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1.
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   
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The neuronal cytoskeleton is one of the most profoundly altered organelles in late life neuro-degenerative disorders that are characterized by progressive impairments in cognitive abilities. The elucidation of the protein building blocks of these organelles as well as advances in understanding how these proteins become altered in Alzheimer's disease (AD) and other less common dementing illnesses, i.e., diffuse Lewy body disease (DLBD) or the Lewy body variant of AD (LBVAD), will provide insights into the molecular basis of these disorders. Within, we review evidence that normal adult human tau is abnormally phosphorylated and converted into the subunits of AD paired helical filaments (PHFs), and that Lewy bodies (LBs) represent accumulation of altered neurofilament (NF) triplet subunits. Although the precise biological consequences of PHF and LB formation in neurons is unknown, growing evidence suggests that the formation of PHFs and LBs from normal neuronal cytoskeletal proteins could have deleterious effects on neuronal function and survival. Finally, insights into the composition of PHFs and LBs could lead to the development of novel strategies for the timely and accurate diagnosis of AD, DLBD and the LBVAD.  相似文献   
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We describe a novel microfluidic perfusion system for high-resolution microscopes. Its modular design allows pre-coating of the coverslip surface with reagents, biomolecules, or cells. A poly(dimethylsiloxane) (PDMS) layer is cast in a special molding station, using masters made by photolithography and dry etching of silicon or by photoresist patterning on glass or silicon. This channel system can be reused while the coverslip is exchanged between experiments. As normal fluidic connectors are used, the link to external, computer-programmable syringe pumps is standardized and various fluidic channel networks can be used in the same setup. The system can house hydrogel microvalves and microelectrodes close to the imaging area to control the influx of reaction partners. We present a range of applications, including single-molecule analysis by fluorescence correlation spectroscopy (FCS), manipulation of single molecules for nanostructuring by hydrodynamic flow fields or the action of motor proteins, generation of concentration gradients, trapping and stretching of live cells using optical fibers precisely mounted in the PDMS layer, and the integration of microelectrodes for actuation and sensing.  相似文献   
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BACKGROUND: Although gastric bypass is an effective treatment for morbid obesity, the postoperative results are unsatisfactory in 10% of all patients. Therapeutic failures after an operation performed with the sole purpose of reducing the risk of obesity-associated diseases have to be taken seriously. The goal of this study was to investigate the causes of these failures. METHOD: From 1979 to 1993, 165 gastric bypass operations (technique: Mason-Griffen) were performed. Long-term results were obtained in 60 patients after an average of 6.6 years (range 3-13). On follow-up all patients were examined and asked about their level of satisfaction with the weight loss achieved and changes in eating habits. RESULTS: In 6 patients the weight reduction was regarded as insufficient (BMI > 35 and reduction of BMI < 10). The causes of these failures were technical in 3 cases (gastric pouch to 0 large in 1, dilatation of gastrojejunostomy in 2). Three patients had a high calorie intake through an intact gastric bypass by snacking. Three patients regarded the operation as a failure although they had achieved significant weight loss, because they could no longer eat the usual amounts of food. CONCLUSION: Correct surgical technique and preoperative information on the changes in eating habits after a gastric bypass operation are the most important steps in preventing therapeutic failures.  相似文献   
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Three-dimensional, turbulent fluid flow analysis with computational methods has emerged as a viable tool in the design process of engine components for passenger cars. If applied in the early stages of the component development such analysis can help reduce the product development time drastically, and may support the design engineer to evaluate several competing design aspects before product completion. However the grid generation for complex geometries still poses a difficult and time consuming taks which strongly influences the accuracy of the numerical solution. The present paper studies the numerical solution of the flow in an inlet-manifold of a five-cylinder engine with two intake-ports for each cylinder. A fast and reliable grid generation technique is discussed in detail. The finite volume based Navier-Stokes solver with schemes of first and second order accuracy for the convective terms is used. Numerical results at several mass flow rates and different boundary conditions at the intake ports are compared with measurements. Finally, the computational results are discussed with respect to their applicability to support the design process of an inlet-manifold.  相似文献   
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Crosslinked copolymers of acrylamide (AA) and ethylacrylate and some ion exchangers derived from them containing either primary amine groups, obtained by the Hofmann degradation of the amide groups, or carboxylic groups, obtained by the alkaline hydrolysis of the ester groups, were studied. Divinylbenzene and N,N′‐methylenebisacrylamide were used as crosslinkers. The starting copolymers and the corresponding ion exchangers were characterized by IR spectroscopy, swelling behavior, and thermogravimetric analysis. The ion‐exchanger properties were correlated with the crosslinker nature and the chemical reactions performed on the AA copolymers. The average molecular weight between two crosslinks, determined from the swelling data in water, was compared with that calculated on the basis of the copolymerization stoichiometry only for the carboxylic cation exchangers. In this way, the preservation of the crosslink density after the hydrolysis was revealed. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 2701–2707, 2003  相似文献   
10.
Successful massively multiplayer online games (MMOGs) have today millions of registered users and hundreds of thousands of active concurrent players. To be able to guarantee quality of service (QoS) to a highly variable number of concurrent users, game operators statically over-provision a large infrastructure capable of sustaining the game peak load, even though a large portion of the resources is unused most of the time. To address this problem, we introduce in this work a new MMOG ecosystem for hosting and provisioning of MMOGs which effectively splits the traditional monolithic MMOG companies into three main service providers: game providers, game operators, and resource providers. Their interaction is regulated through comprehensive service level agreements (SLA) that establish the price, terms of operation, and compensation for service violations. In our model, game operators efficiently provision resources for MMOGs from multiple cloud providers, based on dynamic load forecasts, and ensure proper game operation that maintains the required QoS to all clients under varying resource availability. Game providers manage multiple distributed MMOGs for which they lease services under strict operational SLAs from game operators to satisfy all client requests. These three self-standing, smaller, more agile service providers enable access to the MMOG market for the small and medium enterprises, and to the current commercial cloud providers. We evaluate, through simulations based on real-life MMOG traces and commercial cloud SLAs, the impact of resource availability on the QoS offered to the MMOG clients. We find that our model can mitigate the negative effects of resource failures within four minutes and that MMOG server consolidation can accentuate the negative effects of failures in a resource-scarce environment. We further investigate different methods of ranking MMOG operational offers with either single or multiple (competing) MMOG providers. Our results show that compensations for SLA faults in the offer selection process can lead up to 11–16 % gain in the game providers’ income. We also demonstrate that adequate ranking of offers can lead to MMOG operational cost reductions from 20 up to 60 %.  相似文献   
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