Our power demands are increasing and, with it, a desire to find renewable and long-lasting energy sources, be they solar, wind or nuclear. Among these options also sits wave power -- given that Australia's completely surrounded by, well, loads of waves, it would seem a decent idea to try and harness the energy they create.
What is wave power, exactly? There are many different approaches but, essentially, the idea is to capture the kinetic energy from wave motion. Tidal power, on the other hand, works by holding onto incoming tides and generating power as water is released.
CSIRO's keen on Australia's wave power potential. In a 2011 report, the organisation noted that the wave power between Geraldton, Tasmania and Tassie's southern tip is around 1300TWh per year, enough to supply Australia's energy requirements five times over, though the report mentions that 23TWh would be required by 2050 to provide just five per cent of the country's "grid-based" needs. It estimates 100-200km (less than one per cent) of Australia's coastline would be required to deliver this amount.
A Sydney Morning Herald article from yesterday tells us that Victoria's been keen since at least 2009, having granted a company by the name of Ocean Power Technologies $66 million to develop a 19MW wave farm near Portland, Victoria, about 360km west of Melbourne. Initially, the farm will use ten of OPT's "PowerBuoy" units to produce 1.5MW.
Unfortunately, SMH reports that no "physical" progress has yet been made, which may or may not have something to do with the project requiring an additional $130 million to shift into gear. OPT says it's spent the last two years fine-tuning its technology and is still in the process of securing permits and funding.
Is Victoria on the right track investing in wave power, a technology arguably on the fringes of the renewable energy debate, or should we be putting more thought into gas and possibly nuclear options?
You know, while we wait for cold fusion to get off the ground.

Tá ár n-éileamh ar chumhacht ag méadú agus, leis sin, tá an fonn ann foinsí fuinnimh in-athnuaite agus fadtéarmacha a aimsiú, bíodh siad gréine, gaoithe nó núicléach. I measc na roghanna seo tá cumhacht tonn freisin -- ós rud é go bhfuil an Astráil timpeallaithe go hiomlán ag, go leor tonnta, is cosúil gur smaoineamh maith é iarracht a dhéanamh an fuinneamh a chruthaíonn siad a shaothrú.
Cad é cumhacht tonn, go díreach? Tá go leor cur chuige éagsúla ann ach, go bunúsach, is é an smaoineamh an fuinneamh cinéiteach a ghabháil ó ghluaiseacht tonn. Ar an láimh eile, oibríonn cumhacht na dtimthriall trí thitimí a thagann isteach a choinneáil agus cumhacht a ghiniúint de réir mar a scaoiltear uisce.
Tá CSIRO ar an eolas faoi acmhainneacht chumhacht tonn na hAstráile. I dtuarascáil 2011, thug an eagraíocht faoi deara go bhfuil an chumhacht tonn idir Geraldton, Tasmania agus barr theas Tassie thart ar 1300TWh in aghaidh na bliana, go leor chun riachtanais fuinnimh na hAstráile a sholáthar cúig huaire níos mó, cé go luaitear sa tuarascáil go mbeadh 23TWh ag teastáil faoi 2050 chun ach cúig faoin gcéad de riachtanais "gréasán-bhunaithe" na tíre a sholáthar. Measann sé go mbeadh 100-200km (níos lú ná aon faoin gcéad) de chósta na hAstráile ag teastáil chun an méid seo a sheachadadh.
In alt Sydney Morning Herald ó lá atá inniu ann, dúradh linn go raibh Victoria ag iarraidh é a dhéanamh ó 2009 ar a laghad, tar éis dó $66 milliún a dheonú do chuideachta Ocean Power Technologies chun feirm tonn 19MW a fhorbairt in aice le Portland, Victoria, thart ar 360km siar ó Melbourne. Ar dtús, úsáidfidh an fheirm deich n-aonad "PowerBuoy" OPT chun 1.5MW a tháirgeadh.
Ar an drochuair, tuairiscíonn SMH nach bhfuil aon dul chun cinn "físeach" déanta go fóill, a d'fhéadfadh a bheith i gceist nó nach bhfuil i gceist leis an tionscadal a éilíonn $ 130 milliún breise chun aistriú i ngéar. Deir OPT go bhfuil sé caite an dá bhliain dheireanach feiniméireacht a teicneolaíocht agus tá sé fós i bpróiseas ceadúnais agus maoiniú a fháil.
An bhfuil Victoria ar an mbóthar ceart ag infheistiú i gcumhacht tonn, teicneolaíocht a d'fhéadfaí a rá go bhfuil sí ar imeall an díospóireachta fuinnimh in-athnuaite, nó ba cheart dúinn níos mó smaointe a chur i ngás agus b'fhéidir roghanna núicléacha?
Tá a fhios agat, agus muid ag fanacht le cumasc fuar a fháil as an talamh.


Zirconium Oxide Oxygen Sensors
Zirconium oxide (ZrO2) sensors, otherwise known as high temperature electrochemical sensors (or hot probes), consist of a cell made of yttria stabilized zirconia ceramic forming a crystal lattice structure which acts as a solid electrolyte.
Typically, the cell is shaped like a test tube where the inner and outer surfaces are each coated with an ultra-thin layer of porous platinum to act as cathode and anode electrodes. At high temperatures (above 650ºC), openings in the crystal lattice permit the movement of oxygen ions. As long as the oxygen partial pressures are equal on both sides, the movement of ions within the lattice is random, and there is no net flow within the lattice.
When a sample gas containing oxygen is introduced on one side, oxygen ions migrate through the crystal lattice to form a concentration gradient from the higher O2 partial pressure side to the lower pressure side. The gradient, which determines the amount of oxygen in the sample gas, is measured by the ratio of the O2 partial pressures between a sample gas on one side of the lattice and a reference gas, (typically ambient air) on the other side of the lattice.
At Versaperm we are not tied to any specific sensor types or manufacturer and so we can always select exactly the right sensor for an application. Versaperm is a world technology leader in the measurement of gas permeability. We offer not only instruments but also comprehensive testing and consultancy services.

Sensors Oxygen Zirconium Oxide
Tá braiteoirí ocsaíd zircóiniam (ZrO2), ar a dtugtar braiteoirí leictreachimiceacha ardteochta (nó sondes te), comhdhéanta de chill déanta as ceirmeach zircónia cobhsaithe yttria a chruthaíonn struchtúr gréasán criostail a fheidhmíonn mar leictreallit soladach.
De ghnáth, tá cruth an chealla cosúil le feadán tástála ina bhfuil an dromchla istigh agus an dromchla seachtrach gach ceann acu clúdaithe le ciseal ultra-tinn de phlátaimín porous chun gníomhú mar leictreóidí catóide agus anód. Ag teochtaí ard (os cionn 650oC), ceadaíonn oscailtí sa ghréasán criostail gluaiseacht iain ocsaigine. Chomh fada agus a bhíonn brú páirteach ocsaigine comhionann ar an dá thaobh, tá gluaiseacht na n-iúin laistigh den ghruaig randamach, agus níl aon sreabhadh glan laistigh den ghruaig.
Nuair a chuirtear gáis samplach ina bhfuil ocsaigin isteach ar thaobh amháin, imirceann iain ocsaigine tríd an ngréasán criostail chun gradient tiúchan a chruthú ón taobh le brú páirteach O2 níos airde go dtí an taobh le brú níos ísle. Déantar an gradient, a chinneann méid an ocsaigine sa ghás samplach, a thomhas trí chion na mbrú páirteach O2 idir gás samplach ar thaobh amháin den ghréasán agus gás tagartha (aer timpeallachta de ghnáth) ar an taobh eile den ghréasán.
Ag Versaperm níl muid ceangailte le cineálacha nó monaróirí braiteoirí ar bith agus mar sin is féidir linn an braiteoir ceart a roghnú i gcónaí do iarratas. Is ceannaire teicneolaíochta domhanda é Versaperm i thomhas insliabhadh gáis. Ní amháin go dtugann muid uirlisí ach seirbhísí cuimsitheacha tástála agus comhairleoireachta freisin.


Virtual Mentor. April 2008, Volume 10, Number 4: 220-223.
Cysticercosis: A Zebra in the Neighborhood
Demographic information about a specific subset of patients can help physicians recognize conditions they do not expect to find in the larger population.
Jason Yeh and Jeanne S. Sheffield, MD
One of medicine's most quoted aphorisms is, "when you hear hoofbeats, don't look for zebras." This, of course, is a pithy reminder to physicians that they should be wary when tempted to diagnose a rare condition: it is far more likely to be a common disease than an uncommon one. But as medicine becomes, like trade and travel, more globalized, the proverbial zebra is much less rare.
Learning Objective Learn how demographic information about a specific subset of patients can help physicians recognize conditions they do not expect to find in the larger population.
Between 2000 and 2007, the immigrant population of the U.S. increased by more than 24 percent, with an average of 1.04 million immigrants per year . Estimates project that by the year 2050, whites will be the minority, and 1 in 5 Americans will be foreign-born . The growth of the immigrant population poses diagnostic challenges for physicians in all fields. The increasing immigrant population and ever-broadening scope of pathology force us to ask just how proficient each physician should become in recognizing medical zebras.
It is unrealistic to expect all physicians to become experts in recognizing and treating the rarest of diseases; doing so is an ineffective way to spend one's career. The medical community as a whole has the responsibility to educate physicians about changes in medicine. Compared to the physician in solo practice, large medical institutions have better vantage points from which to recognize gradual shifts in global pathology. Medical communities can shed light on these thematic changes through journal articles and conference presentations and can encourage physicians to apply new information in novel ways.
The compartmentalization of medical knowledge into specialties has also improved physician competence by allowing doctors to maintain greater expertise within their own fields, so that each has to be aware of a limited number of uncommon diseases.
At the same time, physicians have a duty to expand their medical knowledge so that they can anticipate the needs of the unnamed and unknown future patient. One way for professionals to approach this goal is to study the culture and characteristics of their particular patient populations.
Knowing One's Patients
Knowing the characteristics of a population—age, race, cultural traditions, and where they live—offers physicians clues about which medical conditions (common and uncommon) they are more likely to see. A thorough understanding of demographic themes can guide one's study of medicine and allow each physician to make decisions about the specific type of medical knowledge he or she needs beyond what is required for board certification. A physician who understands the complexities of his or her patient population is more likely to recognize an extraordinary medical condition when it appears.
Cysticercosis is one example of a disease that has become more prevalent in certain areas of the U.S. as a result of recent population changes. As the Hispanic population grows in Texas, we at Parkland Hospital are caring for more people infected with cysticercosis.
The tapeworm that causes cysticercosis is endemic to many parts of the world including China, Southeast Asia, India, sub-Saharan Africa, and Latin America. Some studies suggest that the prevalence of cysticercosis in Mexico is between 3.1 and 3.9 percent . Other studies have found the seroprevalence in areas of Guatemala, Bolivia, and Peru as high as 20 percent in humans, and 37 percent in pigs [4, 5]. It is crucial for the physician who deals with a substantial Hispanic or Southeast Asian population to be familiar with the symptoms and treatment of cysticercosis.
The infection starts in the gastrointestinal tract as a result of swallowed foodstuffs contaminated with the larva or eggs of the pork tapeworm, Taenia solium. Once in the gastrointestinal tract, the egg hatches and is able to penetrate the intestinal wall and spread to the bloodstream where it can consequently infect the skin, heart, eyes, skeletal muscle, and brain tissue. When the infection reaches the central nervous system, it is called neurocysticercosis. The immunomodulatory nature of the parasite allows live cysts to persist for up to 5 years before dying or causing symptoms in humans.
Symptoms of cysticercosis infection are generally mild, and infections of the muscle and skin are largely asymptomatic. In the eye, cysticercosis can cause blurry vision and, in more severe cases, swelling and detachment of the retina. Symptoms of brain infection depend on the location and size of the infection. Headaches and seizures are common, but other symptoms include confusion, personality changes, and disequilibrium.
Diagnosing neurocysticercosis is often difficult; lab tests are frequently inaccurate and neuroimaging findings are varied. Still, both CT and MRI are useful for diagnosis and also for monitoring treatment outcomes. The choice of therapy depends on many factors and typically combines the use of antiparasitic drugs, surgery, and medication for symptom control. Both albendazole and praziquantel are effective in treating parenchymal neurocysticercosis. At Parkland we use albendazole as the standard treatment because it costs less and has stronger cysticidal activity than praziquantel .
Neurocysticercosis can cause seizures in pregnant women. There are even case reports of neurocysticercosis having been confused with eclampsia [7, 8]. Distinguishing between these conditions is tricky at best, and the complexity of each illustrates why identifying the populational themes of our patients is important.
Alternatively, presumptive knowledge about a population can complicate the diagnostic process. Medical literature reports an unlikely outbreak of neurocysticercosis in an orthodox Jewish population from New York City . Among this group of people with no history of pork consumption, the source of the infection was not dietary. Instead, the infection was found to have resulted from improper sanitation practices by Hispanic laborers in the community. As this story illustrates, physicians must avoid the rigid application of cultural stereotypes to a population. An overreliance on such assumptions endangers patient safety and risks the breakdown of what should be an objective diagnostic process.
Understanding the cultural characteristics of a specific population does not in itself guarantee better patient care. It is merely one method of realistically approaching the ideal of becoming a fully knowledgeable and capable physician. Achieving our goals as healers and physicians demands that each of us absorb and react to many things, from current events to subtle changes in local demographics. It is an endless pursuit, but ignoring the medical needs of a diversifying patient population is easily a violation of our promise to first, do no harm.
Jason Yeh is a fourth-year medical student at the University of Texas Southwestern Medical School at Dallas, and a graduate of the Plan II Honors Program from the University of Texas at Austin. His interests include cross-cultural medicine and infectious diseases of pregnancy. He will continue his medical training in the field of obstetrics and gynecology at Duke University Medical Center in Durham, North Carolina, and plans to pursue fellowship training in maternal-fetal medicine.
Jeanne S. Sheffield, MD, is an associate professor of obstetrics and gynecology at the University of Texas Southwestern Medical Center at Dallas. She is the director of the maternal-fetal medicine fellowship program and specializes in infectious diseases in pregnancy.
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© 2008 American Medical Association. All Rights Reserved.

Mentor fíorúil. Aibreán 2008, Tomo 10, Uimhir 4: 220-223.
Cysticercosis: Seibhrí sa Chomharsanacht
Is féidir le faisnéis dhaonlathach faoi fho-sraith ar leith othair cabhrú le dochtúirí coinníollacha a aithint nach bhfuil siad ag súil leo a fháil sa daonra níos mó.
Jason Yeh agus Jeanne S. Sheffield, MD
Ceann de na haifreann is mó a luaitear i leigheas ná, "nuair a chloiseann tú buachaillí, ná bí ag lorg seibhrí". Is é seo, ar ndóigh, meabhrúchán soiléire do dhochtúirí gur chóir dóibh a bheith cúramach nuair a bhíonn siad ar an mealladh galar neamhchoitianta a dhiagnóisiú: is dóichí go bhfuil sé ina ghalair coitianta ná mar nach ghalair neamhchoitianta é. Ach de réir mar a bhíonn an leigheas, cosúil le trádáil agus taisteal, níos domhanda, tá an seibhrí seanfhocal i bhfad níos lú annamh.
Oibleagáid Foghlama Foghlaim conas is féidir le faisnéis dhaonlathacha faoi fho-sóim shonrach de othair cabhrú le dochtúirí coinníollacha a aithint nach bhfuil súil acu a fháil sa daonra níos mó.
Idir 2000 agus 2007, d'fhás daonra inimirceach na SA níos mó ná 24 faoin gcéad, le meán 1.04 milliún inimirceach in aghaidh na bliana . Meastar go mbeidh na bántín ina mhionlach faoi 2050, agus go mbeidh 1 as gach 5 Meiriceánach a rugadh thar lear. Cuireann fás an daonra inimirceach dúshláin dhiagnóiseacha ar fáil do dhochtúirí i ngach réimse. Tá an daonra inimirceach atá ag méadú agus raon na paiteolaíochta atá ag leathnú i gcónaí ag cur iallach orainn a iarraidh cé chomh proifisiúnta a ba cheart do gach dochtúir a bheith i dtaithint le seibrí leighis.
Níl sé réalaíoch a bheith ag súil go mbeidh gach dochtúir ina saineolaithe i aithint agus i gcóireáil na ngalar is annamh; is bealach neamhéifeachtach é sin a dhéanamh chun gairme duine a chaitheamh. Tá freagracht ar an bpobal leighis ina iomláine do dhochtúirí a oideachas faoi athruithe sa leigheas. I gcomparáid leis an dochtúir a bhíonn ag cleachtadh ina aonar, tá áiseanna níos fearr ag institiúidí móra le hathruithe de réir a chéile sa phaitíocht dhomhanda a aithint. Is féidir le pobail leighis solas a chaitheamh ar na hathruithe téamacha seo trí ailt iris agus cur i láthair comhdhála agus is féidir leo dochtúirí a spreagadh chun faisnéis nua a chur i bhfeidhm ar bhealaí nua.
Tá feabhas tagtha ar inniúlacht na liachta freisin de bharr go bhfuil an t-eolas leighis roinnte ina speisialachtaí trína ligtear do dhochtúirí saineolas níos mó a choinneáil laistigh dá réimsí féin, ionas go mbeidh ar gach duine a bheith ar an eolas faoi líon teoranta galair neamhchoitianta.
Ag an am céanna, tá dualgas ar dhochtúirí a gcuid eolais leighis a leathnú ionas gur féidir leo dul i ngleic le riachtanais an othair gan ainm agus gan aithne a bheidh ann amach anseo. Bealach amháin le gairmithe dul i ngleic leis an gcuspóir seo ná staidéar a dhéanamh ar chultúr agus ar shaintréithe a ndaoine othair ar leith.
A Bheairt ar a n-Othar
Tá a fhios ag na tréithe daonra - aois, cine, traidisiúin chultúrtha, agus áit ina bhfuil cónaí orthu - le fios ag na lianna cé na coinníollacha leighis (choitianta agus neamhchoitianta) is dóichí a fheiceann siad. Is féidir le tuiscint chuimsitheach ar théamaí déimeagrafacha staidéar ar leigheas a threorú agus ligean do gach dochtúir cinntí a dhéanamh maidir leis an gcineál sonrach eolais leighis a theastaíonn uaidh nó uaithi seachas an méid a theastaíonn le haghaidh deimhniúchán ón mbord. Tá sé níos dóchúla go dtuigfidh dochtúir a thuigeann castachtaí a chuid othair nó a cuid othair riocht speisialta leighis nuair a thagann sé chun cinn.
Is sampla amháin de ghalair atá ag éirí níos coitianta i gceantair áirithe de na Stáit Aontaithe mar thoradh ar athruithe daonra le déanaí é cysticercosis. De réir mar a fhásann daonra Hispanic i Texas, táimid ag Ospidéal Parkland ag tabhairt aire do níos mó daoine atá ionfhabhtaithe le cysticercosis.
Tá an tineas a chuireann cysticercosis i gceist endemic i go leor codanna den domhan lena n-áirítear an tSín, Oirdheisceart na hÁise, an India, an Afraic faoi-Shahárach, agus Meiriceá Laidineach. Tugann roinnt staidéir le fios go bhfuil forleithne cysticercosis sa Mheicsiceo idir 3.1 agus 3.9 faoin gcéad . Fuair staidéir eile go raibh an seroprevalence i gceantair de Ghuatamala, na Bóilíve, agus Phéire chomh hard le 20 faoin gcéad i ndaoine, agus 37 faoin gcéad i muca [4, 5]. Tá sé ríthábhachtach don dhochtúir a bhíonn ag déileáil le daonra suntasach Hispanic nó Oirdheisceart na hÁise a bheith eolach ar na hairíonna agus ar chóireáil cysticercosis.
Tosaíonn an t-ionfhabhtú sa chonair gastrointestinal mar thoradh ar earraí bia a inghlaite atá truaillithe le larbha nó uibheacha an fhógráin chrios, Taenia solium. Nuair a bhíonn sé sa chonair gastrointestinal, eicíonn an ubh agus tá sé in ann dul isteach sa bhalla intestinal agus scaipeadh go dtí an sruth fola áit ar féidir leis an gcraiceann, an croí, na súile, na matáin chnámh, agus fíochán inchinn a ionfhabhtaithe dá bharr sin. Nuair a shroich an t-ionfhabhtú an lárchóras néaróg, tugtar neurocysticercosis air. Ceadaíonn nádúr imdhíonachta an paraisíte go maireann cistí beo ar feadh suas le 5 bliana sula bhfaigheann siad bás nó sula mbíonn comharthaí acu i ndaoine.
De ghnáth bíonn comharthaí ionfhabhtaithe cysticercosis éadrom, agus tá ionfhabhtuithe na matáin agus na craiceann go mór neamhthionsamhlacha. Sa tsúil, is féidir le cysticercosis fís dhúbailte a chur ar bun agus, i gcásanna níos déine, tuirse agus díghrádú an retina. Braitheann comharthaí ionfhabhtaithe inchinn ar shuíomh agus ar mhéid an ionfhabhtaithe. Tá tinneas cinn agus coisithe coitianta, ach tá comharthaí eile ina measc mearbhall, athruithe pearsantachta, agus neamhréireacht.
Is minic a bhíonn sé deacair neurocysticercosis a dhiagnóisiú; is minic nach mbíonn tástálacha saotharlainne cruinn agus tá torthaí neuroimaging éagsúil. Mar sin féin, tá CT agus MRI araon úsáideach le haghaidh diagnóis agus freisin chun monatóireacht a dhéanamh ar thorthaí cóireála. Braitheann an rogha teiripe ar go leor fachtóirí agus de ghnáth bíonn drugaí frith-parasíteacha, máinliacht agus cógais chun comharthaí a rialú. Tá albendazole agus praziquantel araon éifeachtach i gcóireáil neurocysticercosis parenchymal. Ag Parkland úsáidimid albendazole mar chóireáil chaighdeánach toisc go bhfuil sé níos saoire agus tá gníomhaíocht cysticidal níos láidre aige ná praziquantel .
Is féidir le neurocysticercosis cois a chur le hairíonna i measc na mban torracha. Tá tuairiscí cásanna ann fiú de neurocysticercosis a ndearnadh a mheascadh le eclampsia [7, 8]. Tá sé deacair idirdhealú a dhéanamh idir na coinníollacha seo, agus léiríonn an chastacht atá ag gach ceann acu cén fáth go bhfuil sé tábhachtach téamaí daonracha ár n-othar a aithint.
Ina theannta sin, is féidir le eolas réamhbhreithe faoi dhaonra an próiseas diagnóise a chastacht. Tuairiscíonn litríocht leighis ráig neamhchlaon de neurocysticercosis i ndaonra Giúdach orthoideach ó Chathair Nua Eabhrac . I measc an ghrúpa seo daoine gan aon stair ithe muiceoil, ní raibh foinse an ionfhabhtaithe ag an aiste bia. Ina áit sin, fuarthas amach gur mar thoradh ar chleachtais neamhdhíobhálach sláintíochta a rinne oibrithe Hispanic sa phobal a tháinig an t-ionfhabhtú. Mar a léiríonn an scéal seo, ní mór do dhochtúirí a sheachaint na stéaréatíopaí cultúrtha a chur i bhfeidhm go crua ar phobal. Tá an iomarca muiníne a bheith ann ar thairiscintí den sórt sin ag cur sábháilteacht na n-othar i mbaol agus tá riosca ann go gcuirfear an próiseas diagnóiseach oibiachtúil i mbaol.
Ní ráthaíonn tuiscint ar shaintréithe cultúrtha daonra ar leith cúram níos fearr do othair. Níl ann ach modh amháin chun dul i ngleic go réalaíoch leis an idéalach a bheith ina dhochtúir go hiomlán eolach agus cumasach. Chun ár gcuspóirí mar leigheasóirí agus dochtúirí a bhaint amach éilíonn sé ar gach duine againn go nglacfaidh agus go ngníomhóidh sé le go leor rudaí, ó imeachtaí reatha go hathruithe subtle i dtimpeallacht áitiúil. Is é an fonn gan deireadh, ach neamhaird a dhéanamh ar riachtanais leighis de daonra éagsúlacht othair go héasca sárú ar ár gealladh chun an chéad, ní dhéanann dochar.
Jason Yeh is mac léinn míochaine ceathrú bliain in Ollscoil Texas Southwestern Medical School i Dallas, agus céimí de Chlár Onóracha Phlean II ó Ollscoil Texas in Austin. I measc a spéise tá leigheas tras-chultúrtha agus galair ionfhabhtacha toirchis. Leanfaidh sé ar aghaidh lena oiliúint leighis i réimse na ginéagaice agus na ginéagaice ag Ionad Leighis Ollscoil Duke i Durham, Carolina Thuaidh, agus tá sé beartaithe oiliúint comhaltachta a leanúint i leigheas máthar-fhiontae.
Is ollamh comhlánaithe i ginéaclaíocht agus ginéaltóireacht é Jeanne S. Sheffield, MD, in Ionad Leighis Theasthuaisceart Ollscoil Texas i Dallas. Tá sí ina stiúrthóir ar chlár comhaltachta na míochaine máthar-fetal agus speisialtóireacht i ngalar ionfhabhtaithe i ngrá.
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Is iad na húdair féin a léiríonn na tuairimí a léirítear ar an suíomh seo agus ní gá go léiríonn siad tuairimí agus beartais AMA.
© 2008 Cumann Leighis Mheiriceá. Gach Ceart Coimeádta.


The findings, from a group of researchers led by the Johns Hopkins Bloomberg School of Public Health, suggest that young people from poor nations can benefit from mental health treatment, even when health professionals do not provide it. Untreated childhood trauma, the researchers say, is linked to skills deficits and unhealthy decision-making as adults as well as long-term negative health outcomes and lower economic productivity.
A report on the study appears in the June 29 issue of JAMA Pediatrics.
“We found that children from very distressed backgrounds can really be helped by a prescribed set of sessions with trained lay workers who otherwise have absolutely no mental health education and barely a high school education,” says study leader Laura K. Murray, PhD, an associate scientist in the Bloomberg School’s Department of Mental Health. “This study demonstrates that evidence-based treatments can be done in low-resource countries with good outcomes. We need to make these interventions available to children so they aren’t set up for significant difficulties as adults.”
For the study, Murray and her colleagues brought a program called Trauma-Focused Cognitive Behavioral Therapy to vulnerable children between the ages of five and 18 in Lusaka, Zambia from August 2012 to December 2013. Roughly half of the 257 children were randomly chosen for the therapy intervention, while the other half received the “usual” treatment commonly given to orphans or vulnerable children in poor countries. The usual treatment varied, but often included such things as playing soccer, support groups, education, nutrition and HIV-related services such as voluntary counseling and testing. They were called or, if they had no phone, visited once a week to evaluate their safety including the need to be referred to other services such as medical assistance.
The intervention consisted of between eight and 12 one-hour sessions, conducted by workers with no prior formal training in counseling but who received some ongoing training and supervision by the research team. The children had time to get to know the lay counselors and were taught relaxation techniques, how to talk about their feelings and how they could choose how to think about their circumstances. They were walked through their traumatic experiences in detail to clear out the stories causing them nightmares. They learned how to think about the trauma in different ways and to see that it was not their fault. They also worked with counselors to plan how to avoid violent situations in the future in very specific ways. For example, detailed safety plans were developed with the children to avoid violence at home or in the community, such as going to a neighboring “auntie’s” house for the night when they sensed trouble brewing.
Those in the intervention group saw their trauma symptom scores—measures of sleep problems, feelings of sadness, the ability to talk about issues—fall by nearly 82 percent, on average, while those in the treatment-as-usual group had a reduction in their scores of 21 percent.
One limitation of the study is that it did not follow the children in the months after the treatment to see if the positive effect endured. But studies in the United States focused on child trauma in poor populations have found that Trauma-Focused Cognitive Behavioral Therapy is effective and has sustained benefits at six months to two years after treatment.
Murray says she believes that the program in Zambia should be generalizable to other sub-Saharan African nations.
The new study did not compare cost-effectiveness of the two types of treatment, but Murray says the findings raise the question of whether dollars are being spent in the most effective way to help orphans and vulnerable children.
“The United States spends billions in poor countries on programs for orphaned children and others who have experienced trauma, but the programs are often more social in nature and have not shown effectiveness in treating the mental health effects of trauma,” Murray says. “Our research suggests that treatments like the one we studied in Zambia may be able to provide better care for children with trauma-related mental health problems.”
The researchers say cost-effectiveness studies are needed to determine whether the usual treatment provided for this population is worth the money, or if it is better to put those funds where they can make a greater impact.
“Effectiveness of Trauma Focused Cognitive Behavioral Therapy Among Trauma-Affected Children in Lusaka, Zambia: A Randomized Controlled Trial” was written by Laura K. Murray, PhD; Stephanie Skavenski, MSW, MPH; Jeremy C. Kane, MPH; John Mayeya, MSc; Shannon Dorsey, PhD; Judy A. Cohen, MD; Lynn T.M Michalopoulos, PhD; Mwiya Imasiku, PhD; and Paul A. Bolton, MBBS. Collaborators are from the Zambian Ministry of Health, the University of Washington, Allegheny General Hospital, Columbia University and the University of Zambia.
The study was supported by the USAID Displaced Children’s and Orphans Fund.

Tugann na torthaí, ó ghrúpa taighdeoirí faoi stiúir Scoil Sláinte Poiblí Johns Hopkins Bloomberg, le fios go bhféadfadh daoine óga ó thíortha bochta leas a bhaint as cóireáil meabhairshláinte, fiú nuair nach soláthraíonn gairmithe sláinte é. Deir na taighdeoirí go bhfuil baint ag trauma óige nach ndearnadh cóireáil leis an easpa scileanna agus le cinnteoireacht neamhshláintiúil mar dhaoine fásta chomh maith le torthaí diúltacha fadtéarmacha sláinte agus táirgiúlacht eacnamaíoch níos ísle.
Tá tuarascáil ar an staidéar le feiceáil i dtionól 29 Meitheamh de JAMA Pediatrics.
'Fuarthas amach go bhféadfaí cabhrú le páistí ó chúlraí an-droch-chraicinn trí shraith seisiúin fhorordaithe le hoibrithe laigh oiliúnacha nach bhfuil aon oideachas meabhairshláinte acu ar chor ar bith agus nach bhfuil oideachas ardscoile acu ach ar éigean,' a deir Laura K. Murray, PhD, ceannasaí an staidéir, eolaí comhlánaithe i Roinn Sláinte Meabhrach Scoil Bloomberg.  Léiríonn an staidéar seo gur féidir cóireálacha bunaithe ar fhianaise a dhéanamh i dtíortha a bhfuil acmhainní íseal acu agus go bhfuil torthaí maithe acu. Ní mór dúinn na hidirghabhálacha seo a chur ar fáil do leanaí ionas nach mbeidh deacrachtaí suntasacha acu mar dhaoine fásta.
Chun an staidéar a dhéanamh, thug Murray agus a comhghleacaithe clár ar a dtugtar Teiripe Iompraíochta Cognitive dírithe ar Trauma do leanaí leochaileacha idir cúig bliana d'aois agus 18 i Lusaka, an tSambaia ó Lúnasa 2012 go Nollaig 2013. Roghnaíodh thart ar leath de na 257 leanbh go randamach don idirghabháil teiripe, agus fuair an leath eile an chóireáil "choitianta" a thugtar go coitianta do leanaí díolta nó do leanaí leochaileacha i dtíortha bochta. Bhí éagsúlacht ag an gcóireáil is gnách, ach go minic bhí rudaí mar imirt peile, grúpaí tacaíochta, oideachas, cothú agus seirbhísí a bhaineann le VEID mar chomhairle agus tástáil deonach san áireamh. Bhí glaoch orthu nó, mura raibh teileafón acu, cuairt a thabhairt orthu uair sa tseachtain chun a sábháilteacht a mheas lena n-áirítear an gá a bhí le seirbhísí eile mar chúnamh leighis a chur ina luí orthu.
Bhí idirghabháil idir ocht agus 12 seisiún uair an chloig ann, arna stiúradh ag oibrithe gan oiliúint foirmiúil roimhe seo i gcomhairle a thabhairt ach a fuair roinnt oiliúna leanúnach agus maoirseacht ag an bhfoireann taighde. Bhí am ag na páistí na comhairleoirí laigh a fháil ar an eolas agus d'fhoghlaim siad teicnící scíth a ligean, conas labhairt faoina mothúcháin agus conas a d'fhéadfadh siad a roghnú conas smaoineamh faoina gcúinsí. Bhí siad ag siúl trína dtaithí traumatic go mion chun na scéalta a bhí ag cruthú uafáis a ghlanadh. D'fhoghlaim siad conas smaoineamh ar an trauma ar bhealaí éagsúla agus a fheiceáil nach raibh sé ina gcosaint. D'oibrigh siad freisin le comhairleoirí chun pleanáil a dhéanamh ar conas cásanna foréigneacha a sheachaint sa todhchaí ar bhealaí an-sonracha. Mar shampla, d'fhorbair siad pleananna sábháilteachta mionsonraithe leis na páistí chun foréigean sa bhaile nó sa phobal a sheachaint, mar shampla dul chuig teach aunts comharsanachta don oíche nuair a bhraith siad go raibh trioblóid ag breacadh.
Chonaic na daoine sa ghrúpa idirghabhála go raibh laghdú beagnach 82 faoin gcéad ar a scóir comharthaí uraim - tomhais fadhbanna codlata, mothúcháin brón, an cumas labhairt faoi shaincheisteanna - ar an meán, agus bhí laghdú 21 faoin gcéad ar a scóir ag na daoine sa ghrúpa cóireála mar is gnách.
Is é teorainn amháin an staidéir ná nár lean sé na páistí sna míonna tar éis na cóireála chun a fheiceáil an d'fhan an éifeacht dhearfach. Ach tá staidéir sna Stáit Aontaithe a dhírigh ar thrámaí leanaí i ndaoine bochta tar éis a fháil go bhfuil Teiripe Iompar Cognitive atá dírithe ar Thráma éifeachtach agus go bhfuil buntáistí leanúnacha aige sé mhí go dhá bhliain tar éis cóireála.
Deir Murray go gcreideann sí gur chóir go mbeadh an clár sa tSambaib inrochtaineach do náisiúin eile san Afraic faoi-Shahárach.
Ní chuir an staidéar nua i gcomparáid cost-éifeachtúlacht an dá chineál cóireála, ach deir Murray go dtógann na torthaí an cheist an bhfuil na dollar á gcur in iúl ar an mbealach is éifeachtaí chun cabhrú le huirfiú agus le leanaí leochaileacha.
Tá na Stáit Aontaithe ag caitheamh billiúin i dtíortha bochta ar chláir do leanaí díolta agus do dhaoine eile a bhfuil trauma acu, ach is minic go bhfuil na cláir níos sóisialta de chineál agus nach bhfuil éifeachtúlacht léirithe acu i gcóireáil éifeachtaí sláinte meabhrach an uraim, deir Murray. Léiríonn ár dtaighde go bhféadfadh cóireálacha cosúil leis an gceann a rinneamar staidéar air sa tSaimbia cúram níos fearr a sholáthar do leanaí a bhfuil fadhbanna meabhairshláinte a bhaineann le trauma acu.
Deir na taighdeoirí go bhfuil staidéir chostais-éifeachtachta ag teastáil chun a chinneadh an bhfuil an chóireáil is gnách a chuirtear ar fáil don phobal seo fiú an t-airgead, nó más fearr na cistí sin a chur áit ar féidir leo tionchar níos mó a dhéanamh.
Eifeachtúlacht Teiripe Iompraíochta Cognitive Focused Trauma i measc Leanaí a bhfuil Trauma orthu i Lusaka, an tSamba: Trialach Rianaithe Randomized a scríobh Laura K. Murray, PhD; Stephanie Skavenski, MSW, MPH; Jeremy C. Kane, MPH; John Mayeya, MSc; Shannon Dorsey, PhD; Judy A. Cohen, MD; Lynn T.M Michalopoulos, PhD; Mwiya Imasiku, PhD; agus Paul A. Bolton, MBBS. Tá comhoibrithe ó Aireacht Sláinte na Sambaí, Ollscoil Washington, Ospidéal Ginearálta Allegheny, Ollscoil Columbia agus Ollscoil na Sambaí.
Bhí tacaíocht ag Ciste Leanaí Dífhostaithe agus Easpaí USAID don staidéar.


Food safety is increasing in global importance and complexity said David R. Lineback, senior fellow at the Joint Institute for Food Safety and Applied Nutrition at the University of Maryland at College Park.
Lineback spoke at the 11th Annual Patrick Lecture Series during an evening reception and lecture program in the Energy, Coast and Environment Building on the Louisiana State University campus on Sept. 19.
“Food safety is everyone’s responsibility,” Lineback said. “We live globally, so we have to balance between local and distant foods supplied to us.”
While discussing the importance of a safe food supply, he said we live in this global food market and most of us don’t want to go back to where we only have seasonal produce.
The movement of food over long distances does create challenges, Lineback explained. “There is the opportunity for contamination all along the route from producer to consumer.”
Safety of the food supply has been a hot topic recently with the two ground turkey recalls because of contamination.
“In our current situation, we have these three areas – convenience, health and pleasure – which overlap,” he said.
He said it took his grandparents about three hours to prepare the evening meal, while it took his parents about an hour.
“Now it takes between 12 to15 minutes,” Lineback said. “We want it to taste just as good and we want it to be just as healthy.”
When it comes to food safety, he said risk equals magnitude plus probability.
“Perception is important with consumers,” he said. “Danger and kids can’t be used in the same sentence.”
A recent study cited showed that about three-fourths of all Americans obtain their food safety information from a media source today, where it used to be from a doctor, he explained.
In his analysis, the whole story is not being told on many occasions. He referred to a report from Purdue University that showed how some contaminated seed can contaminate the plant that grows from it, which makes it impossible to simply wash off.
Access to clean water is one of the most important assets needed to decrease foodborne illness, according to Lineback.
“The World Health Organization estimated in 2005, the latest figures available, that about 1.8 million people die from diarrheal diseases alone. That’s attributed to food and water,” he said. “If we had potable water around the world, we could reduce foodborne illness by about 50 percent.”
“Dr. Lineback is an internationally known food safety expert,” said Ruth Patrick, one of the founders of the lecture series. “He’s had a really varied academic background.”
Lineback was department head of food science at North Carolina State and Penn State universities, dean of the College of Agriculture at the University of Idaho and director of the Joint Institute for Food Safety and Applied Nutrition at the University of Maryland, where he currently serves as a senior fellow.
With more than 48 million estimated cases of foodborne illness a year, Patrick said, a little common sense could go a long way.
She explained that something as simple as regular hand washing could decrease one of the main problems – staph infection.
Ruth Patrick was a food and nutrition specialist with the LSU AgCenter. She, along with her late husband Bill Patrick, who was director of the LSU Wetland Biogeochemistry Institute, established the Patrick Lecture Series in 1998 through an endowment to the LSU Foundation.
The endowment fund sponsors an annual lecture that alternates between the fields of Human Nutrition/Food Science and Wetlands Science/Coastal Studies, Patrick said.
“The idea for the lecture series is to bring an outstanding scientist/scholar in our discipline here every year to share the latest information and technology about our discipline,” Patrick said.
Each year a scholar is selected to spend several days on the LSU campus where a number of lectures are presented, including a general interest lecture for faculty and students and a scientific lecture for Pennington Biomedical Research Center scientists.
Lineback was selected as the featured speaker for the lecture from nominees submitted by LSU faculty members.

Tá tábhacht agus castacht domhanda ag fás i sábháilteacht bia, a dúirt David R. Lineback, comhalta sinsearach ag an Institiúid Comhpháirteach um Shábháilteacht Bia agus cothú feidhmíochta in Ollscoil Maryland i bPáirc na gColáiste.
Labhair Lineback ag an 11ú Sraith Léachtais Bhliantúil Patrick le linn clár fáilteachais agus léachta tráthnóna sa Tógáil Fuinnimh, Cósta agus Comhshaoil ar champais Ollscoil Stáit Louisiana ar 19 Meán Fómhair.
Is freagracht ar gach duine é sábháilteacht bia, a dúirt Lineback. Tá cónaí orainn ar fud an domhain, mar sin ní mór dúinn cothromaíocht a dhéanamh idir bia áitiúil agus bia atá ar shiúl a sholáthraítear dúinn.
Agus é ag plé le tábhacht an tsoláthair bia sábháilte, dúirt sé go bhfuilimid ag maireachtáil sa mhargadh bia domhanda seo agus nach bhfuil an chuid is mó againn ag iarraidh dul ar ais go dtí áit nach bhfuil ach táirgí séasúracha againn.
Tá an t-aistriú bia thar achar fada ag cruthú dúshláin, a mhínigh Lineback. Tá an deis ann go ndéantar éilliú ar feadh an tslí go léir ó tháirgeoir go tomhaltóir.
Tá sábháilteacht an tsoláthair bia ina ábhar te le déanaí leis an dá turcaí talún a mheabhrú mar gheall ar thruailliú.
"Sa chás atá againn faoi láthair, tá na trí réimse seo againn - áisiúlacht, sláinte agus pléisiúr - a théann thar a chéile", a dúirt sé.
Dúirt sé go raibh thart ar thrí uair an chloig ag a sheantuismitheoirí an béile tráthnóna a ullmhú, agus gur thóg sé uair an chloig ar a thuismitheoirí.
 Anois, tógann sé idir 12 agus 15 nóiméad,  a dúirt Lineback. Ba mhaith linn go mbraitheann sé chomh maith agus ba mhaith linn go mbeadh sé chomh sláintiúil.
Nuair a thagann sé chun sábháilteacht bia, dúirt sé riosca comhionann le méid móide dóchúlacht.
Tá an tuiscint tábhachtach i measc na dtomhaltóirí, a dúirt sé.  Ní féidir contúirtí agus leanaí a úsáid sa bhfrása céanna.
Léirigh staidéar le déanaí a luaitear go bhfaigheann thart ar thrí cheathrú de na Meiriceánaigh go léir a gcuid faisnéise sábháilteachta bia ó fhoinse meán inniu, áit a raibh sé ó dhochtúir roimhe seo, a mhínigh sé.
Ina anailís, ní bhíonn an scéal iomlán á insint i go leor ócáidí. Thug sé tagairt do thuairisc ó Ollscoil Purdue a thaispeáin conas is féidir le roinnt síolta truaillithe an planda a fhásann uaidh a truailliú, rud a fhágann nach féidir é a ní go simplí.
Tá rochtain ar uisce glan ar cheann de na sócmhainní is tábhachtaí a theastaíonn chun galair a bhaineann le bia a laghdú, de réir Lineback.
I 2005, meastar ó Eagraíocht Sláinte na Domhain, na figiúirí is déanaí atá ar fáil, go bhfaigheann thart ar 1.8 milliún duine bás ó ghalair diarrheic amháin. "Tá sé sin mar gheall ar bhia agus uisce", a dúirt sé. Más féidir linn uisce óil a fháil ar fud an domhain, d'fhéadfaimis galair a dtarraingtear ó bhia a laghdú thart ar 50 faoin gcéad.
Dr. Is saineolaí sábháilteachta bia ar eolas go hidirnáisiúnta é Lineback, a dúirt Ruth Patrick, ceann de bhunaitheoirí na sraithe léachta.  Bhí cúlra acadúil an-éagsúil aige.
Bhí Lineback ina cheann roinn eolaíochta bia in ollscoileanna Stáit Carolina Thuaidh agus Stáit Penn, dean na Coláiste Talmhaíochta in Ollscoil Idaho agus stiúrthóir ar an Institiúid Comhpháirteach um Shábháilteacht Bia agus cothú feidhmíochta in Ollscoil Maryland, áit a bhfuil sé ina dhuine sinsearach faoi láthair.
Le níos mó ná 48 milliún cás measta de ghalair a dtarraingítear ó bhia in aghaidh na bliana, a dúirt Patrick, d'fhéadfadh beagán ciall coiteann dul ar bhealach fada.
Mhínigh sí gur féidir le rud chomh simplí le láimhseáil láimhe rialta ceann de na príomhfhadhbanna - ionfhabhtú staph a laghdú.
Bhí Ruth Patrick ina speisialtóir bia agus cothaithe leis an LSU AgCenter. Bhunaigh sí, mar aon lena fear céile Bill Patrick, a bhí ina stiúrthóir ar Institiúid Bigeo-cheimic LSU Wetland, an Sraith Léachta Patrick i 1998 trí bhronntanas do Bhunaíocht LSU.
Tá an ciste urraithe ag urraithe léacht bhliantúil a athraíonn idir réimsí cothaithe daonna / eolaíocht bia agus eolaíocht na bhfód-chríocha / staidéir chósta, a dúirt Patrick.
"Is é an smaoineamh le haghaidh na sraithe léachta ná eolaí/scoldaí den scoth inár disciplín a thabhairt anseo gach bliain chun an fhaisnéis agus an teicneolaíocht is déanaí faoin disciplín a roinnt", a dúirt Patrick.
Gach bliain roghnaítear scoláirí chun roinnt laethanta a chaitheamh ar an gcampas LSU áit a gcuirtear roinnt léachtaí i láthair, lena n-áirítear léacht leasa ginearálta do fhoireann agus do mhic léinn agus léacht eolaíoch do eolaithe Ionad Taighde Bithleighis Pennington.
Roghnaíodh Lineback mar an cainteoir a bhí le feiceáil don léacht ó ainmneacha a chuir baill foirne LSU isteach.


Those people who live a very long time are typically much healthier than their peers, and spend a shorter period of their lives suffering from age-related disease and disability. Aging is a process of accumulating cell and tissue damage, and those people who are more resilient to damage, or who have suffered less of it though simple happenstance, will be less impacted in all aspects of aging. This is exactly what we'd like to achieve through the development of rejuvenation therapies that can repair this damage, which even in their early stages should produce a much greater difference in outcomes than the naturally occurring gap between long-lived and short-lived people.
Research has shown that the human lifespan has the potential to be extended. But would this merely mean people living longer in poor health? The upbeat findings from a new study indicate that those extra years could well be healthy ones. In a study of nearly 3,000 people, the onset of illness came decades later in life for centenarians than for their younger counterparts. "Most people struggle with an ever-increasing burden of disease and disability as they age. But we found that those who live exceptionally long lives have the additional benefit of shorter periods of illness - sometimes just weeks or months - before death."
The researchers looked at the health status of centenarians and near-centenarians enrolled in two ongoing studies: the Longevity Genes Project (LGP) and the New England Centenarian Study (NECS). The LGP recruits healthy, independently living Ashkenazi Jewish people 95 and older from the northeastern United States. For comparison, the LGP includes a group of Ashkenazi Jewish individuals who do not have a parental history of longevity. The NECS began in 1994 as a study of all centenarians living in eight towns near Boston and was later expanded to include participants from North America generally as well as England, Ireland, Australia and New Zealand. The NECS comparison group consisted of people aged 58 to 95.
This study compared (1) the health status of 483 long-lived LGP participants with 696 LGP comparison individuals 60-94 years old, and (2) the health status of 1,498 long-lived NECS participants with 302 NECS comparison subjects aged 58-95. For both sets of comparisons, the researchers looked at the ages at which individuals developed five major age-related health problems: cancer, cardiovascular disease, hypertension, osteoporosis and stroke. Analysis revealed a consistent pattern of delayed onset of illness in the LGP and NECS centenarian groups compared to their respective comparison groups. For example, for the long-lived NECS individuals, cancer didn't afflict 20 percent of men until age 97 and women until 99. In contrast, 20 percent of NECS comparison participants had developed cancer by age 67 in men and 74 in women. Results were similar for the LGP: for the long-lived LGP participants, the age at which 20 percent had developed cancer was delayed to 96 for both sexes. But cancer had affected 20 percent of LGP control-group males by age 78 and control-group females by 74.
Despite their genetic, social and cultural differences, the long-lived LGP and NECS participants proved markedly similar with respect to major illness: Compared to younger comparison groups, their onset of major age-related disease was delayed, with serious illness essentially compressed into a few years very late in life. The findings suggest that discoveries made in one group of centenarians can be generalized to diverse populations. And they contradict the notion that the older people get, the sicker they become and the greater the cost of taking care of them.

Is gnách go mbíonn na daoine sin a bhíonn ag maireachtáil go fada i bhfad níos sláintiúla ná a gcomhghleacaithe, agus caitheann siad tréimhse níos giorra dá saol ag fulaingt ó ghalair agus míchumais a bhaineann le haois. Is próiseas é dul in aois damáiste cealla agus fíocháin a charnadh, agus na daoine sin atá níos athléimní ar damáiste, nó a d'fhulaing níos lú de cé gur teagmhas simplí é, beidh níos lú tionchar acu ar gach gné den dul in aois. Is é seo go díreach a theastaíonn uainn a bhaint amach trí theiripe ath-uasghrádú a fhorbairt a d'fhéadfadh an damáiste seo a dheisiú, rud a d'fhéadfadh, fiú ina gcéimeanna luatha, difríocht i dtorthaí a tháirgeadh i bhfad níos mó ná an bhearna a tharlaíonn go nádúrtha idir daoine a bhfuil saol fada acu agus daoine nach bhfuil saol fada acu.
Léirigh taighde go bhfuil an cumas ag an saolré daonna a shíneadh. Ach an ciallaíonn sé seo go bhfuil daoine ag maireachtáil níos faide i drochshláinte? Léiríonn na torthaí dóchúla ó staidéar nua go bhféadfadh na blianta breise sin a bheith sláintiúla. I staidéar ar bheagnach 3,000 duine, tháinig an galar ar dhaoine céad bliain d'aois blianta ina dhiaidh sin ná a gcomhghleacaithe níos óige. "Tá an chuid is mó daoine ag streachailt le brón níos mó ná riamh de ghalair agus míchumas de réir mar a théann siad in aois. Ach fuair muid amach go bhfuil buntáiste breise ag na daoine a bhfuil saol an-fhada acu ó thréimhse níos giorra tinnis - uaireanta gan ach seachtainí nó míonna - sula bhfaigheann siad bás".
D'fhéach na taighdeoirí ar stádas sláinte na céad bliain agus na céad bliain a bhí cláraithe i dhá staidéar leanúnach: an Tionscadal Gíní Longevity (LGP) agus Staidéar na hAon-Aoisigh Shasana Nua Shasana (NECS). Glacann an LGP daoine Ashkenazi Giúdach 95 agus níos sine atá sláintiúil, atá ag maireachtáil go neamhspleách ó thuaidh na Stát Aontaithe. I gcomparáid, áirítear ar an LGP grúpa daoine aonair Giúdacha Ashkenazi nach bhfuil stair fad saoil tuismitheoirí acu. Thosaigh an NECS i 1994 mar staidéar ar gach duine céad bliain d'aois a bhí ina gcónaí in ocht mbaile gar do Boston agus leathnaíodh é ina dhiaidh sin chun rannpháirtithe ó Mheiriceá Thuaidh i gcoitinne a áireamh chomh maith le Sasana, Éire, an Astráil agus an Nua-Shéalainn. Bhí daoine idir 58 agus 95 bliain d'aois sa ghrúpa comparáide NECS.
I gcomparáid leis an staidéar seo (1) stádas sláinte 483 rannpháirtí LGP fada-beatha le 696 duine LGP comparáide 60-94 bliain d'aois, agus (2) stádas sláinte 1,498 rannpháirtí NECS fada-beatha le 302 duine NECS comparáide 58-95 bliain d'aois. Maidir leis an dá shraith comparáide, d'fhéach na taighdeoirí ar na hoibreacha a d'fhorbair daoine aonair cúig phríomhfhadhb sláinte a bhaineann le haois: ailse, galar cardashoithíoch, ardteannas, osteoporosis agus stróc. Léirigh anailís patrún comhsheasmhach de thús mall na galair i ngrúpaí céad bliain LGP agus NECS i gcomparáid lena ngrúpaí comparáide faoi seach. Mar shampla, i gcás na ndaoine NECS a raibh saol fada acu, ní raibh ailse ag 20 faoin gcéad de na fir go dtí aois 97 agus na mban go dtí aois 99. I gcodarsnacht leis sin, bhí ailse ag 20 faoin gcéad de na rannpháirtithe comparáide NECS ag aois 67 i bhfear agus 74 i mban. Bhí torthaí den chineál céanna ag an LGP: i gcás rannpháirtithe LGP a raibh saol fada acu, cuireadh moill ar an aois a d'fhorbair ailse ag 20 faoin gcéad go 96 don dá ghnéas. Ach bhí ailse tar éis dul i bhfeidhm ar 20 faoin gcéad de na fir sa ghrúpa rialaithe LGP ag aois 78 agus mná sa ghrúpa rialaithe ag 74.
In ainneoin a n-éagsúlachtaí géiniteacha, sóisialta agus cultúrtha, bhí na rannpháirtithe LGP agus NECS a raibh saol fada acu cosúil go suntasach maidir le tinneas mór: I gcomparáid le grúpaí comparáide níos óige, bhí moill ar thús mór-ghalair a bhaineann le haois, agus bhí tinneas tromchúiseach comhbhrúite go bunúsach i gceann cúpla bliain an-deireadh sa saol. Tugann na torthaí le fios gur féidir na fionnachtana a rinneadh i ngrúpa amháin de dhaoine céad bliain d'aois a ghinearálú do dhaonra éagsúla. Agus contrárthaíonn siad an notion go bhfuil an níos sine daoine a fháil, an níos sine a bheith tinn agus an níos mó an costas a aire a thabhairt dóibh.


Evidence-Based Clicker Use: Audience Response Systems for Rehabilitation Nurses
Article first published online: 1 MAY 2012
© 2012 Association of Rehabilitation Nurses
Volume 37, Issue 3, pages 151–159, May/June 2012
How to Cite
Miller, M. and Hartung, S. Q. (2012), Evidence-Based Clicker Use: Audience Response Systems for Rehabilitation Nurses. Rehabilitation Nursing, 37: 151–159. doi: 10.1002/RNJ.00041
- Issue published online: 1 MAY 2012
- Article first published online: 1 MAY 2012
- audience response systems;
- decision tree template;
- interactive technology;
- nursing presentations;
- patient education;
- qualitative research;
- staff development
An Audience Response System (ARS) commonly used in schools and universities was studied for its benefit in rehabilitation. Audience response systems or “clickers” are technological tools for promoting interactive learning. Clickers were studied for their applicability to clinical settings as well.
Current literature shows evidence-based research and best practices for clicker use within schools. This study expanded ARS into the rehabilitation milieu and then analyzed learner opinions and outcomes. Qualitative data was obtained from both professional and patient groups.
Clickers were used while presenting research findings at conferences, when conducting staff seminars, and during client support groups and subsequent educational sessions. Response graphs and decision trees illustrate the flexibility of ARS for helping educators match presentation content to audience feedback.
Clickers narrowed the gap between those with expertise and those with minimal experience, since immediate clarification was given according to clicker results. ARS helped to engage listeners, which is consistent with clicker research conducted in academic environments.
With clickers, the knowledge and viewpoints of participants can be instantly graphed and displayed, and pertinent information can be provided in real-time. Examples from rehabilitation scenarios depict benefits of Audience Response Systems beyond academia.

Úsáid Clicker bunaithe ar Fhianaise: Córais Freagartha an Phobail do Neamh-Oibrithe um Athshlánú
Artaigil a foilsíodh den chéad uair ar líne: 1 MAI 2012
© 2012 Cumann na nAltránaithe Athshlánúcháin
Leabhar 37, Aistriúchán 3, leathanaigh 151159, Bealtaine/Meitheamh 2012
Conas a Luathú
Miller, M. agus Hartung, S. Q. (2012), Úsáid Clicker Bunaithe ar Fhianaise: Córais Freagra an Phobail do Neirbhíseoirí Athshlánúcháin. Aistriúchán ar an nGaeilge, 37151159. doi: 10.1002/RNJ.00041
- Eiseamh foilsithe ar líne: 1 MAY 2012
- Artaigil a foilsíodh ar líne den chéad uair: 1 MAI 2012
- córais freagartha lucht féachana;
- teimpléad crann chinnidh;
- teicneolaíocht idirghníomhach;
- cur i láthair na n-iníon;
- oideachas othar;
- taighde cáilíochtúil;
- forbairt foirne
Rinneadh staidéar ar Chóras Freagartha an Phobail (ARS) a úsáidtear go coitianta i scoileanna agus in ollscoileanna chun a bhuntáiste a bhaint amach i athshlánú. Is uirlisí teicneolaíocha iad córais freagartha lucht féachana nó 'cliceálaithe' chun foghlaim idirghníomhach a chur chun cinn. Rinneadh staidéar ar chliceálaithe le haghaidh a n-infheidhmeacht i suíomhanna cliniciúla freisin.
Taispeánann litríocht reatha taighde bunaithe ar fhianaise agus dea-chleachtais maidir le húsáid cliceálaithe laistigh de scoileanna. Leathnaíodh an staidéar seo ar ARS isteach sa mheán athshlánúcháin agus ansin anailís a rinneadh ar thuairimí agus ar thorthaí na foghlaimeoirí. Baineadh sonraí cáilíochtúla amach ó ghrúpaí gairmiúla agus othar araon.
Baineadh úsáid as cliceálaithe le linn torthaí taighde a chur i láthair ag comhdhálacha, agus seimineáir foirne á ndéanamh acu, agus le linn grúpaí tacaíochta cliant agus seisiúin oideachais ina dhiaidh sin. Léiríonn grafaí freagraí agus crainn chinnidh solúbthacht ARS chun cabhrú le hoideoirí ábhar cur i láthair a mheaitseáil le haiseolas ó lucht féachana.
D'fhág cliceálaithe an bhearna idir na daoine a raibh saineolas acu agus na daoine a raibh taithí íosta acu a laghdú, ós rud é go ndearnadh soiléiriú láithreach de réir thorthaí cliceálaithe. Cabhraigh ARS le lucht éisteachta a mhealladh, rud a bhfuil comhoiriúnach le taighde cliceálaithe a rinneadh i dtimpeallachtaí acadúla.
Le cliceáil, is féidir eolas agus dearcadh na rannpháirtithe a ghrafáil agus a thaispeáint láithreach, agus is féidir faisnéis ábhartha a sholáthar i bhfíor-am. Léiríonn samplaí ó chásanna athshlánúcháin buntáistí na gcóras freagartha lucht féachana lasmuigh den acadamh.


The role of force in myelination. (a) Molecular force generation. Cells bind ECM components through integrin receptors (represented by α and β subunits), thus increasing extracellular adhesion. Integrin activation then triggers signaling cascades involving Fyn kinase, which inhibits RhoA, thus activating ROCK and Myosin IIB. Activated Myosin IIB interacts with actin filaments and creates strong intracellular contractions, which in turn enhances extracellular attachment and possibly mediates cell differentiation. ECM and cytosol color schemes represent the force intensity generated by these molecular events, gray being weakest and red being strongest. (b) Hypothetical effects of extracellular rigidity and intracellular contractions. Optimal myelination conditions require a balance between extracellular forces mediated by matrix rigidity and intracellular forces based on actomyosin contractions (diagonal arrow). A softer matrix inhibits cell differentiation and myelination (shift to the left), which can be counteracted by myosin IIB inhibition (cells return to being balanced). Gliosis, as it occurs in MS, might represent a more rigid matrix (shift to the right), which would require stronger contractile forces to counteract.
Bauer and ffrench-Constant Journal of Biology 2009 8:78 doi:10.1186/jbiol169

Ról na fórsa i miolaínú. (a) Gníomhaíocht móilíneach. Cealla ceangal comhpháirteanna ECM trí gabhdóirí integrin (a ionadaítear ag α agus β fo-aonaid), rud a mhéadaíonn adhesion extracellular. Ansin, spreagann gníomhachtú Integrin cascades comharthaíochta a bhaineann le Fyn kinase, a chuireann cosc ar RhoA, agus dá bhrí sin ROCK agus Myosin IIB a ghníomhachtú. Déantar Myosin IIB gníomhaithe a idirghníomhú le snáithíní actin agus cruthaítear géarbhreitheanna intracillíochta, rud a fheabhsaíonn an greamaitheacht eisceillteach agus a idirghabhálann idirdhealú cille, b'fhéidir. Léiríonn scéimeanna dathanna ECM agus cytosol déine na fórsa a ghineann na himeachtaí móilíneacha seo, agus is é an liath an ceann is laige agus an ceann is láidre. (b) Eacnamaíocht ar éifeachtaí cruachta extracellular agus ar shrianadh intracellular. Éilíonn coinníollacha miolaíneoireachta is fearr cothromaíocht idir fórsaí extracellular idirghabhálaithe ag cruas maitrís agus fórsaí intracellular bunaithe ar shrianadh actomyosin (sliabhán trasna). Cuireann mátrix níos bog cosc ar dhifríochtú agus mielination cealla (athrú ar chlé), ar féidir a throid le cosc myosin IIB (baineann cealla le bheith cothrom). D'fhéadfadh gliosis, mar a tharlaíonn sé i MS, a bheith ina mhátrix níos daingean (athrú ar dheis), a éilíonn fórsaí contractile níos láidre chun dul i ngleic leis.
Bauer agus Fhrench-Constant Journal of Biology 2009 8:78 doi:10.1186/jbiol169


Teaching happiness skills to school pupils should be part of the national curriculum, a University of Canterbury researcher says.
But a Northland principal says schools already have enough social responsibility.
Dr Annie Soutter wants more done to promote wellbeing in New Zealand schools given our high rates of youth depression and suicide.
"In schools, what I've found is how students think or feel tends to be a separate part of the school experience."
Academic achievement, attendance and sporting prowess took precedence over emotional wellbeing, she said.
Okaihau College principal Alan Forgie said he wasn't enthusiastic about introducing "happiness skills" to the curriculum.
"I'd like to see that we offer a rounded education, and you can focus on things like that to the detriment of everything else."
Okaihau had staff trained in looking out for kids who were likely to harm themselves, he said.
And peer support programmes made sure new students knew where to turn if necessary.
But the curriculum was already full.
"Do you keep adding social responsibility into a school's curriculum?" Mr Forgie asked.
However, Dr Soutter said there was room for teaching happiness and wellbeing as part of the school curriculum because an increasing number of young people were seeking help.
"Youthline gets about 10,000 texts a month from students who are needing support."
This could be as simple as students writing regular "gratitude letters" to people who had supported them, keeping a journal of their feelings and buddying up with senior students and staff.
An exercise requiring students to write down three good things that had happened to them had "tremendous results" in trials by psychologists in the United States.
"They [the exercises] have shown some really positive impacts on mood and a decrease in physical symptoms [of depression]."
While the responsibility of promoting wellbeing didn't fall exclusively on teachers, it made sense to integrate it into the school system, Dr Soutter said.
The latest United Nations World Happiness Report ranked New Zealanders 13th out of the 156 nations.
We slipped from eighth spot in last year's report, with a reported 2.1 per cent decline in happiness levels.
We also have one of the highest youth suicide rates, with males fourth-highest and females second-highest in the developed world.
Between July 2012 and June 2013, 69 young Kiwis aged between 10 and 19 took their own lives.
Meanwhile, a 2012 Auckland University survey of 8500 high school students found 29.1 per cent of girls harmed themselves deliberately in the previous year - up from 26 per cent in the 2007 survey.
The number of boys who harmed themselves also increased slightly to 17.9 per cent.
One-in-six girls and one-in-12 boys showed significant depressive symptoms.
New web-based therapy programmes aimed at teenagers are showing promising results at curbing our alarming youth suicide rate.
Otago University is studying the effects of the online programmes on teens experiencing depression.
Users complete online evidence-based exercises, such as cognitive behaviour therapy or problem-solving therapy.

Ba cheart go mbeadh scileanna sonas a mhúineadh do dhaltaí scoile mar chuid den chúrsa náisiúnta, a deir taighdeoir ó Ollscoil Canterbury.
Ach deir príomhoide Northland go bhfuil go leor freagrachta shóisialta ag scoileanna cheana féin.
Tá an Dr Annie Soutter ag iarraidh go ndéanfar níos mó chun folláine a chur chun cinn i scoileanna na Nua-Shéalainne ag féachaint do na rátaí ard atá againn maidir le dúlagar agus féinmharú óige.
"Sa scoil, is é an rud a fuair mé ná go mbíonn an dóigh a smaoiníonn nó a bhraitheann na mic léinn ina chuid ar leith den taithí scoile".
Bhí tosaíocht ag an mbaint acadúil, ag an láthair agus ag an gcumas spóirt thar folláine mhothúchánach, a dúirt sí.
Dúirt príomh-aire Okaihau College Alan Forgie nach raibh sé díograiseach faoi "scileanna sonas" a thabhairt isteach sa chúrsa.
"Ba mhaith liom a fheiceáil go dtugann muid oideachas cruinn, agus is féidir leat díriú ar rudaí mar sin chun dochar do gach rud eile".
Bhí foirne Okaihau oiliúna i breathnú amach do leanaí a bhí seans maith a dhéanamh díobháil dóibh féin, a dúirt sé.
Agus bhí cláir tacaíochta peer ag cinntiú go raibh a fhios ag mic léinn nua cá háit a rachadh siad más gá.
Ach bhí an clár teagaisc lán cheana féin.
"An bhfuil tú ag cur freagracht shóisialta isteach i gcuraclam na scoile?" D'iarr an tUasal Forgie.
Dúirt an Dr Soutter, áfach, go raibh spás ann chun sonas agus folláine a theagasc mar chuid de chúrsa na scoile toisc go raibh líon méadaitheach daoine óga ag lorg cabhrach.
"Faigheann an Líne Óige thart ar 10,000 téacs in aghaidh na míosa ó mhic léinn atá ag teastáil go mór le tacaíocht".
D'fhéadfadh sé seo a bheith chomh simplí le mic léinn a scríobh "litreacha buíochais" rialta do dhaoine a thacaigh leo, ag coinneáil leabharlann dá gcuid mothúchán agus ag cairdeas le mic léinn sinsearacha agus foireann.
Bhí "tairiscintí iontach" ag saineolaithe saineolaithe sna Stáit Aontaithe ar fheidhmíocht a raibh ar mhic léinn trí rud maith a tharla dóibh a scríobh síos.
"Tá tionchar fíor-mhaith ag na cleachtaí ar an mothúchán agus ar laghdú ar na hairíonna fisiciúla [an dúlagar]".
Cé nach raibh an fhreagracht as folláine a chur chun cinn go heisiach ar mhúinteoirí, bhí sé ciallmhar é a chomhtháthú sa chóras scoile, a dúirt an Dr Soutter.
An Tuarascáil is déanaí ar Shábháilteacht Domhanda na Náisiún Aontaithe, tá an tSileandáil Nua ar an 13ú háit as 156 náisiún.
Bhí an t-iomlán ar an 8ú háit sa tuarascáil anuraidh, agus tuairiscíodh go raibh laghdú 2.1% ar leibhéil áthas.
Tá ceann de na rátaí féinmharú óige is airde againn freisin, agus fir an ceathrú ceann is airde agus mná an dara ceann is airde sa domhan forbartha.
Idir Iúil 2012 agus Meitheamh 2013, thóg 69 Kiwi óg idir 10 agus 19 bliana d'aois a saol féin.
Idir an dá linn, fuair suirbhé 2012 Ollscoil Auckland de 8500 mac léinn ardscoile go ndearna 29.1 faoin gcéad de chailíní díobháil dóibh féin go ciallmhar sa bhliain roimhe sin - suas ó 26 faoin gcéad sa suirbhé 2007.
D'ardaigh líon na bhfear a rinne díobháil dóibh féin beagán freisin go 17.9 faoin gcéad.
Bhí comharthaí tromchúiseacha dúlagaracha ag ceann amháin as gach sé cailín agus duine as gach 12 buachaill.
Tá cláir nua teiripe ar líne atá dírithe ar dhéagóirí ag taispeáint torthaí geallta chun an ráta uafásach féinmharú óige a chur faoi chois.
Tá Ollscoil Otago ag déanamh staidéir ar éifeachtaí na gclár ar líne ar dhéagóirí a bhfuil dúlagar orthu.
Déanann úsáideoirí cleachtaí bunaithe ar fhianaise ar líne, mar theiripe imoibritheach cognaíoch nó teiripe réitigh fadhbanna.


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