89 resultados para Sense and reference


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In hyper competition, firms that are agile: sensing and responding better to customer requirements tend to be more successful and achieve supernormal profits. In spite of the widely accepted importance of customer agility, research is limited on this construct. The limited research also has predominantly focussed on the firm’s perspective of agility. However, we propose that the customers are better positioned to determine how well a firm is responding to their requirements (aka a firm’s customer agility). Taking the customers’ stand point, we address the issue of sense and respond alignment in two perspectives-matching and mediating. Based on data collected from customers in a field study, we tested hypothesis pertaining to the two methods of alignment using polynomial regression and response surface methodology. The results provide a good explanation for the role of both forms of alignment on customer satisfaction. Implication for research and practice are discussed.

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This study was a step forward in modeling, simulation and microcontroller implementation of a high performance control algorithm for the motor of a blood pump. The rotor angle is sensed using three Hall effect sensors and an algorithm is developed to obtain better angular resolution from the three signals for better discrete-time updates of the controller. The performance of the system was evaluated in terms of actual and reference speeds, stator currents and power consumption over a range of reference speeds up to 4000 revolutions per minute. The use of fewer low cost Hall effect sensors compared to expensive high resolution sensors could reduce the cost of blood pumps for total artificial hearts.

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BACKGROUND Asthma severity and control can be measured both subjectively and objectively. Sputum analysis for evaluation of percentage of sputum eosinophilia directly measures airway inflammation, and is one method of objectively monitoring asthma. Interventions for asthma therapies have been traditionally based on symptoms and spirometry. OBJECTIVES To evaluate the efficacy of tailoring asthma interventions based on sputum analysis in comparison to clinical symptoms (with or without spirometry/peak flow) for asthma related outcomes in children and adults. SEARCH STRATEGY We searched the Cochrane Airways Group Specialised Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and reference lists of articles. The last search was on 31 October 2006. SELECTION CRITERIA All randomised controlled comparisons of adjustment of asthma therapy based on sputum eosinophils compared to traditional methods (primarily clinical symptoms and spirometry/peak flow). DATA COLLECTION AND ANALYSIS Results of searches were reviewed against pre-determined criteria for inclusion. Three sets of reviewers selected relevant studies.Two review authors independently assessed trial quality extracted data. Authors were contacted for further information but none were received. Data was analysed as "treatment received" and sensitivity analyses performed. MAIN RESULTS Three adult studies were included; these studies were clinically and methodologically heterogenous (use of medications, cut off for percentage of sputum eosinophils and definition of asthma exacerbation). There were no eligible paediatric studies. Of 246 participants randomised, 221 completed the trials. In the meta-analysis, a significant reduction in number of participants who had one or more asthma exacerbations occurred when treatment was based on sputum eosinophils in comparison to clinical symptoms; pooled odds ratio (OR) was 0.49 (95% CI 0.28 to 0.87); number needed to treat to benefit (NNTB) was 6 (95% CI 4 to 32).There were also differences between groups in the rate of exacerbation (any exacerbation per year) and severity of exacerbations defined by requirement for use of oral corticosteroids but the reduction in hospitalisations was not statistically significant. Data for clinical symptoms, quality of life and spirometry were not significantly different between groups. The mean dose of inhaled corticosteroids per day was similar in both groups and no adverse events were reported. However sputum induction was not always possible. AUTHORS' CONCLUSIONS Tailored asthma interventions based on sputum eosinophils is beneficial in reducing the frequency of asthma exacerbations in adults with asthma. This review supports the use of sputum eosinophils to tailor asthma therapy for adults with frequent exacerbations and severe asthma. Further studies need to be undertaken to strengthen these results and no conclusion can be drawn for children with asthma.

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Background The measurement of severity and control of asthma in both children and adults can be based on subjective or objective measures. It has been advocated that fractional exhaled nitric oxide (FeNO) can be used to monitor airway inflammation as it correlates with some markers of asthma. Interventions for asthma therapies have been traditionally based on symptoms and/or spirometry. Objectives To evaluate the efficacy of tailoring asthma interventions based on exhaled nitric oxide in comparison to clinical symptoms (with or without spirometry/peak flow) for asthma related outcomes in children and adults. Search methods We searched the Cochrane Airways Group Specialised Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and reference lists of articles. The last search was completed in February 2009. Selection criteria All randomised controlled comparisons of adjustment of asthma therapy based on exhaled nitric oxide compared to traditional methods (primarily clinical symptoms and spirometry/peak flow). Data collection and analysis Results of searches were reviewed against pre-determined criteria for inclusion. Relevant studies were independently selected in duplicate. Two authors independently assessed trial quality and extracted data. Authors were contacted for further information with response from one. Main results Two studies have been added for this update, which now includes six (2 adults and 4 children/adolescent) studies; these studies differed in a variety of ways including definition of asthma exacerbations, FeNO cut off levels, the way in which FeNO was used to adjust therapy and duration of study. Of 1053 participants randomised, 1010 completed the trials. In the meta-analysis, there was no significant difference between groups for the primary outcome of asthma exacerbations or for other outcomes (clinical symptoms, FeNO level and spirometry). In post-hoc analysis, a significant reduction in mean final daily dose inhaled corticosteroid per adult was found in the group where treatment was based on FeNO in comparison to clinical symptoms, (mean difference -450 mcg; 95% CI -677 to -223 mcg budesonide equivalent/day). However, the total amount of inhaled corticosteroid used in one of the adult studies was 11% greater in the FeNO arm. In contrast, in the paediatric studies, there was a significant increase in inhaled corticosteroid dose in the FeNO strategy arm (mean difference of 140 mcg; 95% CI 29 to 251, mcg budesonide equivalent/day). Authors' conclusions Tailoring the dose of inhaled corticosteroids based on exhaled nitric oxide in comparison to clinical symptoms was carried out in different ways in the six studies and found only modest benefit at best and potentially higher doses of inhaled corticosteroids in children. The role of utilising exhaled nitric oxide to tailor the dose of inhaled corticosteroids cannot be routinely recommended for clinical practice at this stage and remains uncertain.

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Asthma severity and control can be measured both subjectively and objectively. Traditionally asthma treatments have been individualised using symptoms and spirometry/peak flow. Increasingly treatment tailored in accordance with inflammatory markers (sputum eosinophil counts or fractional exhaled nitric oxide (FeNO) data) is advocated as an alternative strategy. The objective of this review was to evaluate the efficacy of tailoring asthma interventions based on inflammatory markers (sputum analysis and FeNO) in comparison with clinical symptoms (with or without spirometry/peak flow) for asthma-related outcomes in children and adults. Cochrane Airways Group Specialised Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and reference lists of articles were searched. The last searches were in February 2009. All randomised controlled comparisons of adjustment of asthma treatment based on sputum analysis or FeNO compared with traditional methods (primarily clinical symptoms and spirometry/peak flow) were selected. Results of searches were reviewed against predetermined criteria for inclusion. Relevant studies were selected, assessed and data extracted independently by at least two people. The trial authors were contacted for further information. Data were analysed as 'intervention received' and sensitivity analyses performed. Six (2 adults and 4 children/adolescent) studies utilising FeNO and three adult studies utilising sputum eosinophils were included. These studies had a degree of clinical heterogeneity including definition of asthma exacerbations, duration of study and variations in cut-off levels for percentage of sputum eosinophils and FeNO to alter management in each study. Adults who had treatment adjusted according to sputum eosinophils had a reduced number of exacerbations compared with the control group (52 vs. 77 patients with >=1 exacerbation in the study period; p=0.0006). There was no significant difference in exacerbations between groups for FeNO compared with controls. The daily dose of inhaled corticosteroids at the end of the study was decreased in adults whose treatment was based on FeNO in comparison with the control group (mean difference -450.03 mug, 95% CI -676.73 to -223.34; p<0.0001). However, children who had treatment adjusted according to FeNO had an increase in their mean daily dose of inhaled corticosteroids (mean difference 140.18 mug, 95% CI 28.94 to 251.42; p=0.014). It was concluded that tailoring of asthma treatment based on sputum eosinophils is effective in decreasing asthma exacerbations. However, tailoring of asthma treatment based on FeNO levels has not been shown to be effective in improving asthma outcomes in children and adults. At present, there is insufficient justification to advocate the routine use of either sputum analysis (due to technical expertise required) or FeNO in everyday clinical practice.

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The Australian Civil Aviation Safety Authority (CASA) currently lists more than 100 separate entities or organisations which maintain a UAS Operator Certificate (UOC) [1]. Approved operations are overwhelmingly a permutation of aerial photography, surveillance, survey or spotting and predominantly, are restricted to Visual Line of Sight (VLOS) operations, below 400 feet, and not within 3 NM of an aerodrome. However, demand is increasing for a Remote Piloted Aerial System (RPAS) regulatory regime which facilitates more expansive operations, in particular unsegregated, Beyond Visual Line of Sight (BVLOS) operations. Despite this demand, there is national and international apprehension regarding the necessary levels of airworthiness and operational regulation required to maintain safety and minimise the risk associated with unsegregated operations. Fundamental to addressing these legitimate concerns will be the mechanisms that underpin safe separation and collision avoidance. Whilst a large body of research has been dedicated to investigating on-board, Sense and Avoid (SAA) technology necessary to meet this challenge, this paper focuses on the contribution of the NAS to separation assurance, and how it will support, as well as complicate RPAS integration. The paper collates and presents key, but historically disparate, threads of Australian RPAS and NAS related information, and distils it with a filter focused on minimising RPAS collision risk. Our ongoing effort is motivated by the need to better understand the separation assurance contribution provided by the NAS layers, in the first instance, and subsequently employ this information to identify scenarios where the coincident collision risk is demonstrably low, providing legitimate substantiation for concessions on equipage and airworthiness standards.

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Adjustable speed induction generators, especially the Doubly-Fed Induction Generators (DFIG) are becoming increasingly popular due to its various advantages over fixed speed generator systems. A DFIG in a wind turbine has ability to generate maximum power with varying rotational speed, ability to control active and reactive by integration of electronic power converters such as the back-to-back converter, low rotor power rating resulting in low cost converter components, etc, DFIG have become very popular in large wind power conversion systems. This chapter presents an extensive literature survey over the past 25 years on the different aspects of DFIG. Application of H8 Controller for enhanced DFIG-WT performance in terms of robust stability and reference tracking to reduce mechanical stress and vibrations is also demonstrated in the chapter.

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Subdiffusion equations with distributed-order fractional derivatives describe some important physical phenomena. In this paper, we consider the time distributed-order and Riesz space fractional diffusions on bounded domains with Dirichlet boundary conditions. Here, the time derivative is defined as the distributed-order fractional derivative in the Caputo sense, and the space derivative is defined as the Riesz fractional derivative. First, we discretize the integral term in the time distributed-order and Riesz space fractional diffusions using numerical approximation. Then the given equation can be written as a multi-term time–space fractional diffusion. Secondly, we propose an implicit difference method for the multi-term time–space fractional diffusion. Thirdly, using mathematical induction, we prove the implicit difference method is unconditionally stable and convergent. Also, the solvability for our method is discussed. Finally, two numerical examples are given to show that the numerical results are in good agreement with our theoretical analysis.

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In a three day trial in April 2008, the United States District Court for the Southern District of New York considered whether the Harry Potter Lexicon infringed the intellectual property rights of J.K. Rowling and Warner Brothers. The case has attracted great media attention. As John Crace, a reporter for The Guardian, observed: “On one side: global-celebrity author J.K. Rowling. On the other: an amateur fan site devoted to the world's favourite boy wizard. At stake: the soul of Harry Potter.” J.K. Rowling is the author of the seven book Harry Potter series, which tell the story of a young wizard, Harry Potter, and his battles with Voldemort, the Lord of Darkness. As the court papers noted, “The Harry Potter Books are a modern day publishing phenomenon and success story.” Warner Brothers sought and obtained the film rights to the series. The entertainment company has thus far produced five films; a sixth is due in November 2008; and the final instalment is planned. The Harry Potter Lexicon is a reference guide created by Steven Vander Ark, a former grade school teacher. He has organised a large volume of material on the Harry Potter books and the Harry Potter films on a website in an alphabetical listing, from “A-Z”. The founder of RDR Books, Roger Rapoport, approached Ark to publish the Harry Potter Lexicon in a book form. Ark agreed to this request, and provided the publisher with a condensed version of the web-site. After RDR Books announced its intention to publish the reference book, J.K. Rowling and Warner Brothers brought a legal action in the United States District Court for the Southern District of New York, alleging that the publishers of the Harry Potter Lexicon were in breach of various intellectual property rights. A spokesperson for Warner Brothers and J.K. Rowling observed: "A fan’s affectionate enthusiasm should not obscure acts of plagiarism. The publishers knew what they were doing. The problem remains that the Lexicon takes an enormous amount of Ms. Rowling’s work and adds virtually no original commentary of its own. As we’ve said in court, it takes too much and adds too little. Authors have a duty to prevent the exploitation of their works by people who contribute nothing original, creative or interpretive." The litigation involves the intersection of copyright law, trade mark law, and consumer protection law. It has a wider significance because it deals with the protection of authorial rights; the use of literary indexes, supplements and reference guides; and the clash between character merchandising and fan fiction.

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Background Hepatitis C (HCV) was described as a “viral time bomb” due to its prevalence and potential for causing serious, life-threatening complications. The Australian’s National Hepatitis C Strategy calls for a coordinated, evidence-based approach to testing, management, care and support of HCV. This review aimed to systematically and comparatively appraise existing international HCV clinical guidelines. Methods A systematic search of bibliographic databases and reference lists from selected papers were the source of data. Inclusion criteria were latest clinical guidelines as defined by Institute of Medicine, published in English, between January 2002 and November 2014. Quality of the guidelines was independently assessed using the iCAHE instrument. Results Twenty-eight international clinical practice guidelines were included. The majority of the international guidelines were based on the same primary studies however clinical recommendations on pre- and in-treatment assessments, choice of pharmaceuticals, and dosages and duration of the same pharmaceutical agents varied considerably. This diversity was beyond what would be considered reasonable practice context variations. Furthermore, there is limited guidance on post-treatment surveillance and care. Conclusions/implications There is a need for a harmonised international consensus on the clinical management of HCV. Key message A lack of consistency among international HCV clinical guidelines may impede effective and efficient patient care.

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Debates on gene patents have necessitated the analysis of patents that disclose and reference human sequences. In this study, we built an automated classifier that assigns sequences to one of nine predefined categories according to their functional roles in patent claims by applying natural language processing and supervised learning techniques. To improve its correctness, we experimented with various feature mappings, resulting in the maximal accuracy of 79%.

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Background The purpose of this study was to explore the workplace acceptance and experiences of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) paramedics. Methods A systematic search of academic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were research papers published in English, which focused on workplace acceptance and experiences of LGBTIQ health personnel. Results The initial focus of this systematic review was the workplace acceptance and experiences of LGBTIQ paramedics. However due to no published research specific to the paramedic profession the scope of the review was broadened to include of all LGBTIQ health personnel. Thirty-three papers were included in this review. Evidence indicated that LGBTIQ health professionals experienced discrimination from their patients, heterosexual colleagues and ‘closeted’ LGBTIQ peers. Positive contribution of LGBTIQ health professionals include improved patient care and role models for LGBTIQ peers. Inclusive policy is required for LGBTIQ health professional workforce retention. Conclusions The paramedic workforce is known to be a high risk occupational group for post-traumatic stress disorder and depression. Theoretically, LGBTIQ paramedics working in a heteronormative culture experience increased level of stress. While LGBTIQ health professionals receive legislative protection against discrimination, discrimination still exists in practice through lack of visibility. Effective and efficient integration of LGBTIQ health professionals could improve workplace satisfaction, workforce retention, and equity of access by marginalised groups. An inclusive workplace policy of LGBTIQ embraces and celebrates the value of diversity.

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Background Around the world, guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) vary greatly. To prevent occlusion, most institutions recommend the use of heparin when the CVC is not in use. However, there is debate regarding the need for heparin and evidence to suggest normal saline may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased costs. Objectives To assess the clinical effects (benefits and harms) of heparin versus normal saline to prevent occlusion in long-term central venous catheters in infants, children and adolescents. Design A Cochrane systematic review of randomised controlled trials was undertaken. - Data sources: The Cochrane Vascular Group Specialised Register (including MEDLINE, CINAHL, EMBASE and AMED) and the Cochrane Register of Studies were searched. Hand searching of relevant journals and reference lists of retrieved articles was also undertaken. - Review Methods: Data were extracted and appraisal undertaken. We included studies that compared the efficacy of normal saline with heparin to prevent occlusion. We excluded temporary CVCs and peripherally inserted central catheters. Rate ratios per 1000 catheter days were calculated for two outcomes, occlusion of the CVC, and CVC-associated blood stream infection. Results Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin. However, between studies, all used different protocols with various concentrations of heparin and frequency of flushes. The quality of the evidence ranged from low to very low. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). Conclusions It remains unclear whether heparin is necessary for CVC maintenance. More well-designed studies are required to understand this relatively simple, but clinically important question. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.

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"Human service workers need more than just common sense. This book offers a comprehensive introduction to practice skills required across the human service sector. The authors use critical analysis to systematically outline the key stages of interaction with clients."--Libraries Australia "A thorough introduction to the core practice skills needed by social work and welfare professionals. Human service workers need more than just common sense. Practice Skills in Social Work and Welfare offers a comprehensive introduction to practice skills required across the human service sector. The authors use critical analysis to systematically outline the key stages of interaction with clients: engagement, assessment, intervention and evaluation. Drawing on a strengths approach, they examine the skills needed for working with different types of clients: individuals, families and community groups. They also explore the dilemmas faced in daily practice, including the challenges of working with involuntary clients, clients from different cultural backgrounds, and clients in crisis situations. Practice Skills in Social Work and Welfare provides a model of integrated practice which incorporates the key components of ideology, theory, phase, skill and context. Detailed case studies demonstrate how welfare services can be delivered in different contexts. Written by experienced teachers and practitioners from Australia and New Zealand, Practice Skills in Social Work and Welfare is a practical and user friendly text for students and reference for practitioners"--Publisher website

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"Fully revised edition of this widely used introduction to the core practice skills needed by social work and other human service professionals. 'The main strength of the book is the consistency of its themes throughout the text.I would like to commend the editors of this book for the contribution it should make to practice teaching with social work and welfare' - Karen Heycox in Australian Social Work Human service workers need more than just common sense. Practice Skills in Social Work and Welfare offers a comprehensive introduction to practice skills required across the human service sector. The authors use critical analysis to systematically outline the key stages of interaction with clients: engagement, assessment, intervention and evaluation. Drawing on a strengths approach, they examine the skills needed for working with different types of clients: individuals, families and community groups. They also explore the dilemmas faced in daily practice, including the challenges of working with involuntary clients, clients from different cultural backgrounds, and clients in crisis situations. Practice Skills in Social Work and Welfare provides a model of integrated practice which incorporates the key components of ideology, theory, phase, skill and context. Detailed case studies demonstrate how welfare services can be delivered in different contexts. This second edition has been thoroughly revised and updated and includes new material on online services and strengths-based practice. Written by experienced teachers and practitioners from Australia and New Zealand, Practice Skills in Social Work and Welfare is a practical and user friendly text for students and reference for practitioners."--Publisher website