297 resultados para Ward, Willis
Resumo:
Management of acute heart failure is an important consideration in critical care. Mechanical support of the failing heart is crucial for improving health outcomes. The most common Australasian application of intraaortic balloon counterpulsation (IABP) is in the setting of cardiogenic shock. High end users of IABP (>37/annum) demonstrate significantly lower mortality for cardiogenic shock managed with IABP (p <0.001) in contrast to hospitals which employ limited IABP (<4/annum). This underscores the importance of proficiency in managing patient receiving IABP support. Nurses play a crucial role in carding for patients with acute heart failure. This paper summarises care considerations for management of the IABP.
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This paper presents the findings of an investigation into the rate-limiting mechanism for the heterogeneous burning in oxygen under normal gravity and microgravity of cylindrical iron rods. The original objective of the work was to determine why the observed melting rate for burning 3.2-mm diameter iron rods is significantly higher in microgravity than in normal gravity. This work, however, also provided fundamental insight into the rate-limiting mechanism for heterogeneous burning. The paper includes a summary of normal-gravity and microgravity experimental results, heat transfer analysis and post-test microanalysis of quenched samples. These results are then used to show that heat transfer across the solid/liquid interface is the rate-limiting mechanism for melting and burning, limited by the interfacial surface area between the molten drop and solid rod. In normal gravity, the work improves the understanding of trends reported during standard flammability testing for metallic materials, such as variations in melting rates between test specimens with the same cross-sectional area but different crosssectional shape. The work also provides insight into the effects of configuration and orientation, leading to an improved application of standard test results in the design of oxygen system components. For microgravity applications, the work enables the development of improved methods for lower cost metallic material flammability testing programs. In these ways, the work provides fundamental insight into the heterogeneous burning process and contributes to improved fire safety for oxygen systems in applications involving both normal-gravity and microgravity environments.
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This paper presents a proposed qualitative framework to discuss the heterogeneous burning of metallic materials, through parameters and factors that influence the melting rate of the solid metallic fuel (either in a standard test or in service). During burning, the melting rate is related to the burning rate and is therefore an important parameter for describing and understanding the burning process, especially since the melting rate is commonly recorded during standard flammability testing for metallic materials and is incorporated into many relative flammability ranking schemes. However, whilst the factors that influence melting rate (such as oxygen pressure or specimen diameter) have been well characterized, there is a need for an improved understanding of how these parameters interact as part of the overall melting and burning of the system. Proposed here is the ‘Melting Rate Triangle’, which aims to provide this focus through a conceptual framework for understanding how the melting rate (of solid fuel) is determined and regulated during heterogeneous burning. In the paper, the proposed conceptual model is shown to be both (a) consistent with known trends and previously observed results, and (b)capable of being expanded to incorporate new data. Also shown are examples of how the Melting Rate Triangle can improve the interpretation of flammability test results. Slusser and Miller previously published an ‘Extended Fire Triangle’ as a useful conceptual model of ignition and the factors affecting ignition, providing industry with a framework for discussion. In this paper it is shown that a ‘Melting Rate Triangle’ provides a similar qualitative framework for burning, leading to an improved understanding of the factors affecting fire propagation and extinguishment.
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This paper examines the patterns of television news coverage of the political parties, their leaders and the issues they raised during the 2001 Australian federal election campaign. By focusing on some issues, parties and leaders, television has long been argued to constrain voters' evaluations. We find that television news coverage in the 2001 Australian election campaign focused primarily on international issues, especially terrorism and asylum seekers, and on the two major parties - virtually to the exclusion of coverage of the minor parties and their leaders. Within the major party 'two-horse race', television gave substantially more coverage to the leaders than to the parties themselves, thereby sustaining what some have called a 'presidential'-style political contest. John Howard emerged as the winner in the leaders' stakes, garnering more coverage than Labor's Kim Beazley.
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The macerals in bituminous coals with varying organic sulfur content from the Early Permian Greta Coal Measures at three locations (Southland Colliery, Drayton Colliery and the Cranky Corner Basin), in and around the Sydney Basin (Australia), have been studied using light-element electron microprobe (EMP) analysis and micro-ATR–FTIR. Electron microprobe analysis of individual macerals reveals that the vitrinite in both the Cranky Corner Basin and Drayton Colliery (Puxtrees seam) samples have similar carbon contents (ca. 78% C in telocollinite), suggesting that they are of equivalent rank. However, the Cranky Corner coals have anomalously low vitrinite reflectance (down to 0.45%) vs. the Drayton materials (ca. 0.7%). They also have very high organic S content (3–6.5%) and lower O content (ca. 10%) than the equivalent macerals in the Drayton sample (0.7% S and 15.6% O). A study was carried out to investigate the impacts of the high organic S on the functional groups of the macerals in these two otherwise iso-rank, stratigraphically-equivalent seams. An iso-rank low-S coal from the overlying Wittingham Coal Measures near Muswellbrook and coals of slightly higher rank from the Greta Coal Measures at Southland Colliery near Cessnock were also evaluated using the same techniques to extend the data set. Although the telocollinite in the Drayton and Cranky Corner coals have very similar carbon content (ca.78% C), the ATR–FTIR spectra of the vitrinite and inertinite macerals in these respectively low S and high S coals show some distinct differences in IR absorbance from various aliphatic and aromatic functional groups. The differences in absorbance of the aliphatic stretching bands (2800–3000 cm−1) and the aromatic carbon (CC) peak at 1606 cm−1 are very obvious. Compared to that of the Drayton sample (0.7% S and 15% O), the telocollinite of the Cranky Corner coal (6% S and 10% O) clearly shows: (i) less absorbance from OH groups, represented by a broad region around 3553 cm−1, (ii) much stronger aliphatic C–H absorbance (stretching modes around 3000–2800 cm−1 and bending modes around 1442 cm−1) and (iii) less absorbance from aromatic carbon functional groups (peaking at 1606 cm−1). Evaluation of the iso-rank Drayton and Cranky Corner coals shows that: (i) the aliphatic C–H absorbances decrease with increasing oxygen content but increase with increasing organic S content and (ii) the aromatic H to aliphatic H ratio (Har/Hali) for the telocollinite increases with (organic) O%, but decreases progressively with increasing organic S. The high organic S content in the maceral appears to be accompanied by a greater proportion of aliphatic functional groups, possibly as a result of some of the O within maceral ring structures in the high S coal samples being replaced.
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This paper is a report of a study to explore what constitutes nurse-patient interactions and to ascertain patients' perceptions of these interactions. BACKGROUND: Nurses maintain patient integrity through caring practices. When patients feel disempowered or that their integrity is threatened they are more likely to make a complaint. When nurses develop a meaningful relationship with patients they recognize and address their concerns. It is increasingly identified in the literature that bureaucratic demands, including increased workloads and reduced staffing levels, result in situations where the development of a 'close' relationship is limited. METHOD: Data collection took two forms: twelve 4-hour observation periods of nurse-patient interactions in one cubicle (of four patients) in a medical and a surgical ward concurrently over a 4-week period; and questionnaires from inpatients of the two wards who were discharged during the 4-week data collection period in 2005. FINDINGS: Observation data showed that nurse-patient interactions were mostly friendly and informative. Opportunities to develop closeness were limited. Patients were mostly satisfied with interactions. The major source of dissatisfaction was when patients perceived that nurses were not readily available to respond to specific requests. Comparison of the observation and survey data indicated that patients still felt 'cared for' even when practices did not culminate in a 'connected' relationship. CONCLUSION: The findings suggest that patients believe that caring is demonstrated when nurses respond to specific requests. Patient satisfaction with the service is more likely to be improved if nurses can readily adapt their work to accommodate patients' requests or, alternatively, communicate why these requests cannot be immediately addressed.
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AfL practices observed in case studies in a North Queensland school were analysed from a sociocultural theoretical perspective. AfL practices of feedback, dialogue and peer assessment were viewed as an opportunity for students to learn the social expectations about being an autonomous learner, or central participant within the classroom community of practice. This process of becoming more expert and belonging within the community of practice involved students negotiating identities of participation that included knowing both academic skills and social expectations within the classroom. This paper argues that when AfL practices are viewed as ways of enhancing participation, there is potential for learners to negotiate identities as autonomous learners. AfL practices within the daily classroom interactions and pedagogy that enabled students to develop a shared repertoire, joint enterprise and mutual engagement in the classroom communities of practice are described. The challenges for teachers in shifting their gaze to patterns of participation are also briefly discussed.
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This study explores coteaching/cogenerative dialoguing with parents to investigate how it may be employed to engage parents more meaningfully in schools. The cogens provided a space where participants became aware of resources available for coteaching, made decisions about planning and enacting coteaching, as well as interstitial culture that facilitated positive parent-teacher relationships.
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An investigation of cylindrical iron rods burning in pressurised oxygen under microgravity conditions is presented. It has been shown that, under similar experimental conditions, the melting rate of a burning, cylindrical iron rod is higher in microgravity than in normal gravity by a factor of 1.8 ± 0.3. This paper presents microanalysis of quenched samples obtained in a microgravity environment in a 2.0 s duration drop tower facility in Brisbane, Australia. These images indicate that the solid/liquid interface is highly convex in reduced gravity, compared to the planar geometry typically observed in normal gravity, which increases the contact area between liquid and solid phases by a factor of 1.7 ± 0.1. Thus, there is good agreement between the proportional increase in solid/liquid interface surface area and melting rate in microgravity. This indicates that the cause of the increased melting rates for cylindrical iron rods burning in microgravity is altered interfacial geometry at the solid/liquid interface.
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The literature reports that workload factors affect nurses' ability to fully engage in continuing professional development. Hence the work environment in acute care calls for innovative approaches to achieve continuous development of nursing practice and work satisfaction. This study employs a one group pre-test post-test design to test the effectiveness of nursing grand rounds on nursing worklife satisfaction and work environment in an acute surgical ward. The effect of nursing grand rounds was measured using the Nursing Worklife Satisfaction Scale and the Practice Environment Scale. There was no change between pre- and post-test on these measures but trends were evident in some component scores. Statistical results were inconclusive but observational data indicated that nursing grand rounds was found to be feasible, well attended with tested processes for implementation in an acute care environment.