high accuracy, an increased rate of convergence to steady-state and non-reflecting boundary conditions by using this approach.Using the SBP technique and WBCs, we have worked out how to construct conservative and energy stable hybrid schemes for shocks using two different approaches. In the first method, we combine a high order finite difference scheme with a second order MUSCL scheme. In the second method, a procedure to locally change the order of accuracy of the finite difference schemes is developed. The main purpose is to obtain a higher order accurate scheme in smooth regions and a low order non-oscillatory scheme in the vicinity of shocks.Furthermore, we have analyzed the energy stability of the MUSCL scheme, by reformulating the scheme in the framework of SBP and artificial dissipation operators. It was found that many of the standard slope limiters in the MUSCL scheme do not lead to a negative semi-definite dissipation matrix, as required to get pointwise stability.Finally, high order simulations of shock diffracting over a convex wall with two facets were performed. The numerical study is done for a range of Reynolds numbers. By monitoring the velocities at the solid wall, it was shown that the computations were resolved in the boundary layer. Schlieren images from the computational results were obtained which displayed new interesting flow features.
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| 9. |
- Abbott, Allan, et al.
(författare)
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Early rehabilitation targeting cognition, behaviour and motor function after lumbar fusion: A randomised controlled trial
- 2010
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Ingår i: Abstracts. ; , s. 186-186
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Study Design: Open label randomised controlled trial with 3, 6, 12 month and 2-3 year follow-up.Objective. To investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy applied during the first 3 months after lumbar fusion.Methods: The study recruited 107 patients, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. The exercise therapy group received a home program focusing on pain contingent training of back, abdominal and leg muscle functional strength and endurance, stretching and cardiovascular fitness. The psychomotor therapy group received a home program and 3 outpatient sessions focusing on modifying maladaptive pain cognitions, behaviours and motor control. Patient-rated questionnaires investigating functional disability, pain, health related quality of life, functional self-efficacy, outcome expectancy, fear of movement/(re)injury and copingwere assessed at baseline, 3, 6, 12 months and 2-3 years after surgery.Results: Follow-up rates were 93% at 12 months and 81% at 2-3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Similar results occurred for pain coping but group differences were non-significant at 2-3 year follow-up.Conclusions: The study shows that post-operative rehabilitation can be effectively implemented during the first 3 months after lumbar fusion and should include measures to modify psychological aswell as motor functions.
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| 10. |
- Abbott, Allan, et al.
(författare)
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Multidimensional assessment of pain related disability after surgery for cervical disc disease
- 2013
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Ingår i: APA Conference 2013. - : Australian Physiotherapy Association. ; , s. 2-2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Questions: Given only 25% of patients, 10 year post-surgery for cervical disc disease report clinically meaningful improvements in functional disability, what are the biopsychosocial factors associated with continued long-term disability? What are the implications for physiotherapy practice?Design: Cross-sectional observational study.Participants: Ninety patients who had undergone anterior discectomy and fusion (ACDF) surgery 10-13 years prior.Outcome Measures: The Neck Disability Index (NDI), ACDF surgery type, surgical fusion status, patient age and Part 1 of the West Haven-Yale multidimensional pain inventory Swedish version (MPI-S) were entered into a statistical model. Part 1 of the MPI-S contains 5 subscales: pain severity, interference, life control, affective distress and support.Results: Seventy-three patients answered the questionnaires. Non-linear categorical regression modeling (CATREG) of the selected predictive variables explained 76.1% of the variance in NDI outcomes 10-13 years post ACDF. Of these predictors, MPI-S affective distress subscale (β = 0.635, p = <0.001) and pain severity subscale (β = 0.354, p = <0.001) were significant individual predictors of NDI ratings.Conclusion: This is the first study to investigate potential factors associated with prolonged functional disability greater than 10 years post-surgery for cervical disc disease. The results suggest the importance of not only pain severity but also screening affective distress as a potential barrier to physical functioning in patients previously operated for cervical disc disease. Future research on the utility of affect-focused body awareness therapy and pain coping strategies for post-surgical patients with continuing pain and physical disability is indicated.Key Practice Points:• The screening of pain severity and affective distress is of importance for patients presenting with continuing physical disability after previous surgery for cervical disc disorders• Affect-focused body awareness therapies and pain coping strategies may be a potential treatment alternative for patients with continuing pain and physical disability.
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