604 resultados para critical condition


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Establishing communities of practice is a tenuous process fraught with a multiplicity of experiences and artefacts that come together and either strengthen or hinder the practice. In this chapter a diverse group of teacher educators reflect on their experience of being brought together to form a community of practice in the scholarship of teaching. Their task was to collaboratively consider and problem solve some of the key issues currently impacting on teacher education, and more broadly on higher education. How the group negotiated shared meaning and purpose is a focus of the chapter. There were many challenges and issues that the group needed to collaboratively and individually solve before progressing towards shared meaning. The experiences of the assigned leaders of this group are also considered, yet it is the evolving understanding of leadership through collaboration that is of greater importance. The interplay of the experiences of all group members along with the artefacts and practices that reify the group’s purpose are considered. We explore how the group members began to understand how to work collaboratively across the boundaries of their disciplines, and how reflecting on their learning and participation in this group enabled them to work through issues that were constraining their progress.

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At a time when debate over critical education is still going on in Australia, Nel Noddings’ book “Critical Lessons, What Our Schools Should Teach” is a timely and important read.Emeritus Professor of Education at Stanford University, Noddings calls us afresh to consider the deeper questions about the purpose of education – teaching adolescents to think clearly, critically and creatively in times when controversial topics (like the Iraq war) are often taboo in school curricula. In the face of what Noddings calls a pervasive neglect of critical and reflective thinking in high schools, teachers and teacher educators are asked to reconsider what we teach and the way we teach it.

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Since 2003, Mainland China has been promoting the public–private partnership (PPP) procurement model in the waste-to-energy incineration sector to reduce the waste burying rate and improve environmental quality. Five critical risk factors (CRFs) that affect the construction and operation of waste-to-energy incineration projects have been identified from real-life risk events of 14 PPP waste-to-energy incineration plants through content analysis. These risk factors are insufficient waste supply, disposal of non-licensed waste, environmental risk, payment risk, and lack of supporting infrastructure. A recently completed PPP waste-to-energy incineration plant, the Shanghai Tianma project, was investigated to learn from the effective management of CRFs. First-hand data about the Shanghai Tianma project was collected, with a focus on project negotiation and concession agreement. Lessons learned about risk management were acquired. This paper presents a detailed study of the contractual structure, risk sharing scheme, risk response measures to CRFs, and project transfer of a PPP project. The study results will provide governments with management implications to prepare equitable concession agreements and benefit private investors by effectively mitigating and managing risks in future PPP waste-to-energy incineration projects.

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Background Bloodstream infections resulting from intravascular catheters (catheter-BSI) in critical care increase patients' length of stay, morbidity and mortality, and the management of these infections and their complications has been estimated to cost the NHS annually £19.1–36.2M. Catheter-BSI are thought to be largely preventable using educational interventions, but guidance as to which types of intervention might be most clinically effective is lacking. Objective To assess the effectiveness and cost-effectiveness of educational interventions for preventing catheter-BSI in critical care units in England. Data sources Sixteen electronic bibliographic databases – including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health Literature (CINAHL), NHS Economic Evaluation Database (NHS EED), EMBASE and The Cochrane Library databases – were searched from database inception to February 2011, with searches updated in March 2012. Bibliographies of systematic reviews and related papers were screened and experts contacted to identify any additional references. Review methods References were screened independently by two reviewers using a priori selection criteria. A descriptive map was created to summarise the characteristics of relevant studies. Further selection criteria developed in consultation with the project Advisory Group were used to prioritise a subset of studies relevant to NHS practice and policy for systematic review. A decision-analytic economic model was developed to investigate the cost-effectiveness of educational interventions for preventing catheter-BSI. Results Seventy-four studies were included in the descriptive map, of which 24 were prioritised for systematic review. Studies have predominantly been conducted in the USA, using single-cohort before-and-after study designs. Diverse types of educational intervention appear effective at reducing the incidence density of catheter-BSI (risk ratios statistically significantly < 1.0), but single lectures were not effective. The economic model showed that implementing an educational intervention in critical care units in England would be cost-effective and potentially cost-saving, with incremental cost-effectiveness ratios under worst-case sensitivity analyses of < £5000/quality-adjusted life-year. Limitations Low-quality primary studies cannot definitively prove that the planned interventions were responsible for observed changes in catheter-BSI incidence. Poor reporting gave unclear estimates of risk of bias. Some model parameters were sourced from other locations owing to a lack of UK data. Conclusions Our results suggest that it would be cost-effective and may be cost-saving for the NHS to implement educational interventions in critical care units. However, more robust primary studies are needed to exclude the possible influence of secular trends on observed reductions in catheter-BSI.

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Large sized power transformers are important parts of the power supply chain. These very critical networks of engineering assets are an essential base of a nation’s energy resource infrastructure. This research identifies the key factors influencing transformer normal operating conditions and predicts the asset management lifespan. Engineering asset research has developed few lifespan forecasting methods combining real-time monitoring solutions for transformer maintenance and replacement. Utilizing the rich data source from a remote terminal unit (RTU) system for sensor-data driven analysis, this research develops an innovative real-time lifespan forecasting approach applying logistic regression based on the Weibull distribution. The methodology and the implementation prototype are verified using a data series from 161 kV transformers to evaluate the efficiency and accuracy for energy sector applications. The asset stakeholders and suppliers significantly benefit from the real-time power transformer lifespan evaluation for maintenance and replacement decision support.

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Animal models of critical illness are vital in biomedical research. They provide possibilities for the investigation of pathophysiological processes that may not otherwise be possible in humans. In order to be clinically applicable, the model should simulate the critical care situation realistically, including anaesthesia, monitoring, sampling, utilising appropriate personnel skill mix, and therapeutic interventions. There are limited data documenting the constitution of ideal technologically advanced large animal critical care practices and all the processes of the animal model. In this paper, we describe the procedure of animal preparation, anaesthesia induction and maintenance, physiologic monitoring, data capture, point-of-care technology, and animal aftercare that has been successfully used to study several novel ovine models of critical illness. The relevant investigations are on respiratory failure due to smoke inhalation, transfusion related acute lung injury, endotoxin-induced proteogenomic alterations, haemorrhagic shock, septic shock, brain death, cerebral microcirculation, and artificial heart studies. We have demonstrated the functionality of monitoring practices during anaesthesia required to provide a platform for undertaking systematic investigations in complex ovine models of critical illness.

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A theoretical basis is required for comparing key features and critical elements in wild fisheries and aquaculture supply chains under a changing climate. Here we develop a new quantitative metric that is analogous to indices used to analyse food-webs and identify key species. The Supply Chain Index (SCI) identifies critical elements as those elements with large throughput rates, as well as greater connectivity. The sum of the scores for a supply chain provides a single metric that roughly captures both the resilience and connectedness of a supply chain. Standardised scores can facilitate cross-comparisons both under current conditions as well as under a changing climate. Identification of key elements along the supply chain may assist in informing adaptation strategies to reduce anticipated future risks posed by climate change. The SCI also provides information on the relative stability of different supply chains based on whether there is a fairly even spread in the individual scores of the top few key elements, compared with a more critical dependence on a few key individual supply chain elements. We use as a case study the Australian southern rock lobster Jasus edwardsii fishery, which is challenged by a number of climate change drivers such as impacts on recruitment and growth due to changes in large-scale and local oceanographic features. The SCI identifies airports, processors and Chinese consumers as the key elements in the lobster supply chain that merit attention to enhance stability and potentially enable growth. We also apply the index to an additional four real-world Australian commercial fishery and two aquaculture industry supply chains to highlight the utility of a systematic method for describing supply chains. Overall, our simple methodological approach to empirically-based supply chain research provides an objective method for comparing the resilience of supply chains and highlighting components that may be critical.

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Background Today, finding an ideal biomaterial to treat the large bone defects, delayed unions and non-unions remains a challenge for orthopaedic surgeions and researchers. Several studies have been carried out on the subject of bone regeneration, each having its own advantages. The present study has been designed in vivo to evaluate the effects of cellular auto-transplantation of tail vertebrae on healing of experimental critical bone defect in a dog model. Methods Six indigenous breeds of dog with 32 ± 3.6 kg average weight from both sexes (5 males and 1 female) received bilateral critical-sized ulnar segmental defects. After determining the health condition, divided to 2 groups: The Group I were kept as control I (n = 1) while in Group II (experimental group; n = 5) bioactive bone implants were inserted. The defects were implanted with either autogeneic coccygeal bone grafts in dogs with 3-4 cm diaphyseal defects in the ulna. Defects were stabilized with internal plate fixation, and the control defects were not stabilized. Animals were euthanized at 16 weeks and analyzed by histopathology. Results Histological evaluation of this new bone at sixteen weeks postoperatively revealed primarily lamellar bone, with the formation of new cortices and normal-appearing marrow elements. And also reformation cortical compartment and reconstitution of marrow space were observed at the graft-host interface together with graft resorption and necrosis responses. Finally, our data were consistent with the osteoconducting function of the tail autograft. Conclusions Our results suggested that the tail vertebrae autograft seemed to be a new source of autogenous cortical bone in order to supporting segmental long bone defects in dogs. Furthermore, cellular autotransplantation was found to be a successful replacement for the tail vertebrae allograft bone at 3-4 cm segmental defects in the canine mid- ulna. Clinical application using graft expanders or bone autotransplantation should be used carefully and requires further investigation.

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Theodor Adorno was opposed to the cinema because he felt it was too close to reality, and ipso facto an extension of ideological Capital, as he wrote in 1944 in Dialectic of Enlightenment. What troubled Adorno was the iconic nature of cinema – the semiotic category invented by C. S. Peirce where the signifier (sign) does not merely signify, in the arbitrary capacity attested by Saussure, but mimics the formal-visual qualities of its referent. Iconicity finds its perfect example in the film’s ingenuous surface illusion of an unmediated reality – its genealogy (the iconic), since classical antiquity, lay in the Greek term eikōn which meant “image,” to refer to the ancient portrait statues of victorious athletes which were thought to bear a direct similitude with their parent divinities. For the postwar, Hollywood-film spectator, Adorno said, “the world outside is an extension of the film he has just left,” because realism is a precise instrument for the manipulation of the mass spectator by the culture industry, for which the filmic image is an advertisement for the world unedited. Mimesis, or the reproduction of reality, is a “mere reproduction of the economic base.” It is precisely film’s iconicity, then, its “realist aesthetic . . . [that] makes it inseparable from its commodity character.”...

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This is a critical review of the scope of the literacy curriculum in the twenty-first century, uncovering the strengths, controversies, and silences that have divided literacy researchers and educators. It conceptualizes the literacy curriculum as a particular set of socially organized symbolic practices that are always selective, and which are inextricably connected to the function and organization of schooling. We trace the political, historical, and ideological antecedents of literacy curriculum and schooling as a form of cultural apparatus of the nation-state, before tracing some of the major interpretive paradigms that have influenced the shape of the literacy curriculum in many parts of the world. These include debates about skills-based approaches, whole language, systemic functional grammar, and critical literacy. It then draws attention to noteworthy advances and shifts in the field over recent decades: debates about the role of orality in the literacy curriculum, home-school community literacy practices, teacher and student knowledge of language and grammar, and the role of curriculum area literacies. It anticipates the future of the literacy curriculum in online textual environments and the changing sensorial and material nature of literacy practices, while acknowledging that curriculum innovation is always limited in complex ways by historically established pedagogic discourses of schooling.

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Critical reflection is central to improving practices in early years services. It is also a learned skill.

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In this chapter, we explore the 'darker' faces of international business (IB). Over a decade ago, Eden and Len way (2001) raised the need for examining both the 'bright' and the 'dark' side of globalization in order to achieve a better understanding of the concept and of its impact on IB activities. In doing this, they posited the multinational enterprise (MNE) as the 'key agent' and 'f.1ee' of globalization and discussed, primarily, the relationship between MNEs and nation-states as the central interf.1ce of its impact. Additionally, they posited that, by and large, the community of IB scholars positioned themselves at the bright end of the globalization spectrum, seeing it as essentially positive, whilst most non-governmental organizations (NGOs) and international political economy (IPE) academics set themselves at the dark end. Whilst they acknowledged their own 'bright side' tendencies, they called for a more nuanced consideration of MNEs as what they referred to as the Janus bee' of globalization.

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The safety and performance of bridges could be monitored and evaluated by Structural Health Monitoring (SHM) systems. These systems try to identify and locate the damages in a structure and estimate their severities. Current SHM systems are applied to a single bridge, and they have not been used to monitor the structural condition of a network of bridges. This paper propose a new method which will be used in Synthetic Rating Procedures (SRP) developed by the authors of this paper and utilizes SHM systems for monitoring and evaluating the condition of a network of bridges. Synthetic rating procedures are used to assess the condition of a network of bridges and identify their ratings. As an additional part of the SRP, the method proposed in this paper can continuously monitor the behaviour of a network of bridges and therefore it can assist to prevent the sudden collapses of bridges or the disruptions to their serviceability. The method could be an important part of a bridge management system (BMS) for managers and engineers who work on condition assessment of a network of bridges.

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This paper explores the efficacy of narrative in reflective practice across a range of creative disciplines. As practitioners within the creative industries the authors internalise experience and re-contextualise it as stories, designs, music videos, fiction and non-fiction films and dance. They are uniquely placed to examine narrative in critical reflection through the prism of their creative practice and in so doing offer insights into reconceptualising professional practice. The authors demonstrate how engagement with and reflection on and in their stories enables wider reflection. Their purpose in reflection is not just to learn from mistakes but to develop an epistemology of practice that enables them to apply rigorous academic inquiry to articulate their tacit professional knowledge and establish new methods for dealing with uncertainty in creative practice research.

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This study involves the analysis of one of the most recent Indigenous Education policies, the Aboriginal and Torres Strait Islander Education Action Plan 2010-2014 (MCEECDYA, 2011). It examines how the language used within policy positions Aboriginal and Torres Strait Islander peoples. Articulating Rigney's (1999) Indigenist Research Principles with Fairclough's (2001) Critical Discourse Analysis provides a platform for critical dialogues about policy decision-making. In doing so, this articulation enables and emphasises the need for potential policy revision to contribute to the Aboriginal and Torres Strait Islander struggle for self-determination.