708 resultados para Critical problems


Relevância:

20.00% 20.00%

Publicador:

Resumo:

In this paper we extend the ideas of Brugnano, Iavernaro and Trigiante in their development of HBVM($s,r$) methods to construct symplectic Runge-Kutta methods for all values of $s$ and $r$ with $s\geq r$. However, these methods do not see the dramatic performance improvement that HBVMs can attain. Nevertheless, in the case of additive stochastic Hamiltonian problems an extension of these ideas, which requires the simulation of an independent Wiener process at each stage of a Runge-Kutta method, leads to methods that have very favourable properties. These ideas are illustrated by some simple numerical tests for the modified midpoint rule.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Aim The purpose of this study was to examine the relationship between registered nurses’ (RN) job satisfaction and their intention to leave critical care nursing in Saudi Arabia. Background Many studies have identified critical care areas as stressful work environments for nurses and have identified factors contributing to job satisfaction and staff retention. However, very little research has examined these relationships in the Saudi context. Design and Methods This study utilised an exploratory, cross-sectional survey design to examine the relationship between RN job satisfaction and intention to leave at King Abdul-Aziz University Hospital, Saudi Arabia. Respondents completed a self-administered survey including demographic items and validated measures of job satisfaction and intention to leave. A convenience sample of 182 RNs working in critical care areas during the data collection period were included. Results Regression analysis predicting RN intention to leave found that demographic variables including age, parental status and length of ICU experience, and three of the job satisfaction subscales including perceived workload, professional support and pay and prospects for promotion, were significantly associated with the outcome variable. Conclusion This study adds to the existing literature on the relationship between job satisfaction and intention to leave critical care areas among RNs working in Saudi Arabia. These findings point to the need for management and policy interventions targeting nurses’ workloads, professional support and pay and promotion in order to improve nurse retention.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

While governments are engaged in developing social policy responses to address wicked issues such as poverty, homelessness, drug addiction and crime, long term resolution of these issues through government policy making and state-based programmatic action has remained elusive. The use of vehicles for joint action and partnership between government and the community sector such as co-management has been offered as a way of harnessing productive capability and innovative capacity of both these sectors to resolve these complex problems. However, it is suggested that while there is a well advanced agenda with the intent for collaboration and partnership, working with the models for undertaking this joint action are not well understood and have not been fully developed or evaluated. This chapter examines new approaches to resolving the wicked issue of homelessness through applying the lens of co-management to understand the complexities of this issue and its resolution. The chapter analyses an attempt to move away from traditional bureaucratic structures of welfare departments, operating through single functional ‘silos’ to a new horizontal ‘hub-based’ model of service delivery that seeks to integrate actors across many different service areas and organizations. The chapter explores case studies of co-management in the establishment, development and operation of service hubs to address homelessness. We argue that the response to homelessness needs a ‘wicked solution’ that goes beyond simply providing shelter to those in need. The case of the hub models of community sector organizations working across organizational boundaries is evaluated to determine whether this approach can be considered successful co-managing of an innovative initiative, and understanding the requirements for developing, improving and extending this model. The role of the third sector in co-managing public services is examined through the in-depth case studies and the results are presented together with an assessment of how co-management can contribute to service quality and service management in public services.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Prior in vitro studies, utilizing 31Pn uclear magnetic resonance (31PN MR) to measure the chemical shift (CT) of 0-ATP and lengthening of the phosphocreatine spin-spin (7"') relaxation time, suggested an assessment of their efficacy in measuring magnesium depletion in vivo. Dietary magnesium depletion (Me$) produced markedly lower magnesium in plasma (0.44 vs 1. I3 mmol/liter) and bone (1 30 vs 190 pmol/g) but much smaller changes in muscle (41 vs 45 pmol/g, P < 0.01), heart (42.5 vs 44.6 prnol/g), and brain (30 vs 32 pmollg). NMR experiments in anesthetized rats in a Bruker 7-T vertical bore magnet showed that in M e $ rats there was a significant change in brain j3-ATP shift (16.15 vs 16.03 ppm, P < 0.05). These chemical shifts gave a calculated free [Mg"] of 0.71 mM (control) and 0.48 mM (MgZ+$). In muscle the change in j3-ATP shift was not significant (Me$ 15.99 ppm, controls 15.96 ppm), corresponding to a calculated free M P of 0.83 and 0.95 mM, respectively. Phosphccreatine Tz (Carr-Purcell, spin-echo pulse sequence) was no different with M e $ in muscle in vivo (surface coil) (M$+$ 136, control 142 ms) or in isolated perfused hearts (Helmholtz coil) (control 83, M e $ 92 ms). 3'P NMR is severely limited in its ability to detect dietary magnesium depletion in vivo. Measurement of j3-ATP shift in brain may allow studies of the effects of interaction in group studies but does not allow prediction of an individual magnesium status.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Recognizing the impact of reconfiguration on the QoS of running systems is especially necessary for choosing an appropriate approach to dealing with dynamic evolution of mission-critical or non-stop business systems. The rationale is that the impaired QoS caused by inappropriate use of dynamic approaches is unacceptable for such running systems. To predict in advance the impact, the challenge is two-fold. First, a unified benchmark is necessary to expose QoS problems of existing dynamic approaches. Second, an abstract representation is necessary to provide a basis for modeling and comparing the QoS of existing and new dynamic reconfiguration approaches. Our previous work [8] has successfully evaluated the QoS assurance capabilities of existing dynamic approaches and provided guidance of appropriate use of particular approaches. This paper reinvestigates our evaluations, extending them into concurrent and parallel environments by abstracting hardware and software conditions to design an evaluation context. We report the new evaluation results and conclude with updated impact analysis and guidance.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

his paper formulates an edge-based smoothed conforming point interpolation method (ES-CPIM) for solid mechanics using the triangular background cells. In the ES-CPIM, a technique for obtaining conforming PIM shape functions (CPIM) is used to create a continuous and piecewise quadratic displacement field over the whole problem domain. The smoothed strain field is then obtained through smoothing operation over each smoothing domain associated with edges of the triangular background cells. The generalized smoothed Galerkin weak form is then used to create the discretized system equations. Numerical studies have demonstrated that the ES-CPIM possesses the following good properties: (1) ES-CPIM creates conforming quadratic PIM shape functions, and can always pass the standard patch test; (2) ES-CPIM produces a quadratic displacement field without introducing any additional degrees of freedom; (3) The results of ES-CPIM are generally of very high accuracy.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

This short essay examines the relationship between academic research and policy with particular emphasis on the question of whether a critical criminology can engage in academic critique at the same time as engaging in policy oriented research. Recognising that critical criminology falls between theory and politics criminologists are urged to adopt pragmatic, strategic positions as they negotiate their role in contentious debates and practical minefi elds. It is concluded that a critical criminology must try not only to think the unthinkable about crime, but also to speak the unspeakable about the conditions in which and by which it is known.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

In recent years ‘‘welfare reform’’ has become a vehicle for many neo-conservative social commentators to invoke marriage vows as a cure for poverty and the abuse of poor women. Their basic claim is that cohabiting relationships are not only more violent than marriages, but that married couples are happier, healthier, and wealthier than cohabiting ones. A policy then of encouraging cohabitants to marry, they claim, would lead to increased family wealth and decreased family violence. We examine these claims in this article, along with the alternative argument that marriage per se is not a solution to these problems. Alternatively we propose an economic exclusion/male peer support model that explains why many cohabiting men abuse women in intimate relationships. If forcing these couples to marry is not a solution, then structural solutions are necessary, along with progressive policy suggestions that address the antecedents of poverty and abuse.