556 resultados para Repeated Calls


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According to a study conducted by the International Maritime organisation (IMO) shipping sector is responsible for 3.3% of the global Greenhouse Gas (GHG) emissions. The 1997 Kyoto Protocol calls upon states to pursue limitation or reduction of emissions of GHG from marine bunker fuels working through the IMO. In 2011, 14 years after the adoption of the Kyoto Protocol, the Marine Environment Protection Committee (MEPC) of the IMO has adopted mandatory energy efficiency measures for international shipping which can be treated as the first ever mandatory global GHG reduction instrument for an international industry. The MEPC approved an amendment of Annex VI of the 1973 International Convention for the Prevention of Pollution from Ships (MARPOL 73/78) to introduce a mandatory Energy Efficiency Design Index (EEDI) for new ships and the Ship Energy Efficiency Management Plan (SEEMP) for all ships. Considering the growth projections of human population and world trade the technical and operational measures may not be able to reduce the amount of GHG emissions from international shipping in a satisfactory level. Therefore, the IMO is considering to introduce market-based mechanisms that may serve two purposes including providing a fiscal incentive for the maritime industry to invest in more energy efficient manner and off-setting of growing ship emissions. Some leading developing countries already voiced their serious reservations on the newly adopted IMO regulations stating that by imposing the same obligation on all countries, irrespective of their economic status, this amendment has rejected the Principle of Common but Differentiated Responsibility (the CBDR Principle), which has always been the cornerstone of international climate change law discourses. They also claimed that negotiation for a market based mechanism should not be continued without a clear commitment from the developed counters for promotion of technical co-operation and transfer of technology relating to the improvement of energy efficiency of ships. Against this backdrop, this article explores the challenges for the developing counters in the implementation of already adopted technical and operational measures.

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Cryotherapy is currently used in various clinical, rehabilitative, and sporting settings. However, very little is known regarding the impact of cooling on the microcirculatory response. Objectives: The present study sought to examine the influence of two commonly employed modalities of cryotherapy, whole body cryotherapy (WBC; -110°C) and cold water immersion(CWI; 8±1°C), on skin microcirculation in the mid- thigh region. Methods: The skin area examined was a 3 × 3 cm located between the most anterior aspect of the inguinal fold and the patella. Following 10 minutes of rest, 5 healthy, active males were exposed to either WBC for 3 minutes or CWI for 5 minutes in a randomised order. Volunteers lay supine for five minutes after treatment, in order to monitor the variation of red blood cell (RBC) concentration in the region of interest for a duration of 40 minutes. Microcirculation response was assessed using a non-invasive, portable instrument known as a Tissue Viability imaging system. After a minimum of seven days, the protocol was repeated. Subjective assessment of the volunteer’s thermal comfort and thermal sensation was also recorded. Results: RBC was altered following exposure to both WBC and CWI but appeared to stabilise approximately 35 minutes after treatments. Both WBC and CWI affected thermal sensation (p < 0.05); however no betweengroup differences in thermal comfort or sensation were recorded (p > 0.05). Conclusions: As both WBC and CWI altered RBC, further study is necessary to examine the mechanism for this alteration during whole body cooling.

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Drawing on the largest Australian collection and analysis of empirical data on multiple facets of Aboriginal and Torres Strait Islander education in state schools to date, this article critically analyses the systemic push for standardized testing and improved scores, and argues for a greater balance of assessment types by providing alternative, inclusive, participatory approaches to student assessment. The evidence for this article derives from a major evaluation of the Stronger Smarter Learning Communities. The first large-scale picture of what is occurring in classroom assessment and pedagogy for Indigenous students is reported in this evaluation yet the focus in this article remains on the issue of fairness in student assessment. The argument presented calls for “a good balance between formative and summative assessment” (OECD, Synergies for Better Learning An International Perspective on Evaluation and Assessment, Pointers for Policy Development, 2013) at a time of unrelenting high-stakes, standardized testing in Australia with a dominance of secondary as opposed to primary uses of NAPLAN data by systems, schools and principals. A case for more “intelligent accountability in education” (O’Neill, Oxford Review of Education 39(1):4–16, 2013) together with a framework for analyzing efforts toward social justice in education (Cazden, International Journal of Educational Psychology 1(3):178–198, 2012) and fairer assessment make the case for more alternative assessment practices in recognition of the need for teachers’ pedagogic practice to cater for increased diversity.

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Business Process Management (BPM) is rapidly evolving as an established discipline. There are a number of efforts underway to formalize the various aspects of BPM practice; creating a formal Body of Knowledge (BoK) is one such effort. Bodies of knowledge are artifacts that have a proven track record for accelerating the professionalization of various disciplines. In order for this to succeed in BPM, it is vital to involve the broader business process community and derive a BoK that has essential characteristics that addresses the discipline’s needs. We argue for the necessity of a comprehensive BoK for the BPM domain, and present a core list of essential features to consider when developing a BoK based on preliminary empirical evidence. The paper identifies and critiques existing Bodies of Knowledge related to BPM, and firmly calls for an effort to develop a more accurate and sustainable BoK for BPM. An approach for this effort is presented with preliminary outcomes.

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Emerging infectious diseases present a complex challenge to public health officials and governments; these challenges have been compounded by rapidly shifting patterns of human behaviour and globalisation. The increase in emerging infectious diseases has led to calls for new technologies and approaches for detection, tracking, reporting, and response. Internet-based surveillance systems offer a novel and developing means of monitoring conditions of public health concern, including emerging infectious diseases. We review studies that have exploited internet use and search trends to monitor two such diseases: influenza and dengue. Internet-based surveillance systems have good congruence with traditional surveillance approaches. Additionally, internet-based approaches are logistically and economically appealing. However, they do not have the capacity to replace traditional surveillance systems; they should not be viewed as an alternative, but rather an extension. Future research should focus on using data generated through internet-based surveillance and response systems to bolster the capacity of traditional surveillance systems for emerging infectious diseases.

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BACKGROUND: The intense pain and anxiety triggered by burns and their associated wound care procedures are well established in the literature. Non-pharmacological intervention is a critical component of total pain management protocols and is used as an adjunct to pharmacological analgesia. An example is virtual reality, which has been used effectively to dampen pain intensity and unpleasantness. Possible links or causal relationships between pain/anxiety/stress and burn wound healing have previously not been investigated. The purpose of this study is to investigate these relationships, specifically by determining if a newly developed multi-modal procedural preparation and distraction device (Ditto) used during acute burn wound care procedures will reduce the pain and anxiety of a child and increase the rate of re-epithelialization. METHODS/DESIGN: Children (4 to 12 years) with acute burn injuries presenting for their first dressing change will be randomly assigned to either the (1) Control group (standard distraction) or (2) Ditto intervention group (receiving Ditto, procedural preparation and Ditto distraction). It is intended that a minimum of 29 participants will be recruited for each treatment group. Repeated measures of pain intensity, anxiety, stress and healing will be taken at every dressing change until complete wound re-epithelialization. Further data collection will aid in determining patient satisfaction and cost effectiveness of the Ditto intervention, as well as its effect on speed of wound re-epithelialization. DISCUSSION: Results of this study will provide data on whether the disease process can be altered by reducing stress, pain and anxiety in the context of acute burn wounds. TRIAL REGISTRATION: ACTRN12611000913976.

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BACKGROUND: In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat, Acticoat combined with Mepitel and Mepilex Ag dressings for acute, paediatric partial thickness burns. METHODS/DESIGN: Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. DISCUSSION: The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613000105741.

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Agent-based modelling (ABM), like other modelling techniques, is used to answer specific questions from real world systems that could otherwise be expensive or impractical. Its recent gain in popularity can be attributed to some degree to its capacity to use information at a fine level of detail of the system, both geographically and temporally, and generate information at a higher level, where emerging patterns can be observed. This technique is data-intensive, as explicit data at a fine level of detail is used and it is computer-intensive as many interactions between agents, which can learn and have a goal, are required. With the growing availability of data and the increase in computer power, these concerns are however fading. Nonetheless, being able to update or extend the model as more information becomes available can become problematic, because of the tight coupling of the agents and their dependence on the data, especially when modelling very large systems. One large system to which ABM is currently applied is the electricity distribution where thousands of agents representing the network and the consumers’ behaviours are interacting with one another. A framework that aims at answering a range of questions regarding the potential evolution of the grid has been developed and is presented here. It uses agent-based modelling to represent the engineering infrastructure of the distribution network and has been built with flexibility and extensibility in mind. What distinguishes the method presented here from the usual ABMs is that this ABM has been developed in a compositional manner. This encompasses not only the software tool, which core is named MODAM (MODular Agent-based Model) but the model itself. Using such approach enables the model to be extended as more information becomes available or modified as the electricity system evolves, leading to an adaptable model. Two well-known modularity principles in the software engineering domain are information hiding and separation of concerns. These principles were used to develop the agent-based model on top of OSGi and Eclipse plugins which have good support for modularity. Information regarding the model entities was separated into a) assets which describe the entities’ physical characteristics, and b) agents which describe their behaviour according to their goal and previous learning experiences. This approach diverges from the traditional approach where both aspects are often conflated. It has many advantages in terms of reusability of one or the other aspect for different purposes as well as composability when building simulations. For example, the way an asset is used on a network can greatly vary while its physical characteristics are the same – this is the case for two identical battery systems which usage will vary depending on the purpose of their installation. While any battery can be described by its physical properties (e.g. capacity, lifetime, and depth of discharge), its behaviour will vary depending on who is using it and what their aim is. The model is populated using data describing both aspects (physical characteristics and behaviour) and can be updated as required depending on what simulation is to be run. For example, data can be used to describe the environment to which the agents respond to – e.g. weather for solar panels, or to describe the assets and their relation to one another – e.g. the network assets. Finally, when running a simulation, MODAM calls on its module manager that coordinates the different plugins, automates the creation of the assets and agents using factories, and schedules their execution which can be done sequentially or in parallel for faster execution. Building agent-based models in this way has proven fast when adding new complex behaviours, as well as new types of assets. Simulations have been run to understand the potential impact of changes on the network in terms of assets (e.g. installation of decentralised generators) or behaviours (e.g. response to different management aims). While this platform has been developed within the context of a project focussing on the electricity domain, the core of the software, MODAM, can be extended to other domains such as transport which is part of future work with the addition of electric vehicles.

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This document calls on governments, civil society and in particular educators to prioritize processes that develop and strengthen education for sustainable development (ESD). The world has changed since the UN World Summit on Sustainable Development in 2002. While there have been significant initiatives and progress has been made, the scale of effort is still overshadowed by the scope of the problem. For instance, human-induced climate change is creating a long-lasting ecological crisis with severe economic and social consequences. Recently the global economic crisis has drawn attention to the problem of borrowing from resources that do not exist. Poverty, conflict and social injustice remain critical issues on the global agenda. A renewed sense of commitment to the UN Decade of Education for Sustainable Development 2005-2014 is required. Formal, informal and non-formal education and learning processes for sustainability must be strengthened and prioritized. This document supports and builds on the concepts and values that are put forward within UNESCO’s International Implementation Scheme for Education for Sustainable Development and in the Earth Charter. The purpose of ESD is to reorient education in order to contribute to a sustainable future for the common good of present and future generations. ESD recognizes the interdependence of environmental, social and economic perspectives and the dependence of humanity on a healthy biosphere. Participation and involvement are necessary components of ESD, with an emphasis on empowerment and agency for active citizenship, human rights and societal change. Re-orientation is necessary at all levels and in all phases of education, and encompasses community learning, thus making ESD a wider process challenging the form and purpose of education itself.

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Considering the wide spectrum of situations that it may encounter, a robot navigating autonomously in outdoor environments needs to be endowed with several operating modes, for robustness and efficiency reasons. Indeed, the terrain it has to traverse may be composed of flat or rough areas, low cohesive soils such as sand dunes, concrete road etc... Traversing these various kinds of environment calls for different navigation and/or locomotion functionalities, especially if the robot is endowed with different locomotion abilities, such as the robots WorkPartner, Hylos [4], Nomad or the Marsokhod rovers.

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Considering the wide spectrum of situations that it may encounter, a robot navigating autonomously in outdoor environments needs to be endowed with several operating modes, for robustness and efficiency reasons. Indeed, the terrain it has to traverse may be composed of flat or rough areas, low cohesive soils such as sand dunes, concrete road etc. . .Traversing these various kinds of environment calls for different navigation and/or locomotion functionalities, especially if the robot is endowed with different locomotion abilities, such as the robots WorkPartner, Hylos [4], Nomad or the Marsokhod rovers. Numerous rover navigation techniques have been proposed, each of them being suited to a particular environment context (e.g. path following, obstacle avoidance in more or less cluttered environments, rough terrain traverses...). However, seldom contributions in the literature tackle the problem of selecting autonomously the most suited mode [3]. Most of the existing work is indeed devoted to the passive analysis of a single navigation mode, as in [2]. Fault detection is of course essential: one can imagine that a proper monitoring of the Mars Exploration Rover Opportunity could have avoided the rover to be stuck during several weeks in a dune, by detecting non-nominal behavior of some parameters. But the ability to recover the anticipated problem by switching to a better suited navigation mode would bring higher autonomy abilities, and therefore a better overall efficiency. We propose here a probabilistic framework to achieve this, which fuses environment related and robot related information in order to actively control the rover operations.

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Objectives: To investigate the relationship between two assessments to quantify delayed onset muscle soreness [DOMS]: visual analog scale [VAS] and pressure pain threshold [PPT]. Methods: Thirty-one healthy young men [25.8 ± 5.5 years] performed 10 sets of six maximal eccentric contractions of the elbow flexors with their non-dominant arm. Before and one to four days after the exercise, muscle pain perceived upon palpation of the biceps brachii at three sites [5, 9 and 13 cm above the elbow crease] was assessed by VAS with a 100 mm line [0 = no pain, 100 = extremely painful], and PPT of the same sites was determined by an algometer. Changes in VAS and PPT over time were compared amongst three sites by a two-way repeated measures analysis of variance, and the relationship between VAS and PPT was analyzed using a Pearson product-moment correlation. Results: The VAS increased one to four days after exercise and peaked two days post-exercise, while the PPT decreased most one day post-exercise and remained below baseline for four days following exercise [p < 0.05]. No significant difference among the three sites was found for VAS [p = 0.62] or PPT [p = 0.45]. The magnitude of change in VAS did not significantly correlate with that of PPT [r = −0.20, p = 0.28]. Conclusion: These results suggest that the level of muscle pain is not region-specific, at least among the three sites investigated in the study, and VAS and PPT provide different information about DOMS, indicating that VAS and PPT represent different aspects of pain.

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Background A goal of the postgraduate clinical pharmacy programme (PGCPP) at the University of Queensland is to enhance clinical practice. Aims To evaluate student perceptions of the impact of the PGCPP on practice and the inclusion of a competency-based performance evaluation as a formative component of the curriculum. Method In 2010, students completed a questionnaire to evaluate the impact of the PGCPP. In 2011, formative competency-based performance evaluations were conducted as a component of the course and the questionnaire was repeated. Responses, competency ratings and evaluation feedback were collated. Data were analysed using descriptive statistics. Results 51/57 (89%) of students completed the questionnaire in 2010 and 2011. Over 90% of students agreed or strongly agreed that the PGCPP enhanced practice, knowledge, confidence and contribution to patient care. Responses were similarly positive after the inclusion of the performance evaluation. Conclusion This study demonstrated that the PGCPP is achieving the goal of enhancing the practice of pharmacists.

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Purpose To investigate the differences between and variations across time in corneal topography and ocular wavefront aberrations in young Singaporean myopes and emmetropes. Methods We used a videokeratoscope and wavefront sensor to measure the ocular surface topography and wavefront aberrations of the total eye optics in the morning, mid-day and late afternoon on two separate days. Topography data were used to derive the corneal surface wavefront aberrations. Both the corneal and total wavefronts were analysed up to the 4th radial order of the Zernike polynomial expansion, and were centred on the entrance pupil (5 mm). The participants included 12 young progressing myopes, 13 young stable myopes and 15 young age-matched emmetropes. Results For all subjects considered together there were significant changes in some of the aberrations terms across the day, such as spherical aberration ( ) and vertical coma ( ) (repeated measures ANOVA, p<0.05). The magnitude of positive spherical aberration ( ) was significantly lower in the progressing myope group than that of the stable myopes (p=0.04) and emmetrope group (p=0.02). There were also significant interactions between refractive group and time of day for with/against-the-rule astigmatism ( ). Significantly lower 4th order RMS of ocular wavefront aberrations were found in the progressing myope group compared with the stable myopes and emmetropes (p<0.01). Conclusions These differences and variations in the corneal and total aberrations may have significance for our understanding of refractive error development and for clinical applications requiring accurate wavefront measurements.

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Aims This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure. Background Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour. Design Randomized controlled trial. Methods Heart failure patients attending cardiac clinics in northern Taiwan from October 2006–May 2007 were randomly assigned to two groups: control (n = 46) and intervention (n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models. Results Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use. Conclusion The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease.