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171.
This paper examines the relationship between self-efficacy and social power (expert and referent) and how the application of this relationship, leads to client adherence and compliance. Referent power is defined, including methods that health care professionals may use to develop and apply referent power. Expert power is defined and addressed in the context of referent power, self-esteem and self-efficacy as a means of promoting adherence. Self-efficacy as a concept is defined and explored in the context of social power. The relationships between self-efficacy and social power (expert and referent) are shown as important determinants of adherence and compliance. The theory of the application of referent and expert power in relationship with self-efficacy has been compared with an effective programme, yielding high compliance, at Western Psychiatric Institute and Clinic, showing the theory's relevance and applicability in determining compliance. Explored are the reasons for non-compliance in the elderly population and how the theory model can remedy these detriments for compliance. The empowerment of elderly patients through the application of this theory to medication compliance is examined. The determination of adherence and compliance is shown by the application of the relationship between self-efficacy and both expert and referent power.  相似文献   
172.
Due to the changes in the frequency of penicillin-resistant strains of S. pneumoniae, it is necessary to perform surveillance studies of bacterial resistance. Isolates from the upper respiratory tract of asymptomatic children have been useful. There is no information about the difference between isolates from children with and without upper respiratory tract infection (URTI). The objective of the authors in this paper is to establish the prevalence of carrier-state, serotype and antimicrobial resistance of S. pneumoniae isolates from children with and without acute upper respiratory tract infection (URTI) in a rural area in Mexico. A cross-sectional comparative study was performed in Tlaxcala, Mexico. Children from one month 5 years of age were included. Nasopharyngeal swabs were obtained. Identification was done by international microbiology standards. Serotyping was done by the capsular Quellung test. The susceptibility testing was performed by the agar dilution method. Four-hundred and fifty patients were included. S. pneumoniae was isolated in 134 children (29.7%). Frequency of carriers was greater in patients with URTI (107/323) than without URTI (27/127) (33.1% vs. 21.1% p = 0.012, OR 1.84, IC 95% 1.1-3.08). The six most frequent serotypes were: 6B (16.4%); 19F (11.9%); 19A (6.7%); 14, 23F, and 35 (5.2% each), with no difference among the groups. Only 3% of the strains had high level resistance to penicillin, and 12.6% had intermediate resistance, and for ampicillin 4%, amoxicillin 4%, amoxicillin-clavulanate 4%, ceftriaxone 3%, cefotaxime 1.5%, erythromycin 6%, miocamycin 3%, chloramphenicol 4%, and vancomycin 0%. Trimethoprim-sulfamethoxazole resistance was very high (42%). In conclusion, colonization is higher in children with URTI. Five of the most frequent serotypes identified in this study were the same as those identified in patients with S. pneumoniae invasive diseases in Mexico City. In Tlaxcala, Mexico, beta-lactams could be the drug of choice for the treatment of S. pneumoniae lower respiratory tract infections. It is necessary to perform clinical assays to evaluate the efficacy of trimethoprim-sulfamethoxazole due to the high resistance in vitro.  相似文献   
173.
Morgagni hernias are the least common form of diaphragmatic hernias. Although they are congenital, most of them are not diagnosed until later in life. The indication for surgery is based on the patient's symptoms or on the radiological evidence of incarcerated tissue, and until quite recently involved a laparotomy or thoracotomy. Laparoscopy not only permits the suspected diagnosis to be confirmed--which is otherwise often difficult--but also makes it possible to close the hernia site by suturing. For improved security, the hernia site is augmented by fixing in place a non-absorbable mesh. The operative technique employed is described.  相似文献   
174.
The influence of ionic strength and composition on the binding and inhibition of human leukocyte elastase by glycosaminoglycans with variable degree and position of sulfation was investigated. The kinetic mechanism of inhibition had a hyperbolic, mixed-type character with a competitive component that was promoted by low ionic strength, reduced by phosphate ions, and which also depended on the substrate and glycosaminoglycan structure. Enzyme binding was a cooperative phenomenon that varied with ionic strength and composition. The inhibition patterns correlated with the cationic character of elastase and with the distribution of arginines on its molecular surface, most notably with residues located in the vicinity of the substrate binding region. The order of affinity for elastase binding was chondroitin 4-sulfate < chondroitin 6-sulfate < dermatan sulfate, iduronate-containing derivatives being superior with respect to the glucuronate-containing counterparts. Additional sulfation at both the 4- and 6- positions or at the N- and 4-positions of the N-acetylgalactosamine moiety decidedly improved the inhibitory efficiency. The results highlight a fundamental physiological role of enzyme-glycosaminoglycan interactions. In the azurophil granule of the human polymorphonuclear neutrophil, elastase and other enzymes are bound to a matrix of chondroitin 4-sulfate because this is the only glycosaminoglycan that simultaneously offers good binding for enzyme compartmentalization together with prompt release from the bound state at the onset of phagocytosis.  相似文献   
175.
176.
We study run-time issues, such as site allocation and query scheduling policies, in executing read-only queries in a hierarchical, distributed memory, multicomputer system. The particular architecture considered is based on the hypercube interconnection. The data are stored in a base cube, which is controlled by a control cube and host node hierarchy. Input query trees are transformed into operation sequence trees, and the operation sequences become the units of scheduling. These sequences are scheduled dynamically at run-time. Algorithms for dynamic site allocation are provided. Several query scheduling policies that support interquery concurrency are also studied. Average query completion times and initiation delays are obtained for the various policies using simulations  相似文献   
177.
We propose and evaluate a parallel “decomposite best-first” search branch-and-bound algorithm (dbs) for MIN-based multiprocessor systems. We start with a new probabilistic model to estimate the number of evaluated nodes for a serial best-first search branch-and-bound algorithm. This analysis is used in predicting the parallel algorithm speed-up. The proposed algorithm initially decomposes a problem into N subproblems, where N is the number of processors available in a multiprocessor. Afterwards, each processor executes the serial best-first search to find a local feasible solution. Local solutions are broadcasted through the network to compute the final solution. A conflict-free mapping scheme, known as the step-by-step spread, is used for subproblem distribution on the MIN. A speedup expression for the parallel algorithm is then derived using the serial best-first search node evaluation model. Our analysis considers both computation and communication overheads for providing realistic speed-up. Communication modeling is also extended for the parallel global best-first search technique. All the analytical results are validated via simulation. For large systems, when communication overhead is taken into consideration, it is observed that the parallel decomposite best-first search algorithm provides better speed-up compared to other reported schemes  相似文献   
178.
Considers the applicability of algorithm based fault tolerance (ABET) to massively parallel scientific computation. Existing ABET schemes can provide effective fault tolerance at a low cost For computation on matrices of moderate size; however, the methods do not scale well to floating-point operations on large systems. This short note proposes the use of a partitioned linear encoding scheme to provide scalability. Matrix algorithms employing this scheme are presented and compared to current ABET schemes. It is shown that the partitioned scheme provides scalable linear codes with improved numerical properties with only a small increase in hardware and time overhead  相似文献   
179.
Several variations of cache-based checkpointing for rollback error recovery from transient errors in shared-memory multiprocessors have been recently developed. By modifying the cache replacement policy, these techniques use the inherent redundancy in the memory hierarchy to periodically checkpoint the computation state. Three schemes, different in the manner in which they avoid rollback propagation, are evaluated in this paper. By simulation with address traces from parallel applications running on an Encore Multimax shared-memory multiprocessor, we evaluate the performance effect of integrating the recovery schemes in the cache coherence protocol. Our results indicate that the cache-based schemes can provide checkpointing capability with low performance overhead, but with uncontrollable high variability in the checkpoint interval  相似文献   
180.
Multicast communication, in which the same message is delivered from a source node to an arbitrary number of destination nodes, is being increasingly demanded in parallel computing. System supported multicast services can potentially offer improved performance, increased functionality, and simplified programming, and may in turn be used to support various higher-level operations for data movement and global process control. This paper presents efficient algorithms to implement multicast communication in wormhole-routed direct networks, in the absence of hardware multicast support, by exploiting the properties of the switching technology. Minimum-time multicast algorithms are presented for n-dimensional meshes and hypercubes that use deterministic, dimension-ordered routing of unicast messages. Both algorithms can deliver a multicast message to m-1 destinations in [log 2 m] message passing steps, while avoiding contention among the constituent unicast messages. Performance results of implementations on a 64-node nCUBE-2 hypercube and a 168-node Symult 2010 2-D mesh are given  相似文献   
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